Assefa Tsion, Haile Mariam Damen, Mekonnen Wubegzier, Derbew Miliard
School of Public Health, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia.
School of Medicine, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia.
BMC Med Educ. 2017 May 30;17(1):96. doi: 10.1186/s12909-017-0934-z.
In Ethiopia, the health care delivery and the system of medical education have been expanding rapidly. However, in spite of the expansion, no studies have been carried out among medical students to identify their career choices and attitudes towards the medical instruction. Therefore, this study aimed to fill the gap in evidence in these specific areas.
Pretested questionnaire was self-administered among fifth and sixth year medical students in six government owned medical schools in Ethiopia. A total of 959 students were involved in the study with a response rate of 82.2%. Career choices, intention where to work just after graduation, and attitudes towards medical instruction were descriptively presented. Binary logistic regression model was fitted to identify factors associated with the intention of medical students to work in rural and remote areas.
Majority, (70.1%) of the medical students wanted to practice in clinical care settings. However, only a small proportion of them showed interest to work in rural and remote areas (21% in zonal and 8.7% in district/small towns). For most, internal medicine was the first specialty of choice followed by surgery. However, students showed little interest in obstetrics and gynecology, as well as in pediatrics and child health as their first specialty of choice. Medical students' attitudes towards their school in preparing them to work in rural and remote areas, to pursue their career within the country and to specialize in medical disciplines in which there are shortages in the country were low. The binary logistic regression model revealed that a significantly increased odds of preference to work in rural and remote areas was observed among males, those who were born in rural areas, the medical students of Addis Ababa University and those who had the desire to serve within the country.
This study showed that Ethiopian medical schools are training medical workforce with preferences not to work in rural and remote places, and not to specialize in disciplines where there are shortages in the country. Thus, attention should be given to influence medical students' attitude to work in rural and remote locations and to specialize in diverse clinical specialties.
在埃塞俄比亚，医疗服务提供和医学教育体系一直在迅速扩张。然而，尽管有所扩张，但尚未对医学生进行研究以确定他们的职业选择以及对医学教学的态度。因此，本研究旨在填补这些特定领域的证据空白。
在埃塞俄比亚六所政府所有的医学院中，对五年级和六年级医学生进行了预先测试的问卷调查。共有959名学生参与了该研究，回复率为82.2%。对职业选择、毕业后工作意向以及对医学教学的态度进行了描述性呈现。采用二元逻辑回归模型来确定与医学生在农村和偏远地区工作意向相关的因素。
大多数（70.1%）医学生希望在临床护理环境中执业。然而，只有一小部分人表现出在农村和偏远地区工作的兴趣（在地区级为21%，在县级/小镇为8.7%）。对于大多数人来说，内科是首选的第一个专业，其次是外科。然而，学生对妇产科以及儿科和儿童健康作为首选的第一个专业兴趣不大。医学生对学校在为他们在农村和偏远地区工作做准备、在国内从事职业以及在国内短缺的医学学科进行专业化培养方面的态度较低。二元逻辑回归模型显示，男性、出生在农村地区的人、亚的斯亚贝巴大学的医学生以及那些希望在国内服务的人，在农村和偏远地区工作的偏好几率显著增加。
本研究表明，埃塞俄比亚医学院培养的医学人才倾向于不在农村和偏远地区工作，也不选择在国内短缺的学科进行专业化培养。因此，应关注影响医学生在农村和偏远地区工作以及选择不同临床专业的态度。
