Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school

Introduction: Rural residents of the United States (US) and Canada face problems in accessing healthcare. International medical graduates (IMGs) play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care. Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD) course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation. Methods: The study was conducted among premedical and preclinical undergraduate medical (MD) students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied. Results: Ninety nine of the 108 students (91.7%) participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth. Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues. Conclusions: About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been mentioned above. Graduates from Caribbean medical schools have a role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce.

[1]  Alan A. Monavvari,et al.  International medical graduates: past, present, and future. , 2015, Canadian family physician Medecin de famille canadien.

[2]  D. Cummings,et al.  Factors Associated with Placement of Rural Primary Care Physicians in North Carolina , 2014, Southern medical journal.

[3]  W. Woloschuk,et al.  Beyond bricks and mortar: a rural network approach to preclinical medical education , 2014, BMC Medical Education.

[4]  J. Stevermer,et al.  Summer in the Country: Changes in Medical Students’ Perceptions Following an Innovative Rural Community Experience , 2013, Academic medicine : journal of the Association of American Medical Colleges.

[5]  J. Boulet,et al.  Medical Education in the Caribbean: Quantifying the Contribution of Caribbean-Educated Physicians to the Primary Care Workforce in the United States , 2013, Academic medicine : journal of the Association of American Medical Colleges.

[6]  S. Mollahaliloglu,et al.  Physician scarcity in underdeveloped areas of Turkey: what do new graduate physicians think? , 2012, Rural and remote health.

[7]  T. Thapa,et al.  Student perception about working in rural Nepal after graduation: a study among first- and second-year medical students , 2012, Human Resources for Health.

[8]  K. Mathieson,et al.  Medical student characteristics predictive of intent for rural practice. , 2012, Rural and remote health.

[9]  Malcolm Moore,et al.  Innovative training for rural medical students , 2012, The clinical teacher.

[10]  J. R. Kolstad.  How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania. , 2011, Health economics.

[11]  K. Kallail,et al.  Scholars in Rural Health: outcomes from an assured admissions program. , 2010, Family medicine.

[12]  N. L. Eckhert.  Perspective: private schools of the Caribbean: outsourcing medical education. , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[13]  F. Barnett,et al.  Factors influencing occupational therapy students' perceptions of rural and remote practice. , 2009, Rural and remote health.

[14]  Matthew J. Thompson,et al.  Do international medical graduates (IMGs) "fill the gap" in rural primary care in the United States? A national study. , 2009, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[15]  J. Jackson,et al.  Rural Health Leaders Pipeline, 1990–2005: Case Study of a Second-Generation Rural Medical Education Program , 2008, Journal of agromedicine.

[16]  D. Ogunyemi,et al.  Career intentions of U.S. medical graduates and international medical graduates. , 2007, Journal of the National Medical Association.

[17]  W. Dauphinee,et al.  The circle game: understanding physician migration patterns within Canada. , 2006, Academic medicine : journal of the Association of American Medical Colleges.

[18]  R. Pong,et al.  Advances in rural medical education in three countries: Canada, The United States and Australia. , 2005, Rural and remote health.

[19]  Mamoru Watanabe,et al.  Canadian and immigrant international medical graduates. , 2005, Canadian family physician Medecin de famille canadien.

[20]  J. Boulet,et al.  U.S. Citizens Who Graduated from Medical Schools Outside the United States and Canada and Received Certification from the Educational Commission for Foreign Medical Graduates, 1983–2002 , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[21]  Jane Farmer,et al.  Sustaining the rural primary healthcare workforce: survey of healthcare professionals in the Scottish Highlands. , 2005, Rural and remote health.

[22]  G. Koch,et al.  Outcomes of States’ Scholarship, Loan Repayment, and Related Programs for Physicians , 2004, Medical care.

[23]  R. Rosenblatt,et al.  Physicians and rural America. , 2000, The Western journal of medicine.

[24]  J. Page,et al.  Factors influencing medical interns trained at U.W.I. to work subsequently in a rural area in Jamaica. , 1992, The West Indian medical journal.

[25]  Brian W. Little,et al.  Demographic characteristics and responses of student respondents , 2014 .

[26]  Nano Trias,et al.  Fill the gap , 2010 .

[27]  R. Pong,et al.  Advances in rural medical education in three countries: Canada, the United States and Australia. , 2005, Education for health.

[28]  Matthew J. Thompson,et al.  The role of international medical graduates in America's small rural critical access hospitals. , 2004, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.