ABSTRACT
Introduction: The maldistribution of health care workers is a near-universal problem, particularly in developing countries. Shortages have become most critical over the past 2 decades with both out-migration of health care workers from developing to developed countries, and intra-country disparities between urban centres and rural regions. A variety of solutions have been proposed and tried, but in recent years the problem has become increasingly serious. Programme Description: Over the past 15 years, we have conceptualised and implemented a programme directed at the re-supply of rural physicians to our own state, Illinois, which was recently ranked as low as sixth worse in the US with regard to physician manpower shortages in rural areas. More recently, this programme has been expanded to include other health care workers where there are equivalent shortages in health services accessibility, and the entire programme is now designated as the National Center for Rural Health Professions. Programme Evaluation: Currently, the physician programme enjoys a 65% to 70% success rate in terms of the return of physicians to rural communities; a success largely due to the unique selection process, training, and the close relationship between students and faculty. Here, we describe this programme in detail, in the hope that elements of this somewhat unique programme may be “exportable”.
The movement of people from one place to another has shaped today’s political, social and economic world and continues to be a major influence on society. In 2000, almost 175 million people, or 2.9% of the world’s population, were living outside their country of birth for 1 year or longer. These numbers have doubled since 1965, and the migration of health care workers has closely followed these general trends. 1 Today, however, certain features of the health care labour market have given rise to new concerns. First, new communication technologies are shaping the global labour market through electronic access, which means that jobs, and often education for jobs by distant learning, are available internationally, as are visa applications and access to processes. Mahroum2 and Findlay3 have commented that certain sets of skills and competencies are so specialised or in such short supply that they are being sourced globally.
This article is available only as a PDF. Please click on “Download PDF” to view the full article.
