MOTIVES AND CONCERNS FOR PRACTICING MEDICALLY UNDERSERVED AREAS AMONG SIXTH-YEAR JAPANESE MEDICAL STUDENTS IN A SPECIAL QUOTA SYSTEM

Introduction and Objective To improve physician shortages in medically underserved areas (MUAs) in Japan, many of Japanese medical schools have introduced a rural quota since 2008. In this program, students who receive educational and financial support are placed in MUAs after graduation. The aim of this study is to investigate the motives and concerns of the quota students. Method We conducted a nationwide survey in 2015. The subjects were all sixth-year (final year) rural quota students in Japanese medical schools. In the questionnaire, we asked about their intention to work in MUAs after obligatory practice, their concerns about belonging to rural quota, and the possibility of dropping out of rural quota system. Results and Conclusions There were 346 students at 41 medical schools who answered the questionnaire (response rate, 72.1%). Twenty-one percent of rural quota students were very or somewhat willing to remain in MUAs after obligatory practice. More than half of rural quota students had concerns about their career (restriction of seeking employment and becoming a non-primary care specialist). Approximately 30% of students had concerns about their living places and their family lives. In addition, 33% rural quota students were thinking of dropping out of rural quota systems. Career support system of rural quota should be improved to increase the number of doctors who remain in MUAs for a long period of time.