Results of physician licence examination and scholarship contract compliance by the graduates of regional quotas in Japanese medical schools: a nationwide cross-sectional survey

ObjectivesResponding to the serious shortage of physicians in rural areas, the Japanese government has aggressively increased the number of entrants to medical schools since 2008, mostly as achiikiwaku, entrants filling a regional quota. The quota has spread to most medical schools, and these entrants occupied 16% of all medical school seats in 2016. Most of these entrants were admitted to medical school with a scholarship with the understanding that after graduation they will practise in designated areas of their home prefectures for several years. The quota and scholarship programmes will be revised by the government starting in 2018. This study evaluates the intermediate outcomes of these programmes.DesignCross-sectional survey to all prefectural governments and medical schools every year from 2014 to 2017 to obtain data on medical graduates.SettingsNationwide.ParticipantsAll quota and non-quota graduates with prefecture scholarship in each prefecture, and all the quota graduates without scholarship in each medical school.Primary outcome measuresPassing rate of the National License Examination for Physicians and the percentage of graduates who have not bought out the scholarship contract after graduation.ResultsMost prefectures and medical schools in Japan participated in this study (97.8%–100%). Quota graduates with scholarship were significantly more likely to pass the National License Examination for Physicians than the other medical graduates in Japan at all the years (97.9%, 96.7%, 97.4% and 94.7% vs 93.9%, 94.5%, 94.3% and 91.8%, respectively). The percentage of quota graduates with scholarship who remained in the scholarship contract 3 years after graduation was 92.2% and 89.9% for non-quota graduates with scholarship.ConclusionsQuota entrants showed better academic performance than their peers. Most of the quota graduates remained in the contractual workforce. The imminent revision of the national policy regarding quota and scholarship programmes needs to be based on this evidence.

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Career Intentions and Dropout Causes Among Medical Students in Kazakhstan

Medicina ◽

10.3390/medicina49060045 ◽

2013 ◽

Vol 49 (6) ◽

pp. 45

Author(s):

Kamila Faizullina ◽

Galina Kausova ◽

Zhanna Kalmataeva ◽

Ardak Nurbakyt ◽

Saule Buzdaeva

Keyword(s):

Medical Students ◽

Human Resources ◽

Rural Areas ◽

Urban Areas ◽

Human Resources For Health ◽

Medical Schools ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Unequal Distribution ◽

Survey Tool

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.

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Bedside ultrasound education in Canadian medical schools: A national survey

Canadian Medical Education Journal ◽

10.36834/cmej.36646 ◽

2016 ◽

Vol 7 (1) ◽

pp. e78-e86 ◽

Cited By ~ 16

Author(s):

Peter Steinmetz ◽

Octavian Dobrescu ◽

Sharon Oleskevich ◽

John Lewis

Keyword(s):

Medical School ◽

Undergraduate Curriculum ◽

Medical Schools ◽

School Curriculum ◽

Bedside Ultrasound ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based ◽

Ultrasound Education ◽

Current Characteristics

Background: This study was carried out to determine the extent and characteristics of bedside ultrasound teaching in medical schools across Canada.Methods: A cross-sectional, survey-based study was used to assess undergraduate bedside ultrasound education in the 17 accredited medical schools in Canada. The survey, consisting of 19 questions was pilot-tested, web-based, and completed over a period of seven months in 2014.Results: Approximately half of the 13 responding medical schools had integrated bedside ultrasound teaching into their undergraduate curriculum. The most common trends in undergraduate ultrasound teaching related to duration (1-5 hours/year in 50% of schools), format (practical and theoretical in 67% of schools), and logistics (1:4 instructor to student ratio in 67% of schools). The majority of responding vice-deans indicated that bedside ultrasound education should be integrated into the medical school curriculum (77%), and cited a lack of ultrasound machines and infrastructure as barriers to integration.Conclusions: This study documents the current characteristics of undergraduate ultrasound education in Canada.

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Why Patients with Chronic Disease Keep Silent? Analysis of Item Nonresponse in Rural China

Iranian Journal of Public Health ◽

10.18502/ijph.v48i4.987 ◽

2019 ◽

Author(s):

Yiqing MAO ◽

Zhanchun FENG ◽

Shangfeng TANG ◽

Tailai WU ◽

Ruoxi WANG ◽

...

Keyword(s):

Chronic Disease ◽

Rural Areas ◽

Health Knowledge ◽

Rural China ◽

School Education ◽

Vulnerable Groups ◽

Item Nonresponse ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Government

Background: This study aimed to identify the characteristics of item nonresponse and examine the factors affecting the refusal or failure to respond of patients with chronic disease in rural China. Methods: A cross-sectional survey data from patients with chronic disease from rural China were analyzed. A total of 1,099 patients were enrolled. Chi-square test and cumulative logistic regression determined the predictors of having item nonresponse. Results: The respondents in central provinces (OR = 2.311, 95%CI = 0.532~1.144, P < 0.001) with over eight household members (OR = 0.067, 95%CI = -1.632~-0.349, P = 0.002), multiple chronic diseases (OR = 0.301, 95%CI = -1.673~-0.727, P < 0.001), and low health knowledge level (OR = 2.112, 95%CI = 0.405~1.090, P < 0.001) had more item nonresponse numbers. Compared with the participants with high school education level and above, the item nonresponse number seemed to increase when the participants were illiterate (OR = 2.159, 95%CI = 0.254~1.285, P = 0.003), had primary school education (OR = 2.161, 95%CI = 0.249~1.294, P = 0.004) and junior school education (OR = 2.070, 95%CI = 0.160~1.296, P = 0.012). Conclusion: This study indicates the influencing factors of the item nonresponse in survey of patients with chronic disease in rural China. This study contributes to investigation practice and highlights that health institutions should improve the quality of follow-up services. Moreover, the government should pay more attention to the care of vulnerable groups, especially patients with chronic disease in rural areas.

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Predictors of quality of life of older persons in rural Uganda: A cross sectional study

AAS Open Research ◽

10.12688/aasopenres.12874.2 ◽

2018 ◽

Vol 1 ◽

pp. 22 ◽

Cited By ~ 1

Author(s):

Fred Maniragaba ◽

Betty Kwagala ◽

Emmanuel Bizimungu ◽

Stephen Ojiambo Wandera ◽

James Ntozi

Keyword(s):

Quality Of Life ◽

Rural Areas ◽

Older Persons ◽

Cross Sectional Study ◽

Poor Quality ◽

Hiv And Aids ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Government

Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda. Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied. Results: Older persons in northern (OR=0.39; CI=0.224-0.711) and western (OR=0.33; CI=0.185-0.594) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; CI=0.220-0.928) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; CI=1.391-3.002). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06;CI=1.032-4.107) relative to those whose assets were controlled by their children. Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.

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Epidemiological study of obesity and overweight among adolescents in schools in district Ghaziabad

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20193089 ◽

2019 ◽

Vol 6 (8) ◽

pp. 3177

Author(s):

Susmita Thakur ◽

Narendra Singh ◽

Mitasha Singh

Keyword(s):

Private School ◽

Rural Areas ◽

Urban Areas ◽

Overweight And Obesity ◽

Cross Sectional Survey ◽

Government Schools ◽

Cross Sectional ◽

Government School ◽

Obesity And Overweight ◽

The Government

Background: Developing countries are experiencing an epidemic of obesity and overweight. Adolescence is the stage when the lifestyle behavior sets in and decides the future pattern of health. The objective was to study the prevalence and correlates of overweight and obesity among school going adolescents of district Ghaziabad.Methods: A school based cross sectional survey was conducted in district Ghaziabad. Adolescents (10-19 years) from both urban and rural government and private schools were included. Multistage sampling technique was used to study 1128 study population. Anthropometry and a structured questionnaire were used as study tool.Results: In urban area, the proportion of underweight students in government schools (20.9%) was significantly more than the private school (13.8%) whereas the number of overweight students in private school (18.2%) was significantly more than the government schools (10.3%). In rural area underweight students in government school (30.5%) was significantly more than the private school (21.3%) whereas the number of overweight students in private school (11.3%) was significantly more than the government school (3.2%). Obesity was significantly associated with the area of residence, type of school, consumption of carbonated drinks, fast foods and decreased physical activity.Conclusions: An overall higher prevalence of overweight and obesity among adolescents in urban areas and increasing trend in rural areas too alarm us to focus on the modifiable risk factors.

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A primer of an in-depth resilience status for German medical graduates: results of a cross-sectional survey on the status quo of resilience among graduates of human medicine in Bavaria, Germany - a necessary step in building an emotionally equipped healthcare work-force

BMC Medical Education ◽

10.1186/s12909-021-02933-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

J. Kiesewetter ◽

J. Huber

Keyword(s):

Work Performance ◽

Work Force ◽

Medical Schools ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Medical Graduates ◽

Graduate Survey ◽

Resilience Scale ◽

The Status ◽

Healthcare Work

Abstract Background Resilience is a widely-used catchword in the last couple of years to describe the resistance to psychological strains of life, especially for the healthcare work-force. The promises of resilience to burnout sound great and what we all would want: less health impairment despite stress, higher work satisfaction and last but not least higher work performance. There is research that shows that students and physicians have high emotional distress and low resilience, yet comparably little is known which aspects of resilience are exactly impaired in the upcoming work-force. With our study we investigated the in-depth resilience status of medical graduates from five medical schools within their first year after graduation. In this, additionally to assessing the resilience status as a whole we investigate the answers on the singular items and the relationship of the resilience status with neighboring constructs. Methods In 2018, 1610 human medical graduates from five Bavarian medical schools were asked to take part at cross-sectional Bavarian graduate survey (Bayerische Absolventenstudie Medizin, MediBAS). The response rate was 38,07, 60% of the participants were female. For the identification of the in-depth resilience status we included the 5-point Likert 10-Item Connor-Davidson Resilience Scale, German Version in a graduate survey posted to 5 medical schools and over 1610 eligible participants of whom 610 (60% female) filled out at least parts of the survey. To identify relationships to other aspects we posed further questionnaires. Results The resilience status showed a mean resilience score of M = 37.1 (SD = 6.30). The score ranges from 3.22 (I am not easily discouraged by failure) to 4.26 (I am able to adapt to change). One third of the participants chose not to answer the item “I am able to handle unpleasant feeling”. Relationships to job satisfaction, scientific competence and stress are presented in the article. Conclusions The study shows that the overall resilience status of medical graduates one year after their graduation is rather high, but subjectively they do not feel equivalently resilient for the different aspects they face in their job. Especially, how to handle their emotions seems to be challenging for some of the young physicians. In the article we sketch ideas how to handle the specific training needs the study has identified.

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Perception of learning science: the case of females offering STEM majors in Ghana

African Journal of Educational Studies in Mathematics and Sciences ◽

10.4314/ajesms.v15i2.12 ◽

2019 ◽

Vol 15 (2) ◽

pp. 141-154

Author(s):

Darko Kwaku Amponsah ◽

Maigari Salifu Mohammed

Keyword(s):

Rural Areas ◽

Female Students ◽

Learning Science ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Stem Majors ◽

Information And Communication ◽

The Government ◽

Training Clinics ◽

Post Hoc

The study investigated the differences among female students pursuing selected STEM programmes in a Science and Technology university in Ghana, in their perception of learning science. Three hundred and twenty-eight (328) final year female students offering computer science and information and communication technology, engineering, pharmacy, and medicine formed the sample. The research design was a descriptive cross-sectional survey, and a questionnaire was utilised for data collection. The reliability coefficient obtained using Cronbach alpha formula was 0.85. The study discovered that female students in STEM majors were goal-oriented and extraordinarily impressive with their academics however lacked the capacity to have fun as a result of the loaded curriculum. Again, the study showed specific differences in self-perception among students of the four STEM majors, when analysed using ANOVA and Post hoc analyses. It was revealed that pregnancy is no longer a barrier to educate the girl child as a result of unique interventions put in place by the government of Ghana. It was recommended among others that the Ghana Education Service intensifies the STEM training Clinics in the rural areas of Ghana to enhance rural female students’ involvement in STEM Majors at Tertiary level.

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Implementation fidelity of village health and nutrition days in Hardoi District, Uttar Pradesh, India: a cross-sectional survey

BMC Health Services Research ◽

10.1186/s12913-019-4625-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Mira Johri ◽

Louis Rodgers ◽

Dinesh Chandra ◽

Cybil Abou-Rizk ◽

Eleanor Nash ◽

...

Keyword(s):

Antenatal Care ◽

Rural Areas ◽

Institutional Delivery ◽

Uttar Pradesh ◽

Implementation Fidelity ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

The Government ◽

Village Health

Abstract Background Village Health and Nutrition Days (VHNDs) are a cornerstone of the Government of India’s strategy to provide first-contact primary health care to rural areas. Recent government programmes such as the Janani Suraksha Yojana (JSY) and Mission Indradhanush (MI) have catalysed important changes impacting VHNDs. To learn how VHNDs are currently being delivered, we assessed the fidelity of services provided as compared to government norms in a priority district of Uttar Pradesh. Methods We fielded a cross-sectional study of VHNDs to provide a snapshot of health services functioning. Process evaluation data were collected via administrative sources, non-participant observation using a standardised form, and structured questionnaires. Questionnaires were designed using a framework to assess implementation fidelity. Key respondents were VHND participants, front-line workers involved in VHND delivery, and VHND non-participants (pregnant women due for antenatal care or children due for vaccination as per administrative records). Results were summarised as counts, frequencies, and proportions. Results In the 30 villages randomly selected for inclusion, 36 VHNDs were scheduled but four (11.1%) were cancelled and one VHND was not surveyed. Vaccination and antenatal care were offered at 96.8% (30/31) and child weighing at 83.9% (26/31) of VHNDs. Other normed services were infrequently provided or completely absent. Health education and promotion were particularly weak; institutional delivery was the only topic discussed in a majority of VHNDs. The true proportion of any serious problem impeding vaccine delivery was 47.2% (17/36), comprising 4 VHND cancellations and 13 VHNDs experiencing vaccine shortages. Of the 13 incidents of vaccine shortage, 11 related to an unexpected global shortage of injectable polio vaccine (IPV). Over the 31 VHNDs, 37.8% (171 of the 452 scheduled beneficiaries) did not participate. Analysis of missed opportunities for vaccination highlighted inaccuracies in beneficiary identification and tracking and demand side-factors. Conclusions The transformative potential of VHNDs to improve population health is only partially being met. A core subset of high-priority services for antenatal care, institutional delivery, and vaccination associated with high-priority government programmes (JSY, MI) is now being provided quite successfully. Other basic health promotion and prevention services are largely not provided, constituting a critical missed opportunity.

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Predictors of quality of life of older persons in rural Uganda: A cross sectional study

AAS Open Research ◽

10.12688/aasopenres.12874.1 ◽

2018 ◽

Vol 1 ◽

pp. 22 ◽

Cited By ~ 2

Author(s):

Fred Maniragaba ◽

Betty Kwagala ◽

Emmanuel Bizimungu ◽

Stephen Ojiambo Wandera ◽

James Ntozi

Keyword(s):

Quality Of Life ◽

Rural Areas ◽

Older Persons ◽

Cross Sectional Study ◽

Poor Quality ◽

Hiv And Aids ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Government

Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda. Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied. Results: Older persons in northern (OR=0.39; p=0.002) and western (OR=0.33; p<0.001) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; p=0.031) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; p=<0.001). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06; p=0.040) relative to those whose assets were controlled by their children. Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.

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Education policies to increase rural physicians in Japan: a nationwide cohort study

Human Resources for Health ◽

10.1186/s12960-021-00644-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Masatoshi Matsumoto ◽

Yasushi Matsuyama ◽

Saori Kashima ◽

Soichi Koike ◽

Yuji Okazaki ◽

...

Keyword(s):

Cohort Study ◽

Rural Areas ◽

Retention Rate ◽

Education Policies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Relative Risks ◽

Rural Physicians ◽

Significant Difference ◽

License Examination

Abstract Background Japan has established comprehensive education-scholarship programs to supply physicians in rural areas. Their entrants now comprise 16% of all medical students, and graduates must work in rural areas for a designated number of years. These programs are now being adopted outside Japan, but their medium-term outcomes and inter-program differences are unknown. Methods A nationwide prospective cohort study of newly licensed physicians 2014–2018 (n = 2454) of the four major types of the programs—Jichi Medical University (Jichi); regional quota with scholarship; non-quota with scholarship (scholarship alone); and quota without scholarship (quota alone)—and all Japanese physicians in the same postgraduate year (n = 40,293) was conducted with follow-up workplace information from the Physician Census 2018, Ministry of Health, Labour and Welfare. In addition, annual cross-sectional survey for prefectural governments and medical schools 2014–2019 was conducted to obtain information on the results of National Physician License Examination and retention status for contractual workforce. Results Passing rate of the National Physician License Examination was highest in Jichi, followed in descending order by quota with scholarship, the other two programs, and all medical graduates. The retention rate for contractual rural service of Jichi graduates 5 years after graduation (n = 683; 98%) was higher than that of quota with scholarship (2868; 90%; P < 0.001) and scholarship alone (2220; 81% < 0.001). Relative risks of working in municipalities with the least population density quintile in Jichi, quota with scholarship, scholarship alone, and quota alone in postgraduate year 5 were 4.0 (95% CI 3.7–4.4; P < 0.001), 3.1 (2.6–3.7; < 0.001), 2.5 (2.1–3.0; < 0.001), and 2.5 (1.9–3.3; < 0.001) as compared with all Japanese physicians. There was no significant difference between each program and all physicians in the proportion of those who specialized in internal medicine or general practice in postgraduate years 3 to 5 Conclusions Japan’s education policies to produce rural physicians are effective but the degree of effectiveness varies among the programs. Policymakers and medical educators should plan their future rural workforce policies with reference to the effectiveness and variations of these programs.

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