Shortage of physicians in rural areas and in the public health service: A critical analysis of the evidence on the role of medical education and training; Ärztemangel in der hausärztlichen Versorgung auf dem Lande und im Öffentlichen Gesundheitsdienst: Eine kritische Analyse der Evidenz bezüglich der Rolle von Aus- und Weiterbildung

Abstract

Background: A shortage of medical personnel has been seen for several decades in at least two sectors of the healthcare system: primary care in remote areas as well as medical care in the state public health departments (Öffentliches Gesundheitswesen). Strategies to reduce these problems are being sought. Objective: This review examines the proposals, practical initiatives and empirical studies in under- and postgraduate medical education in order to estimate their potential impact on the solution of these problems. The analysis covers both Germany and Anglo-Saxon countries. Materials and methods: The study is based on a literature search in PubMed and Medline covering the last 20 years. With regard to Germany, programmatic documents and studies published in the German Journal of General Practice (Zeitschrift für Allgemeinmedizin) were also included. Results and discussion: Foreign empirical studies identify almost equal two factors with regard to primary care in remote areas: the recruitment of students from rural areas combined with special educational programs with a rural primary care orientation both in under- and postgraduate medical education. These programs should include several and longer practical working periods in primary care units and be well coordinated between the medical school and the local teaching physicians. As for the state public health sector, comparable initiatives are still lacking. © 2017, Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature.

Keywords

Author Keywords

Primary care Public health Postgraduate medical education Undergraduate medical education Medical workforce

Index Keywords

human Humans Systematic Review student general practice general practitioner physician postgraduate education primary medical care Germany rural area health service medical school empiricism public health Medline rural health care Rural Health Services health care planning Medically Underserved Area Physicians, Primary Care statistics and numerical data public health service supply and distribution Health Services Needs and Demand National Health Programs Public Health Practice

Author Affiliations

Universitätsklinikum Hamburg-Eppendorf, Hamburg, Hamburg, Germany

Institut für Allgemeinmedizin, Christian-Albrechts-Universität zu Kiel, Kiel, Schleswig-Holstein, Germany

Akademie für Öffentliches Gesundheitswesen, Dusseldorf, Germany

Funding & Acknowledgements

No funding information

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