Matsumoto Masatoshi, Inoue Kazuo, Kajii Eiji
Division of Community and Family Medicine, Centre for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
Health Policy. 2008 Aug;87(2):194-202. doi: 10.1016/j.healthpol.2007.12.006. Epub 2008 Feb 19.
Selective admission policies of medical schools favoring students of rural origin have been implemented in many countries in hope of increasing rural physicians. This study evaluated the characteristics of medical students from rural origins and their choice of future practice location.
Personal, familial, and academic information of 1929 graduates of Jichi Medical University (JMU), a Japanese medical school with a special mission to produce rural doctors, was collected on admission and graduation between 1972 and 1997, and follow-up information on workplace addresses were collected in 2000, 2004, and 2006. Jichi Medical University has a unique contract system under which all the graduates have the obligation to work in rural areas in exchange for having their tuition fee during their 6 years of undergraduate medical education waived.
Subjects with rural origin were more likely to have parents with lower academic background, improve their academic standing throughout undergraduate medical education, and engage in rural practice than those from urban origins. Positive linear relationships between places of upbringing and workplaces were recognized in various geographic/demographic indicators.
The selective admission policy seems to be a reasonable way of increasing the number of rural physicians without placing an undue burden on medical schools.
许多国家实施了医学院校的选择性招生政策,偏向招收农村生源的学生,以期增加农村地区的医生数量。本研究评估了农村生源医学生的特征及其未来执业地点的选择。
收集了自1972年至1997年期间入学和毕业的1929名自治医科大学(JMU)毕业生的个人、家庭和学业信息,该校是一所日本医学院校,肩负着培养农村医生的特殊使命。并于2000年、2004年和2006年收集了他们工作地点的随访信息。自治医科大学有一个独特的合同制,即所有毕业生都有义务在农村地区工作,以换取其本科6年医学教育期间的学费减免。
与城市生源的学生相比,农村生源的学生更有可能父母学历背景较低,在整个本科医学教育期间提高学业成绩,并从事农村医疗工作。在各种地理/人口指标中,成长地与工作地之间存在正线性关系。
选择性招生政策似乎是增加农村医生数量且不给医学院校带来过重负担的合理方式。