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A systematic review of strategies to recruit and retain primary care doctors

This review by Verma et al  (2016) identified 51 studies from across the world that assessed 42 different programs and initiatives designed to improve the identification, recruitment and retention of primary care doctors.


The studies were of interventions in, mainly, the wealthiest countries; Australia, USA, Norway, UK, Japan and Canada but also one on the experience of attracting and retaining Doctors in rural Chile. Like the Chilean example many of the studies looked at efforts made to encouraging  Doctors through to work in challenging environments such as rural USA, northern Norway and the Highlands of Scotland.


The 42 interventions had two forms of support. Financial and non-Financial.  


The financial incentivized packages for GP and trainees included;

  • Waving of college fees

  • Scholarships

  • Bursaries

  • Assistance with loan repayments

  • Rural 'weighting' onto salary

  • Specially funded residencies

  • Commuting time counted in hours worked

  • ‘Golden Hellos’.


The non-financial covered areas such as;

  • Targeting of students from a rural background

  • Training of medical students near their rural homes

  • Distance and remote learning for rural students

  • Language immersion training for internationally recruited Doctors

  • Peer support and collaboration between GPs in isolated regions

  • Obligatory internships in rural areas.

  • Encouraging GPs in rural areas to blog about their experience

  • Granting extra time off for training and up skilling

  • Waving of Visa requirements.


The majority of the financial incentives were conditional on a certain number of years that the qualified GP would work rurally or in areas of most need. This period ranged from 1 year to 6 years.


The results of the findings were generally inconclusive, the authors point out that some of the sample sizes of participants were very small and they point out “studies were of low methodological quality with no Randomized Control Trials and only 15 studies with a comparison group”.


The authors did however conclude “this review found evidence to support undergraduate and postgraduate placements in underserved areas, and selective recruitment of medical students” but pointed out that more high quality research is needed.


See the full paper published in the BMC Health Services Research

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