Miller J B, Crittenden R A
Tacoma Family Medicine, WA 98405, USA.
J Rural Health. 2001 Summer;17(3):160-4. doi: 10.1111/j.1748-0361.2001.tb00952.x.
Many states have considered implementing payback programs on state-subsidized medical education to increase the rate of graduates returning to those states to practice. An alternative is for states to offer and expand loan repayment programs to entice medical school graduates from rural states to return to their home states. The goal of this study is to determine and contrast the impact these two types of programs might have on medical school choice and students' intentions to return to their home states. Two hundred twenty-nine medical students were surveyed (response rate 80 percent). The questionnaire collected background information on the students and addressed the possible impact of payback and loan repayment policy proposals on student plans. Forty-seven percent of students reported that they would attend a different medical school if a required payback program were in place. Students who were more competitive at the time of admission to medical school were significantly more likely to say they would attend another medical school than were less competitive students. In contrast, 48 percent of students reported that they would be more likely to return to their home states if expanded loan repayment programs were available for service in areas of need. The findings suggest that payback programs may dissuade more competitive students from entering medical schools with such requirements, compromising the pool of students most likely to return to rural areas. Conversely, medical students appear willing to consider loan repayment programs upon completion of their training.
许多州都在考虑实施针对州政府补贴的医学教育的回报计划，以提高毕业生回到这些州执业的比例。另一种选择是，各州提供并扩大贷款偿还计划，以吸引来自农村地区的医学院毕业生回到家乡州。本研究的目的是确定并对比这两种计划可能对医学院选择以及学生回到家乡州的意愿产生的影响。对229名医学生进行了调查（回复率为80%）。问卷收集了学生的背景信息，并探讨了回报和贷款偿还政策提议对学生计划可能产生的影响。47%的学生表示，如果实施强制回报计划，他们会选择就读其他医学院。医学院入学时竞争力更强的学生比竞争力较弱的学生更有可能表示会选择就读另一所医学院。相比之下，48%的学生表示，如果扩大后的贷款偿还计划适用于在需要的地区服务，他们更有可能回到家乡州。研究结果表明，回报计划可能会劝阻竞争力更强的学生进入有此类要求的医学院，从而影响最有可能回到农村地区的学生群体。相反，医学生在完成学业后似乎愿意考虑贷款偿还计划。
