Indian Journal of Community Medicine

LETTER TO EDITOR
Year
: 2014  |  Volume : 39  |  Issue : 2  |  Page : 124-

Attracting doctors to rural areas: Interventions and their outcomes is complex


Kieran Walsh 
 BMJ Group, BMA House, Tavistock Square, London, WC1H 9JR, United Kingdom

Correspondence Address:
Kieran Walsh
BMJ Group, BMA House, Tavistock Square, London, WC1H 9JR
United Kingdom




How to cite this article:
Walsh K. Attracting doctors to rural areas: Interventions and their outcomes is complex.Indian J Community Med 2014;39:124-124


How to cite this URL:
Walsh K. Attracting doctors to rural areas: Interventions and their outcomes is complex. Indian J Community Med [serial online] 2014 [cited 2019 Dec 10 ];39:124-124
Available from: http://www.ijcm.org.in/text.asp?2014/39/2/124/132744


Full Text

Sir,

Shroff et al., have reported a fascinating study on the initiative in Andhra Pradesh that has been designed to attract doctors to rural areas. [1] It is worthwhile looking at this study in detail as it touches on three core areas in medical education: Training, service delivery, and cost. [2] It also looks at how these three factors interact with each other to output the healthcare workforce that we have today and ultimately the healthcare that is delivered. [3]

The authors do report an increase in the number of graduates in the required areas, but it is an interesting question whether this can be attributed to the scheme. There was certainly a large increase in graduates across the board, this increase in itself may have resulted in an increased number of doctors in rural areas. In other words it may not have been the scheme at all.

The bond that the learners had to pay may have caused the increased numbers. Learners had to pay a bond of Rs. 20 lakhs and were required to serve the state government for 5 years after completing their postgraduate education. However, against this is the lack of oversight of the administration of the bond. The authors report that there is no information on how many students break their bonds or pay a penalty. This lack of oversight essentially means that the impact that a bond may have will not be sustainable. Learners will simply only obey rules that they know will be enforced.

Lastly and perhaps most importantly is the concern that those brought to rural areas by means of the scheme may not be doing their jobs as well as they should. This results in poor training, poor immediate service delivery, and will likely result in poor healthcare into the future. Whether no doctor or a poor doctor is better is perhaps a debate that we could do without; in rural areas and elsewhere.

References

1Shroff ZC, Murthy S, Rao KD. Attracting doctors to rural areas: A case study of the post-graduate seat reservation scheme in Andhra Pradesh. Indian J Community Med 2013;38:27-32.
2Walsh K. Cost effectiveness in medical education. Oxon: Radcliffe; 2010.
3Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. Lancet 2010;376:1923-58.