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ID 48618
file
creator
Owaki, Tetsuhiro
Iguchi, Seitaro
Inoue, Kazuo
Maeda, Takahiro
abstract
Purpose
To show the practice location of graduates from two Japanese programs recruiting physicians to rural areas: a regional quota program of medical schools and a prefecture scholarship program (a prefecture is an administrative geographic division). Graduates of each program must work in a designated rural prefecture for a fixed period.

Method
A nationwide cohort study was conducted for three groups of participants graduating between 2014 and 2016: quota graduates without scholarship (quota alone), nonquota graduates with scholarship (scholarship alone), and quota graduates with scholarship. A questionnaire was sent via medical school or prefecture office to each potential subject to collect baseline individual data, including home prefecture and graduation year. Data were connected through physician identification number to the Physician Census 2016 of the Ministry of Health, Labour and Welfare to identify the subjects’ practice location and compared with data for other physicians in the census. Comparisons were conducted with Mann-Whitney and chi-square tests.

Results
The proportion of physicians working in nonmetropolitan municipalities for quota alone (185/244; 75.8%), scholarship alone (305/363; 84.0%), and quota with scholarship (341/384; 88.8%) was significantly higher than for other physicians (13,299/22,906; 58.1%). Median population density of the municipalities where subjects worked for quota alone (1,042.4 persons per square kilometer), scholarship alone (613.5), and quota with scholarship (547.4) was significantly lower than that for other physicians (3,214.0). These disparities increased with number of years since graduation.

Conclusions
The regional quota and prefecture scholarship programs succeeded in producing physicians who practiced in rural areas of Japan.
description
This study was funded by the Japanese Ministry of Education, Culture, Sports, Science and Technology KAKENHI Grant-in-Aid for Scientific Research (C), Grant Number (25460803) and (18K10084).
journal title
Academic Medicine
volume
Volume 94
issue
Issue 8
start page
1244
end page
1252
date of issued
2019-08
publisher
Association of American Medical Colleges
issn
1040-2446
1938-808X
publisher doi
pubmed id
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
author
rights
This is not the final published version. Please cite only the published version. この論文は出版社版でありません。引用の際には出版社版をご確認、ご利用ください。
relation url
department
Graduate School of Biomedical & Health Sciences
note
Post-print version/PDF may be used in an institutional repository after an embargo period of 12 months.