Tiwari Harish Chandra, Mishra Richa, Singh Yogendra, Khan Imran Ahmed, Srivastava Dhirendra K
Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND.
Community Medicine, Mahamaya Rajkiya Allopathic Medical College, Ambedkar Nagar, IND.
Cureus. 2023 Sep 4;15(9):e44682. doi: 10.7759/cureus.44682. eCollection 2023 Sep.
Background To increase the availability of doctors in the public healthcare delivery system, the state government of Uttar Pradesh, India, has implemented a two-year compulsory service bond since 2018. Students of the 2018 batch are going to complete their Bachelor of Medicine, Bachelor of Surgery (MBBS) in 2023 and are supposed to serve through this bond. There are many dilemmas in the minds of medical students regarding their compulsory service bond. Hence, there is a need to know their attitude and perceptions regarding the compulsory service bond. This study was conducted to assess the attitude and perception of undergraduate medical students toward compulsory service bonds. Methods This was a mixed-method study conducted in July-September 2022 among undergraduate medical students at Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India. For quantitative data, a structured questionnaire was developed using Google Forms (Google LLC, Mountain View, California, United States) and circulated via WhatsApp (Meta Platforms, Inc., Menlo Park, California, United States) through the random sampling method. Focused group discussions were carried out to collect the qualitative data. Result Regarding the compulsory service bond after MBBS, 100 (31.8%) medical students were found to be interested and 56 (17.8%) were disinterested. The majority (n=158; 50.4%) of participants were neutral, while 278 (88.6%) medical students perceived it as an opportunity to help poor people. Higher possibilities of social recognition and respect were some noticeable perceptions of 243 (77.4%) MBBS students. Lack of confidence to tackle serious cases without a senior doctor's supervision was perceived as an important hurdle by 286 (91%) participants. Non-availability of advanced medical facilities, issues like the safety of doctors, and the lack of availability of electricity, roads, and infrastructure were also perceived as hurdles. Conclusions and recommendations Students perceived the compulsory service bond as an opportunity if met with certain conditions like a transparent method of posting and basic facilities or an incentive for accommodation and transportation. The compulsory service bond for addressing the shortfall of doctors in the public healthcare delivery system may be more effective if these hurdles are corrected and certain opportunities are met, as mentioned in the present study. This will help the government move smoothly towards achieving Universal Health Coverage (UHC).
背景 为了增加公共医疗服务体系中医生的数量,印度北方邦政府自2018年起实施了一项为期两年的义务服务契约。2018届的学生将于2023年完成医学学士、外科学士(MBBS)课程,并应通过该契约进行服务。医学生对于他们的义务服务契约存在诸多困惑。因此,有必要了解他们对义务服务契约的态度和看法。本研究旨在评估本科医学生对义务服务契约的态度和看法。
方法 这是一项混合方法研究,于2022年7月至9月在印度北方邦戈勒克布尔市巴巴拉格哈夫达斯医学院的本科医学生中开展。对于定量数据,使用谷歌表单(谷歌有限责任公司,美国加利福尼亚州山景城)开发了一份结构化问卷,并通过随机抽样方法通过WhatsApp(Meta平台公司,美国加利福尼亚州门洛帕克)进行分发。开展焦点小组讨论以收集定性数据。
结果 关于MBBS课程后的义务服务契约,发现100名(31.8%)医学生感兴趣,56名(17.8%)不感兴趣。大多数参与者(n = 158;50.4%)持中立态度,而278名(88.6%)医学生将其视为帮助穷人的机会。243名(77.4%)MBBS学生明显认为有更高的社会认可和尊重可能性。286名(91%)参与者认为在没有资深医生监督的情况下处理重症病例缺乏信心是一个重要障碍。先进医疗设施的缺乏、医生安全等问题以及电力、道路和基础设施的缺乏也被视为障碍。
结论与建议 如果满足某些条件,如透明的分配方法和基本设施,或提供住宿和交通补贴,学生们会将义务服务契约视为一个机会。如本研究所述,如果纠正这些障碍并满足某些机会,用于解决公共医疗服务体系中医生短缺问题的义务服务契约可能会更有效。这将有助于政府顺利迈向实现全民健康覆盖(UHC)。