School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria.
S Afr Fam Pract (2004). 2020 Feb 6;62(1):e1-e7. doi: 10.4102/safp.v62i1.5033.
The University of Pretoria (UP) had its first intake of Bachelor of Clinical Medical Practice (BCMP) students in 2009. The objectives of this study were to examine the trends in geographical practice intentions and preferences of the first nine cohorts of BCMP students. We also assessed sector and level of care preferences of six BCMP cohorts.
Cross-sectional studies were conducted 2011, 2014 and 2017. First-, second- and third-year UP BCMP students were invited to complete a electronic questionnaire. Our analyses consisted of calculating proportions for the practice intentions and preferences for each surveys, and performing multiple logistic regression on the aggregated date to determine their associations with sociodemographic and training characteristics.
The proportion of participants intending to practise as a clinical associate in a rural area in South Africa directly after graduating was 62.5% in the 2014 survey and 69.7% in the 2017 survey, compared to 59.6% in the 2011 survey. The majority in all three surveys (53.4% in 2011, 56.6% in 2014 and 59.8% in 2017) indicated a preference for rural practice. Both rural practice intention and rural practice preference were found to be significantly associated with respondent's self-description of having lived most of her/his life in a rural area, and rural district hospital exposure during training. In 2014 and 2017, approximately two-thirds of the participants selected a public sector option as their most preferred work setting. District hospitals were the most preferred setting of 30.3% participants in 2014 and 32.0% in 2017.
Most participants across the three surveys intended to work in rural settings. Considering that this could provide a sustainable solution to the shortage of health care workforce in rural areas, policy makers in both higher education and health need to promote and ensure the viability of the training of this category of health care providers.
比勒陀利亚大学（UP）于 2009 年首次招收临床医学实践学士（BCMP）学生。本研究的目的是检查前九届 BCMP 学生的地理实践意向和偏好趋势。我们还评估了六个 BCMP 队列的部门和护理水平偏好。
2011 年、2014 年和 2017 年进行了横断面研究。邀请 UP BCMP 的一年级、二年级和三年级学生完成电子问卷。我们的分析包括为每个调查计算实践意向和偏好的比例，并对汇总数据进行多项逻辑回归，以确定它们与社会人口统计学和培训特征的关联。
2014 年调查中，62.5%的参与者毕业后打算在南非农村地区担任临床助理，而 2017 年调查中这一比例为 69.7%，而 2011 年调查中这一比例为 59.6%。在所有三个调查中，大多数人（2011 年为 53.4%，2014 年为 56.6%，2017 年为 59.8%）表示更喜欢农村实践。农村实践意向和农村实践偏好都与受访者自述一生中大部分时间生活在农村地区以及培训期间接触农村地区综合医院显著相关。在 2014 年和 2017 年，大约三分之二的参与者选择公共部门作为他们最理想的工作场所。2014 年，30.3%的参与者选择区医院作为最理想的设置，2017 年，这一比例为 32.0%。
在这三个调查中，大多数参与者都希望在农村地区工作。考虑到这可能为农村地区医疗保健人员短缺提供可持续的解决方案，高等教育和卫生政策制定者都需要促进和确保这一类医疗保健提供者的培训可行性。
