The impact of socially-accountable, community-engaged medical education on graduates in the Central Philippines: Implications for the global rural medical workforce

Abstract

Introduction: Developing and retaining a high quality medical workforce, especially within low-resource countries has been a world-wide challenge exacerbated by a lack of medical schools, the maldistribution of doctors towards urban practice, health system inequities, and training doctors in tertiary centers rather than in rural communities.

Aim: To describe the impact of socially-accountable health professional education on graduates; specifically: their motivation towards community-based service, preparation for addressing local priority health issues, career choices, and practice location.

Methods: Cross-sectional survey of graduates from two medical schools in the Philippines: the University of Manila-School of Health Sciences (SHS-Palo) and a medical school with a more conventional curriculum.

Results: SHS-Palo graduates had significantly (p < 0.05) more positive attitudes to community service. SHS-Palo graduates were also more likely to work in rural and remote areas (p < 0.001) either at district or provincial hospitals (p = 0.032) or in rural government health services (p < 0.001) as Municipal or Public Health Officers (p < 0.001). Graduates also stayed longer in both their first medical position (p = 0.028) and their current position (p < 0.001).

Conclusions: SHS-Palo medical graduates fulfilled a key aim of their socially-accountable institution to develop a health professional workforce willing and able, and have a commitment to work in underserved rural communties.

Acknowledgements

We would like to acknowledge and thank graduates, colleagues, and community members who participated in this study. Specific thank you to Prof. Helen Gumba, Dr. Rolando Borrinaga, Prof. Angie Camposano, Prof. Evangeline Culas-Pasagui, Dr. Charlie Labarda, Dr. Herman Nicolas and Victor Matthew Sur. Atlantic Philanthopies have funded THEnet for this study through Resources for Health Equity.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes on contributors

Jusie Lydia J. Siega-Sur, RN, MHPEd, is an Associate Professor and was Dean of the University of the Philippines Manila – School of Health Sciences from 2006 to 2012.

Dr. Torres Woolley, PhD, is the Evaluation Coordinator for the JCU College of Medicine and Dentistry. Torres has been an active researcher for 20 years using both quantitative and qualitative methodologies, and is experienced in a range of research and evaluation methods, analyses and software.

Simone J Ross, MDR, is the Project Manager for the Training for Health Equity Network, and Lecturer in General Practice and Rural Medicine, College of Medicine and Dentistry, James Cook University.

Dr. Carole Reeve, PhD, previously of Flinders University, now at James Cook University, is a rural general practitioner and public health physician involved in health service and education research in rural and remote areas. Her research and teaching interests are around research translation to improve health equity in disadvantaged populations.

Dr. A-J Neusy, DTM&H, is a retired Professor of Medicine at New York University School of Medicine. He cofounded the Training for Health Equity Network (THEnet) in 2008. He is the Senior Director, Research and Programs and a visiting professor in several universities around the world. His work focuses on health workforce and institutional development.

Additional information

Funding

This work was supported by Atlantic Philanthropies who have funded the Training for Health Equity Network (THEnet; Grant Number 0003), via Resources for Health Equity, to conduct an impact study of SAHPE in the Philippines (www.atlanticphilanthropies.org/grantees/resources-for-health-equity).