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Indian Journal of Public Health Research & Development
Year : 2018, Volume : 9, Issue : 7
First page : ( 231) Last page : ( 236)
Print ISSN : 0976-0245. Online ISSN : 0976-5506.
Article DOI : 10.5958/0976-5506.2018.00646.0

Indonesian Rural Medical Internship: The Impact on Health Service and the Future Workforce

Dasman Hardisman1, Mwanri Lillian2, Martini Angelita2

1Department of Public Health and Community Medicine, Andalas University

2Department of Public Health, College of Medicine and Public Health, Flinders University of Australia

Online published on 21 July, 2018.

Abstract

Background

Studies have shown a shortage of medical practitioners in rural areas, and that graduate doctors are reluctant to practice in the rural areas. To address this shortage and reluctance, the Government of Indonesia implemented a rural medical internship program with the aims of preparing medical graduates for primary medical practice, and attracting them to rural areas. The purpose of this study was to understand the experience of medical interns in the rural medical internship program, and to identify the barriers and enablers to achieving the program aims.

Method

A purposive sample of 38 medical interns (70.4%) from five districts of West Sumatera Province, participated in focus group interviews. The interviews were recorded and transcribed verbatim. Data was coded and categorized before thematic analysis for experiences in rural setting specifically to identify factors important for retention of the doctors.

Results

The medical interns indicated that their exposure to rural practice did not influence their decision to practice in rural area in the future, with most interns reporting that they did not intend to undertake clinical practice as rural doctors. The main reasons expressed were due to interpersonal issues with senior clinicians, nurses and hospital staff, which resulted in their autonomy and decision making processes being undermined; and a perceived lack of professional and financial reward for practicing as rural doctors. Overall, the study found that the program improved access to medical services in the five districts, but may not improve the shortage of medical practitioners in rural areas on a long term basis.

Conclusion

A rural medical internship program improves rural medical services. However, the program alone will not address the long term goal of improving rural workforce shortage. Providing incentives for rural doctors and structural change are needed in order to make rural practice more attractive.

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Keywords

Medical internship, rural, primary care, Indonesia.

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