The persistent shortfall in medical staffing in the UK has drawn renewed focus since the government first published its NHS Long Term Workforce Plan, in which it pledged to double the capacity of UK medical schools in the context of significant bottlenecks in doctors' pathways to career progression. In this article, we challenge the viability of medical school expansion as a tool to combat the persistent workforce crisis in the NHS. Our critique contributes to the ongoing workforce planning debate, and highlights issues with clinical capacity, sustainability, and the preservation of educational standards. With an updated Long Term Workforce Plan forthcoming, we urge policymakers to implement an immediate moratorium on medical school expansion in the UK until these factors - and a viable future for the medical profession - can be guaranteed.
Background: This analytical cross-sectional study assessed job satisfaction, stress, and perceived social support among postgraduate dental students and identified contributing factors.
Methods: Sixty-four postgraduate dental students across 10 specialties at Mashhad Dental School participated between January and February 2024. A structured questionnaire included the Brayfield-Rothe Job Satisfaction Scale, a validated Persian Job Satisfaction Scale, the Multidimensional Scale of Perceived Social Support, and the Ryff Psychological Well-Being Scale. Demographic data were also collected. Statistical analyses examined relationships between variables, with a significance level of 0.05.
Results: The Brayfield-Rothe Scale indicated above-average job satisfaction (p < 0.05), while the Persian Job Satisfaction Scale showed below-average scores (p < 0.05). Perceived social support (p < 0.05) and psychological well-being (p < 0.05) were above average. Married students reported significantly higher satisfaction and social support (p = 0.002). Significant correlations were found between job satisfaction, perceived social support, and psychological well-being.
Conclusion: Postgraduate dental students reported high perceived social support and psychological well-being but elevated stress levels, with varying job satisfaction across scales. Married students demonstrated higher satisfaction and support. Enhancing support systems and stress-reduction strategies in dental education is recommended.
Introduction: The training of clinical specialists in Malaysia on completion of the undergraduate medical programme is long and expansive. In recent years, the training process has been plagued with issues of funding, recognition, insufficient training opportunities, and lack of uniformity in the delivery of the training. However, there is a dire shortage of clinical specialists across all specialties in Malaysia, especially with the increase in demand for healthcare services. An analysis of the intentions of Malaysian medical students to specialise and the factors that influence their decisions is currently lacking. This study aims to provide insights into specialty training and may inform the planning of human resources for health in the country.
Methods: This was a cross-sectional study involving 859 medical students from 21 medical schools in Malaysia. This study was part of the Malaysian Medical Students' Career Intentions (MMSCI) project. Data were collected via a self-administered online questionnaire.
Results: Majority of medical students expressed an interest to specialise (85%). The most favoured specialties were General Surgery, Paediatrics, and Obstetrics and Gynaecology. Medical students from private universities had a greater intention to specialise compared to public university students (p < 0.001). Male medical students were more likely to select a pure surgical specialty as compared to medical-based specialties (p = 0.037). Female medical students rated "Working Environment & Conditions" and "Work-Life Balance" as important factors for the choice of specialty training (p = 0.044 and p = 0.032, respectively).
Conclusion: Majority of Malaysian medical students expressed intentions to specialise. The preferences in specialty choices in our study reflect the global trends. Passion and interest were the top reasons for medical students when indicating their specialty of choice. Further studies are needed to explore the changing trends in specialty choices and the influencing factors.
Background: Tracking country-wide human resources for health (HRH) information is a milestone in the global strategy for HRH 2030, and digitalized HRH information systems have been recommended by the World Health Organization. However, the implementation status differs among countries, and most systematic reviews on this topic have been conducted in high-income countries. This scoping review aimed to identify (1) stages of implementation, (2) functional components, (3) facilitators and barriers, and (4) policy impacts or outcomes of digitalized HRH information systems in low- and middle-income countries (LMICs).
Methods: The methodological framework of the Johanna Briggs Institute was used in this scoping review. English articles in two databases (PubMed and Web of Science) with publication dates ranging from inception to August 2023 were gathered, followed by a gray literature search and a reference search. Two author pairs independently performed the study selection. Data were extracted, analyzed, and presented in tabular form alongside a narrative summary.
Results: Forty studies and gray literature from 26 LMICs in Asia and Africa were included in the scoping review. Thirty-three studies and gray literature covered different stages of digitalized HRH information systems' implementation, including development, pilot, rollout, and maintenance. The HRH registry was the most common, whereas finances and migration were the least common functional components. Thirty-two studies and gray literature reported barriers and facilitators, stratified into four factors and stages. Many barriers were identified in organizational and environmental factors, especially in governance. Interoperability among multiple HRH information systems within a country is the key facilitator, where development partners play a critical role. Sixteen studies and gray literature from nine countries reported positive policy impacts/outcomes. Political commitment, strong national and subnational leadership, and coordination mechanisms among national stakeholders and development partners were key to gaining policy impact.
Conclusions: Barriers and facilitators were common across the studies, and governance factors were particularly crucial at all stages of digitalization. Our stratified methodology for analyzing facilitators and barriers can serve as an analytical framework for evaluating HRH information systems in any country. Data on the private sector and migration could be further strengthened as system components.
Introduction: The Project Extension for Community Health Care Outcomes (Project ECHO) is a renowned collaborative model of medical education and care management. This model enhances the capabilities of primary care providers through telementoring, providing a promising and cost-effective approach to augmenting healthcare professionals' knowledge. Participation in weekly ECHO sessions often falls short of expectations despite its benefits. This study examined the personal factors that influence Tanzanian nurses' engagement with Project ECHO.
Methods: We conducted a cross-sectional study involving 450 nurses from 42 primary healthcare facilities in Dar es Salaam, Tanzania. A standardised questionnaire served as the data collection tool. Descriptive analysis was performed to calculate means, frequencies and percentages for socio-demographic variables and the level of participation of nurses. Bivariate and multivariate logistic regression were used to test the association between the level of participation of nurses in ECHO sessions and their socio-demographic factors.
Results: Only 36% (n = 162) of 450 nurses attended at least two ECHO sessions (median 2, IQR 1-2). Paediatric ECHO sessions had the highest attendance (43.8%, n = 71). Ease of computer use (AOR = 1.95, p = 0.015) and ICT self-motivation (AOR = 2.08, p = 0.003) significantly increased attendance. A majority (58%) lacked personal computers. Surprisingly, adequate ICT skills lowered the likelihood of attending at least two sessions (AOR = 0.37, p < 0.001).
Conclusion: The study found low participation of nurses in ECHO sessions, with paediatric ECHO sessions showing the highest engagement. Comfort with online format and ease of instructions motivated attendance, while computer proficiency and ICT motivation were positive predictors. Surprisingly, adequate ICT skills correlated with lower participation. Enhancing basic computer literacy and ICT motivation is crucial for improved engagement. Future research should explore reasons for lower participation among digitally skilled nurses and tailor session content accordingly.
Background: With the development of society and the economy, along with the aging population, the demand for primary health care services is growing. As the core providers of primary healthcare services, the job satisfaction of general practitioners (GPs) directly affects the quality of healthcare services and patient satisfaction, and it is one of the key indicators for assessing the effectiveness of relevant policy implementations. However, the heavy workload of Chinese primary care physicians, their low income levels, and their weak sense of professional identity may lead to an effort-reward imbalance (ERI). Therefore, analyzing the mechanisms behind ERI in relation to GPs' job satisfaction is crucial for advancing their professional growth. This is particularly relevant in less developed regions, as it can significantly boost the performance of healthcare services, elevate the standard of primary healthcare, and ultimately contribute to the realization of universal health coverage.
Methods: This study, conducted from December 2023 to March 2024, employed a cross-sectional analysis of primary care GPs in Gansu Province, China, based on social exchange theory, to investigate whether and how ERI affects job satisfaction among primary care GPs. An electronic questionnaire survey was distributed to resident doctors who had completed their training through standardized residency training bases to test the theoretical hypotheses.
Findings: This study found that the ERI among primary care GPs in China was relatively significant (3.57/5.00). The ERI negatively affected primary care GPs' job satisfaction (B = - 0.381, p < 0.01), explaining 23.6% of the variance in job satisfaction. Additionally, public service motivation (PSM) fully mediated the relationship between ERI and primary care GPs' job satisfaction (mediation effect of - 0.500, 95% bootstrap confidence interval [- 0.818 to - 0.156]). The study also revealed that GPs in primary hospitals had higher job satisfaction, while rural order-oriented GPs experienced lower job satisfaction.
Conclusion: This study examines the detrimental effects and underlying mechanisms of ERI on the job satisfaction of primary care GPs, thereby contributing to the body of research on the factors influencing their job satisfaction. The findings underscore the importance of considering PSM as a critical intermediary when addressing ERI among primary care GPs. The conclusions offer practical insights for enhancing the job satisfaction of GPs, which, in turn, may lead to improved medical service performance in underdeveloped regions of China.
Purpose: This study aims to develop and validate a mathematical model for estimating the number of emergency physicians required in post-earthquake scenarios, using actual data from the 2023 Kahramanmaraş earthquakes in Türkiye.
Methodology: The methodology follows a structured five-step framework to assess earthquake impact and emergency healthcare demand. First, population impact is analyzed using USGS PAGER data to estimate exposure levels. Second, household and building stock characteristics are profiled from TurkStat, focusing on construction year and building types, which influence structural vulnerability. Third, collapse probabilities are determined through empirical fragility functions that relate earthquake intensity to building failure rates. Fourth, casualties are estimated by combining structural damage with fatality and injury ratios specific to building types. Finally, physician demand is calculated using the M/M/s queuing theory model, incorporating key variables, such as emergency healthcare capacity, patient arrival rates, and examination duration, to forecast medical staffing needs in the aftermath of a disaster.
Findings: The model estimated 11,645 potential emergency department visits in Hatay province within the first 144 h post-earthquake. Based on this, 27 emergency physicians per shift-or 81 total physicians across three shifts-are required to operate at full capacity. These figures closely align with actual post-disaster hospital admission data, validating the model.
Conclusions: This study presents a scalable, actual-data-validated model for physician workforce planning in disaster scenarios. The queuing-based approach supports strategic resource allocation and enhances organizational resilience. Unlike existing models, this study directly integrates field-specific damage and population data to forecast real-time health system needs.
Background: Physician migration is a known global phenomenon, with the migration intention of medical students serving as early indicators of the trends in workforce mobility. Understanding the factors influencing their decision to migrate is crucial in the planning of human resources for health in a country and the sustainability of a healthcare system, particularly in low- and middle-income countries (LMIC). This scoping review synthesises current available evidence on the trends, determinants, and implications of medical student international migration.
Methods: A systematic search was conducted on PubMed, Scopus, and Proquest from July 2013 to May 2025, following the PRISMA for Scoping Reviews framework. The selected articles included primary research investigating factors influencing migration intention among medical students. Articles were excluded if the study only explored on perception of migration. Included studies were assessed for quality according to Joanna Briggs Institute (JBI) Critical Appraisal tool, and extracted factors were reclassified and regrouped into domains of Academic and Personal Development, Economic and Working Conditions, and Social and Living Environment factors.
Results: 517 articles were screened, of which 33 articles were included, covering medical students from diverse geographical locations. Migration intentions were varied across regions, with studies from 6 countries each reporting that over 80% of sampled medical students intended to migrate. The most common push factors included income, working culture and environment, and career progression. The most frequently cited stay factors were family, financial, and patriotism.
Conclusion: Migration intentions were widely reported among medical students across different regions, though the proportions varied by country. This serves as a predictor and could indicate the evolving global trend of physician migration in the years to come. Financial prospects, career opportunities, and working conditions play critical roles in determining the migration intentions of medical students. Targeted retention strategies should be implemented especially in resource-limited settings to address brain drain, although at the same time achieving balance in ethical recruitment practices in high-income countries. Future research is warranted to study the longitudinal trends of migration intention and assess the impact of policies on retention.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：