Financial barriers and inequity in medical education in India: challenges to training a diverse and representative healthcare workforce.

IF 3.1 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH
Medical Education Online Pub Date : 2024-12-31 Epub Date: 2024-01-09 DOI:10.1080/10872981.2024.2302232
Faique Rahman, Vivek Bhat, Ahmad Ozair, Donald K E Detchou, Manmeet S Ahluwalia
{"title":"Financial barriers and inequity in medical education in India: challenges to training a diverse and representative healthcare workforce.","authors":"Faique Rahman, Vivek Bhat, Ahmad Ozair, Donald K E Detchou, Manmeet S Ahluwalia","doi":"10.1080/10872981.2024.2302232","DOIUrl":null,"url":null,"abstract":"<p><p>India has been historically challenged by an insufficient and heterogeneously clustered distribution of healthcare infrastructure. While resource-limited healthcare settings, such as major parts of India, require multidisciplinary approaches for improvement, one key approach is the recruitment and training of a healthcare workforce representative of its population. This requires overcoming barriers to equity and representation in Indian medical education that are multi-faceted, historical, and rooted in inequality. However, literature is lacking regarding the financial or economic barriers, and their implications on equity and representation in the Indian allopathic physician workforce, which this review sought to describe. Keyword-based searches were carried out in PubMed, Google Scholar, and Scopus in order to identify relevant literature published till November 2023. This state-of-the-art narrative review describes the existing multi-pronged economic barriers, recent and forthcoming changes deepening these barriers, and how these may limit opportunities for having a diverse workforce. Three sets of major economic barriers exist to becoming a specialized medical practitioner in India - resources required to get selected into an Indian medical school, resources required to pursue medical school, and resources required to get a residency position. The resources in this endeavor have historically included substantial efforts, finances, and privilege, but rising barriers in the medical education system have worsened the state of inequity. Preparation costs for medical school and residency entrance tests have risen steadily, which may be further exacerbated by recent major policy changes regarding licensing and residency selection. Additionally, considerable increases in direct and indirect costs of medical education have recently occurred. Urgent action in these areas may help the Indian population get access to a diverse and representative healthcare workforce and also help alleviate the shortage of primary care physicians in the country. Discussed are the reasons for rural healthcare disparities in India and potential solutions related to medical education.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10778416/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Education Online","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10872981.2024.2302232","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/9 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"EDUCATION & EDUCATIONAL RESEARCH","Score":null,"Total":0}
引用次数: 0

Abstract

India has been historically challenged by an insufficient and heterogeneously clustered distribution of healthcare infrastructure. While resource-limited healthcare settings, such as major parts of India, require multidisciplinary approaches for improvement, one key approach is the recruitment and training of a healthcare workforce representative of its population. This requires overcoming barriers to equity and representation in Indian medical education that are multi-faceted, historical, and rooted in inequality. However, literature is lacking regarding the financial or economic barriers, and their implications on equity and representation in the Indian allopathic physician workforce, which this review sought to describe. Keyword-based searches were carried out in PubMed, Google Scholar, and Scopus in order to identify relevant literature published till November 2023. This state-of-the-art narrative review describes the existing multi-pronged economic barriers, recent and forthcoming changes deepening these barriers, and how these may limit opportunities for having a diverse workforce. Three sets of major economic barriers exist to becoming a specialized medical practitioner in India - resources required to get selected into an Indian medical school, resources required to pursue medical school, and resources required to get a residency position. The resources in this endeavor have historically included substantial efforts, finances, and privilege, but rising barriers in the medical education system have worsened the state of inequity. Preparation costs for medical school and residency entrance tests have risen steadily, which may be further exacerbated by recent major policy changes regarding licensing and residency selection. Additionally, considerable increases in direct and indirect costs of medical education have recently occurred. Urgent action in these areas may help the Indian population get access to a diverse and representative healthcare workforce and also help alleviate the shortage of primary care physicians in the country. Discussed are the reasons for rural healthcare disparities in India and potential solutions related to medical education.

印度医学教育中的财政障碍和不公平现象:培养一支多样化和具有代表性的医疗队伍所面临的挑战。
印度在历史上一直面临着医疗基础设施不足和分布不均的挑战。虽然印度主要地区等资源有限的医疗环境需要多学科方法来改善,但其中一个关键方法是招聘和培训一支能代表印度人口的医疗队伍。这就需要克服印度医学教育中的公平性和代表性障碍,这些障碍是多方面的、历史性的,并且植根于不平等。然而,有关财政或经济障碍及其对印度全科医生队伍的公平性和代表性的影响的文献却很缺乏,本综述试图对此进行描述。我们在 PubMed、Google Scholar 和 Scopus 中进行了关键词搜索,以确定截至 2023 年 11 月发表的相关文献。这篇最先进的叙述性综述描述了现有的多方面经济障碍、最近和即将发生的加深这些障碍的变化,以及这些变化如何限制了拥有一支多元化人才队伍的机会。在印度,要成为一名专科医生,存在三组主要的经济障碍--被印度医学院选中所需的资源、继续攻读医学院所需的资源以及获得住院医师职位所需的资源。这一努力所需的资源历来包括大量的努力、资金和特权,但医学教育体系中不断增加的障碍加剧了不公平状况。医学院和住院医生入学考试的准备费用持续上升,最近有关执照和住院医生选拔的重大政策变化可能会进一步加剧这种情况。此外,医学教育的直接和间接成本最近也大幅增加。在这些领域采取紧急行动可能有助于印度人口获得多样化和具有代表性的医疗保健队伍,也有助于缓解该国初级保健医生短缺的问题。本文讨论了印度农村医疗差距的原因以及与医学教育相关的潜在解决方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Medical Education Online
Medical Education Online EDUCATION & EDUCATIONAL RESEARCH-
CiteScore
6.00
自引率
2.20%
发文量
97
审稿时长
8 weeks
期刊介绍: Medical Education Online is an open access journal of health care education, publishing peer-reviewed research, perspectives, reviews, and early documentation of new ideas and trends. Medical Education Online aims to disseminate information on the education and training of physicians and other health care professionals. Manuscripts may address any aspect of health care education and training, including, but not limited to: -Basic science education -Clinical science education -Residency education -Learning theory -Problem-based learning (PBL) -Curriculum development -Research design and statistics -Measurement and evaluation -Faculty development -Informatics/web
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信