Workload Assessment of Medical Doctors at Primary Health Care Centers in the Duhok Governorate

Background: A shortage in human resources, particularly physicians, has become a challenge confronting health authorities in the Duhok governorate, as these resources are the key input for delivering health care. It has become necessary to identify the most appropriate scientifically sound method for having adequate staffing levels. This study aimed to forecast the required number of physicians to cope with the current workload at the main primary health care centers in the Duhok governorate.Methods: A cross-sectional study was adopted to collect data for one full year. Data collection included both primary and secondary data sources. A semi-structured questionnaire was developed to obtain information every month from health centers on activities related to training and leaves. Data analysis was performed using Workload Indicators of Staffing Need software.Results: Sixty-one primary health care centers met the final criteria for analysis. The study revealed physician shortages and inequity in the distribution of staffing. In these centers, 145 physicians lacked an adequate delivery of health services based on the workload imposed on them. The 'workload indicators of staffing need' ratio was 0.33, indicating high work pressure on medical doctors. Some centers offered more health care than others but had fewer doctors based on the current staffing practices. Conclusions: This study pointed out the importance for the public health sector and academic medical institutions to use Workload Indicators of Staffing Needs software in health policy administration to restructure their efforts to address the physician shortages and distribution imbalances at primary health care facilities.

Early outcomes of a rural-oriented physician education programme against rural physician shortages in Guangxi province: a prospective cohort study

ObjectivesThis study aimed to investigate early outcomes of one of the first medical undergraduate education programmes with a goal of mitigating severe rural physician shortages in China, which was developed by Guangxi Medical University (GXMU) and was called the Rural-oriented Free Tuition Medical Education (RTME)-GXMU programme.DesignA prospective cohort study comprising a baseline investigation and follow-up research was conducted to dynamically observe the evolution of the RTME-GXMU programme that began since 2010.Participants380 RTME-GXMU graduates and 383 non-RTME-GXMU graduates from GXMU who completed trainings between 2015 and 2018 were recruited in the baseline investigation. Among them, 285 RTME-GXMU and 283 non-RTME-GXMU graduates responded to the follow-up research.Main outcome measuresGraduate practice location, registered specialty, passing rate of the National Medical Licensing Examination (NMLE), specialty of residency programme and contract compliance for the RTME-GXMU graduates.ResultsBy the end of 2018, 100% of the 2015 RTME-GXMU graduates enrolled in this study practised in rural township health centres and registered themselves as general practitioners (GPs). All the RTME-GXMU graduates had completed or were attending residency programmes of general practice (GP). The above data stood in stark contrast to that of the non-RTME-GXMU graduates among whom as few as 1.06% worked in rural areas, 2.13% registered as GPs and less than 3% chose GP residency programmes. No significant differences were detected on passing rates of the NMLE between the two groups. Only one RTME-GXMU graduate broke the contract and dropped off the programme.ConclusionsThe RTME-GXMU programme has achieved encouraging early outcomes. Reduced entry score and proper usage of urban primary care institutions are two key approaches contributing to these positive early results.

Rurality and Origin–Destination Trajectories of Medical School Application and Matriculation in the United States

Physician shortages are more pronounced in rural than in urban areas. The geography of medical school application and matriculation could provide insights into geographic differences in physician availability. Using data from the Association of American Medical Colleges (AAMC), we conducted geospatial analyses, and developed origin–destination (O–D) trajectories and conceptual graphs to understand the root cause of rural physician shortages. Geographic disparities exist at a significant level in medical school applications in the US. The total number of medical school applications increased by 38% from 2001 to 2015, but the number had decreased by 2% in completely rural counties. Most counties with no medical school applicants were in rural areas (88%). Rurality had a significant negative association with the application rate and explained 15.3% of the variation at the county level. The number of medical school applications in a county was disproportional to the population by rurality. Applicants from completely rural counties (2% of the US population) represented less than 1% of the total medical school applications. Our results can inform recruitment strategies for new medical school students, elucidate location decisions of new medical schools, provide recommendations to close the rural–urban gap in medical school applications, and reduce physician shortages in rural areas.

An assessment of the barriers regarding international medical doctors' path to licensure in Ontario and the initiatives put forth to tackle these challenges

Upon arrival to Canada, International Medical Doctors (IDMs) must undergo a lengthy and complex process in becoming accredited in order to be able to practice in this country, IMDs have historically contributed substantially to the Canadian healthcare system and have great potential to tackle the current physician shortages in the provinces. However, although they have significant skills and experience and can be regarded as a fairly obvious resource to address the physician shortage, their potential remains underutilized. Therefore, this major research paper will focus on the province of Ontario to examine some of the barriers IMDs face in their path to re-entering their profession and outline and assess some of the initiatives and programs put forth to tackle some of these challenges faced by IMDs in this province.

An assessment of the barriers regarding international medical doctors' path to licensure in Ontario and the initiatives put forth to tackle these challenges

Upon arrival to Canada, International Medical Doctors (IDMs) must undergo a lengthy and complex process in becoming accredited in order to be able to practice in this country, IMDs have historically contributed substantially to the Canadian healthcare system and have great potential to tackle the current physician shortages in the provinces. However, although they have significant skills and experience and can be regarded as a fairly obvious resource to address the physician shortage, their potential remains underutilized. Therefore, this major research paper will focus on the province of Ontario to examine some of the barriers IMDs face in their path to re-entering their profession and outline and assess some of the initiatives and programs put forth to tackle some of these challenges faced by IMDs in this province.

An assessment of the barriers regarding international medical doctors' path to licensure in Ontario and the initiatives put forth to tackle these challenges

Upon arrival to Canada, International Medical Doctors (IDMs) must undergo a lengthy and complex process in becoming accredited in order to be able to practice in this country, IMDs have historically contributed substantially to the Canadian healthcare system and have great potential to tackle the current physician shortages in the provinces. However, although they have significant skills and experience and can be regarded as a fairly obvious resource to address the physician shortage, their potential remains underutilized. Therefore, this major research paper will focus on the province of Ontario to examine some of the barriers IMDs face in their path to re-entering their profession and outline and assess some of the initiatives and programs put forth to tackle some of these challenges faced by IMDs in this province.

An assessment of the barriers regarding international medical doctors' path to licensure in Ontario and the initiatives put forth to tackle these challenges

Upon arrival to Canada, International Medical Doctors (IDMs) must undergo a lengthy and complex process in becoming accredited in order to be able to practice in this country, IMDs have historically contributed substantially to the Canadian healthcare system and have great potential to tackle the current physician shortages in the provinces. However, although they have significant skills and experience and can be regarded as a fairly obvious resource to address the physician shortage, their potential remains underutilized. Therefore, this major research paper will focus on the province of Ontario to examine some of the barriers IMDs face in their path to re-entering their profession and outline and assess some of the initiatives and programs put forth to tackle some of these challenges faced by IMDs in this province.

Finding the line of best fit: constructing a profile for rural-based international medical graduates in Canada.

Canada's vast landscape has produced challenges in providing equitable access to healthcare for those living in rural and remote areas. Over several decades physician shortages have increasingly compromised rural communities' access to medical services. In response, provinces and territories have recruited international medical graduates (IMGs) to address these shortages. Synthesizing literature and frameworks from American, Australian and Canadian sources, this paper will explore issues related to IMG recruitment and retention to rural practice. Using an evidence-based review of the literature and data from the Canadian Residency Matching Service (CaRMS) this investigation will examine the profiles of IMGs who voluntarily pursue rural practice in hopes of identifying trends and future directions for recruitment and retention efforts.

Finding the line of best fit: constructing a profile for rural-based international medical graduates in Canada.

Canada's vast landscape has produced challenges in providing equitable access to healthcare for those living in rural and remote areas. Over several decades physician shortages have increasingly compromised rural communities' access to medical services. In response, provinces and territories have recruited international medical graduates (IMGs) to address these shortages. Synthesizing literature and frameworks from American, Australian and Canadian sources, this paper will explore issues related to IMG recruitment and retention to rural practice. Using an evidence-based review of the literature and data from the Canadian Residency Matching Service (CaRMS) this investigation will examine the profiles of IMGs who voluntarily pursue rural practice in hopes of identifying trends and future directions for recruitment and retention efforts.