Thai Govt Scheme Aims To Resolve Drastic Shortage Of Rural Doctors

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RURAL DOCTORS

Scheme aims to resolve drastic shortageThe Nation 2011-05-25

Top students from provinces helped into medicine

A health ministry scheme has been set up to recruit medical students from the provinces to serve in their home areas after they graduate.

The move seeks to counter the severe shortage of government doctors serving in hospitals in rural areas.

Under the Collaborative Projects to Increase Production of Rural Doctors (CPIRD) programme, which started back in 2004 and will run till 2013, around 10,678 doctors selected from straight-A 12th graders are expected to graduate and serve in home areas, programme head Dr Lalittaya Kongkham said.

Some 45 per cent of medical students are from rural areas, and they make up 32 per cent of students attending general medical schools, she said.

Lalittaya said she had proposed the CPIRD be extended after it had proved successful in prolonging doctors' service in rural areas. It also helped reduce the number of doctors resigning from government hospitals through voluntary payments of fines if they fail to complete the three years of mandatory service at state hospitals after graduation.

She said only 30 per cent of doctors who graduated via the CPIRD programme left government service, compared to 50 per cent of those who graduated from general medical schools.

Despite heavy fines for graduates who fail to finish their public service, it was common for a large number of doctors to resign from state hospitals, especially if they were selected to serve in rural areas or in the South, where violence is common.

Figures as of May 1, from the Human Resources for Health Research and Development Office (HRDO), which funds the CPIRD programme, showed there were three state hospitals without a doctor available, while 26 community hospitals in various provinces had just one doctor.

HRDO director Dr Nonglak Phakaiya said the Bannang Sata hospital in Yala, plus the clinic on Khood Island off Trat, and a hospital on Phu Kradung in Loei were without a doctor. The 26 others, mostly in the Northeast, had just one doctor but they were never able to provide a sufficient public service to needy residents.

To solve the problem, the ministry sends new graduates or medical students on their internship to needy hospitals, but they tended to quit government service once they learnt how hardship and unattractive the working conditions were.

"This will continue no matter how much more salary doctors are given," she warned.

Ideally, all hospitals should employ full-time doctors, especially those repaying government funding for their education, she said. "But in reality they are willing to pay fines to quit the service, in many cases even after they learn of hospitals selected for them," she said.

This year, she said some 356 doctors paid a fine and sought jobs elsewhere, out of a total of 1,189 graduates, mainly from government medical schools.

The CPIRD programme is jointly run by the Education Ministry, the Office of Higher Education and the Consortium of Thai Medical Schools. There were no details on the number of medical students currently under this scheme.