Gross inequality in access to health services is a common problem in developing countries like Panama. This study responds to the current shortage of physicians from economically depressed communities in Panama. By using qualitative research methods, I examined the personal, financial, curricular and environmental factors that shape low-income students’ commitment to become physicians; the forces that shape these medical students to practice medicine once they graduate; and how policies and institutional practices in medical schools in Panama influence rates at which low-income students become physicians. Specifically, data sources were used to explore how the nation’s educational policies, as well as recruitment, admissions, and student support practices in medical schools, influence rates at which low-income students become physicians. Documents were analyzed to determine statistical trends in medical school enrollment and completion for some of the selected medical schools; and the availability and effectiveness of various policy initiatives enacted to increase the production of physicians across the country.
Interviews were conducted with senior academic officers of medical schools (e.g., vice provost, deans and directors) and others who know much about the country’s current human resources challenges in medicine (e.g., a former minister of health, the deputy minister of education, and the health senior adviser to the president of Panama). Interviews with these stakeholders provided insights into the educational, political, and economic forces that shape whoever enrolls in and ultimately completes medical school. Additionally, recent graduates or students in their final year of medical school from four schools of medicine in the Republic of Panama participated in focus groups, to offer information into the personal, familiar and institutional factors that supported and undermined low-income students’ goals of becoming doctors. Some attention was paid to socioeconomic demographics of communities in which certified physicians ultimately choose to practice.
The findings of this study provide Panamanian policymakers with valuable information for defining better approaches to train physicians for underserved areas and may help Panama achieve compliance with the millennium objectives that were agreed to by member countries of the World Health Organization in 2000. Finally, implications for future research on the training of low-income students to become physicians in underserved communities are proposed.
|Commitee:||Jimenez, Maximiliano, Perna, Laura W.|
|School:||University of Pennsylvania|
|Department:||Higher Education Management|
|School Location:||United States -- Pennsylvania|
|Source:||DAI-A 78/10(E), Dissertation Abstracts International|
|Subjects:||Education Policy, Medicine, Health education, Higher education|
|Keywords:||General practitioner, Low-income students, Medicine in emerging countries, Panama, Physician shortage, Student resilience|
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