scholarly journals Influence of student debt on health career location and specialty

2018 ◽  
Vol 10 (1) ◽  
pp. 54 ◽  
Author(s):  
Steven Ling ◽  
Robert Jacobs ◽  
Rhys Ponton ◽  
Julia Slark ◽  
Antonia Verstappen ◽  
...  
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
Medical Students ◽  
Rural Areas ◽  
Student Loan ◽  
Rural Practice ◽  
Pharmacy Students ◽  
Student Debt ◽  
Optometry Students ◽  
Debt Levels

ABSTRACT INTRODUCTION In New Zealand (NZ), there are shortages of health professionals in rural areas and in primary care. AIM This study aims to examine the association of student debt levels of medical, nursing, pharmacy and optometry students with: (1) preferred geographical location of practice, specifically preference to work in urban vs. rural areas; and (2) preferred career specialties, specifically interest in primary health care. METHODS Medical, nursing, pharmacy and optometry students completed a questionnaire at graduation that included questions about levels of New Zealand Government Student Loan debt and preferences regarding location of practice and career specialty. In an additional survey, medical students were asked to self-rate the effect of financial factors on their career choices. RESULTS Debt patterns varied across programmes. Medical and pharmacy students with high debt were significantly more likely than students with low debt to prefer rural over urban practice (P = 0.003). There was no difference in level of interest in a primary care specialty by debt level for any programme. Medical students reported little influence of debt on career choice, although students with high debt levels were less concerned over career financial prospects than students with lower levels of debt. DISCUSSION Current levels of student debt do not deter students from planning a career in rural or primary care settings. Somewhat surprisingly, higher levels of debt are associated with greater rural practice intentions for medical and pharmacy students, although the underlying reasons are uncertain.

Rural midwifery practice in Aotearoa/New Zealand: Strengths, vulnerabilities, opportunities and challenges

2020 ◽  
Vol 56 ◽  
pp. 17-25
Author(s):  
Rea Daellenbach ◽  
Lorna Davies ◽  
Mary Kensington ◽  
Susan Crowther ◽  
Andrea Gilkison ◽  
...  
Keyword(s):  
New Zealand ◽  
Rural Communities ◽  
Social Services ◽  
Health Professionals ◽  
Rural Women ◽  
Rural Areas ◽  
Service Providers ◽  
Rural Practice ◽  
Midwifery Practice ◽  
Adverse Weather

Background: The sustainability of rural maternity services is threatened by underfunding, insufficient resourcing and challenges with recruitment and retention of midwives. Aims: The broader aim of this study was to gain knowledge to inform the optimisation of equitable and sustainable maternity care for rural communities within New Zealand and Scotland, through eliciting the views of rural midwives about their working conditions and practice. This article focuses on the New Zealand midwives’ responses. Method: Invitations to participate in an online questionnaire were sent out to midwives working in rural areas. Subsequently, themes from the survey results were followed up for more in-depth discussion in confidential, online group forums. 145 New Zealand midwives responded to the survey and 12 took part in the forums. Findings: The New Zealand rural midwives who participated in this study outlined that they are attracted to, and sustained in, rural practice by their sense of connectedness to the countryside and rural communities, and that they need to be uniquely skilled for rural practice. Rural midwives, and the women they provide care to, frequently experience long travel times and distances which are economically costly. Adverse weather conditions, occasional lack of cell phone coverage and variable access to emergency transport are other factors that need to be taken into account in rural midwifery practice. Additionally, many participants noted challenges at the rural/urban interface in relation to referral or transfer of care of a woman and/or a baby. Strategies identified that support rural midwives in New Zealand include: locum and mentoring services, networking with other health professionals, support from social services and community service providers, developing supportive relationships with other rural midwives and providing rural placements for student midwives. Conclusion: Midwives face economic, topographic, meteorological and workforce challenges in providing a service for rural women. However, midwives draw strength through their respect of the women, and the support of their midwifery colleagues and other health professionals in their community.

scholarly journals Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics

2020 ◽  
Vol 4 (5) ◽  
pp. 425-430
Author(s):  
Michael L. Parchman ◽  
Brooke Ike ◽  
Katherine P Osterhage ◽  
Laura-Mae Baldwin ◽  
Kari A Stephens ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Rural Areas ◽  
Building Blocks ◽  
Rural Practice ◽  
Barriers And Facilitators ◽  
External Support ◽  
Rural Setting ◽  
Opioid Prescribing ◽  
Patient Resources

AbstractBackground:Opioids are more commonly prescribed for chronic pain in rural settings in the USA, yet little is known about how the rural context influences efforts to improve opioid medication management.Methods:The Six Building Blocks is an evidence-based program that guides primary care practices in making system-based improvements in managing patients using long-term opioid therapy. It was implemented at 6 rural and rural-serving organizations with 20 clinic locations over a 15-month period. To gain further insight about their experience with implementing the program, interviews and focus groups were conducted with staff and clinicians at the six organizations at the end of the 15 months and transcribed. Team members used a template analysis approach, a form of qualitative thematic analysis, to code these data for barriers, facilitators, and corresponding subcodes.Results:Facilitators to making systems-based changes in opioid management within a rural practice context included a desire to help patients and their community, external pressures to make changes in opioid management, a desire to reduce workplace stress, external support for the clinic, supportive clinic leadership, and receptivity of patients. Barriers to making changes included competing demands on clinicians and staff, a culture of clinician autonomy, inadequate data systems, and a lack of patient resources in rural areas.Discussion:The barriers and facilitators identified here point to potentially unique determinants of practice that should be considered when addressing opioid prescribing for chronic pain in the rural setting.

Social Capital’s Impact on College Graduation Rates, Debt, and Student Loan Defaults

2020 ◽  
pp. 152102512091887
Author(s):  
Steve Joanis ◽  
James Burnley ◽  
J. D. Mohundro
Keyword(s):  
Social Capital ◽  
Graduation Rates ◽  
Student Loan ◽  
Theory And Practice ◽  
College Graduation ◽  
Student Debt ◽  
Loan Default ◽  
College Graduation Rates ◽  
Default Rates ◽  
Debt Levels

This study extends the literature on education economics and student retention by examining social capital as a predictor of college graduation rates, student debt levels, and student loan default rates. Coleman’s social capital theory is employed to understand how social influences can impact students through external social support (i.e., social capital). The study uses school-level data from the U.S. Department of Education’s Integrated Postsecondary Education Data System and two social capital measures. Results suggest that social capital, at both the state and the community level, significantly influences graduation rates, student debt levels, and loan default rates. Implications for theory and practice are discussed.

scholarly journals Assessing Initiatives for Rural Health Practices in South Carolina

2020 ◽  
Vol 17 (3) ◽  
pp. 61-72
Author(s):  
Aalia Soherwardy ◽  
Elizabeth Crouch
Keyword(s):  
South Carolina ◽  
Medical Students ◽  
Rural Area ◽  
Rural Areas ◽  
Financial Incentives ◽  
Medical Practitioner ◽  
Rural Practice ◽  
Incentive Programs ◽  
Personal Motivation ◽  
Loan Forgiveness

The purpose of this study was to determine which incentives are most effective in motivating medical students to practice in rural areas of South Carolina, which can be informative for the medical practitioner rural recruitment process. Medical students attending the University of South Carolina School of Medicine located in Columbia, South Carolina were surveyed about demographic information, motivations for rural practice, and considerations for choosing a practice location (n=109). Chi-square tests and bivariate analyses were used to test for significant differences. A significant relationship was found between previous residence in a rural area and personal motivation to practice in a rural area (p<0.001). It was also found that 86.2% of students who had previously lived, worked, or served in rural areas had a personal motivation to practice medicine in a rural area, confirming previous research. Loan forgiveness options were the most appealing personal incentive for the students in this study, closely followed by guaranteed minimum incomes and tax incentives; financial incentives were more preferred than non-financial incentives like reduced on-call work and accelerated residencies. The results of this study can be utilized to craft future state-supported incentive programs or to tailor current programs to more effectively recruit students to rural practice. KEYWORDS: Rural; Recruitment; Healthcare Provider; Shortage; Incentive Programs; Medical Student; Southern United States; Loan Forgiveness

scholarly journals Rural general practice training: experience of a rural general practice team and a postgraduate year two registrar

2013 ◽  
Vol 5 (3) ◽  
pp. 243
Author(s):  
Joseph Scott-Jones ◽  
Sarah Lucas
Keyword(s):  
General Practice ◽  
New Zealand ◽  
Rural Areas ◽  
Teaching Experience ◽  
Rural Practice ◽  
Medical Graduate ◽  
Training Experience ◽  
Medical Trainee ◽  
Practice Team ◽  
Wide Range

INTRODUCTION: Undertaking training in rural areas is a recognised way of helping recruit staff to work in rural communities. Postgraduate year two medical doctors in New Zealand have been able to undertake a three-month placement in rural practice as part of their pre-vocational training experience since November 2010. AIM: To describe the experience of a rural general practice team providing training to a postgraduate year two medical trainee, and to describe the teaching experience and range of conditions seen by the trainee. METHODS: A pre- and post-placement interview with staff, and analysis of a logbook of cases and teaching undertaken in the practice. RESULTS: The practice team’s experience of having the trainee was positive, and the trainee was exposed to a wide range of conditions over 418 clinical encounters. The trainee received 22.5 hours of formal training over the three-month placement. DISCUSSION: Rural general practice can provide a wide range of clinical experience to a postgraduate year two medical trainee. Rural practices in New Zealand should be encouraged to offer teaching placements at this training level. Exposure to rural practice at every level of training is important to encourage doctors to consider rural practice as a career. KEYWORDS: Education, medical, graduate; general practice; rural health services

scholarly journals Association between medical student debt and choice of specialty: a 6-year retrospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Erik M. Fritz ◽  
Suzanne van den Hoogenhof ◽  
Jonathan P. Braman
Keyword(s):  
Primary Care ◽  
Medical Students ◽  
Medical Specialty ◽  
Public Institution ◽  
Statistical Hypothesis ◽  
Student Debt ◽  
Statistical Hypothesis Testing ◽  
Average Income ◽  
Residency Programs ◽  
Significant Difference

Abstract Background The effect of rapidly increasing student debt on medical students’ ultimate career plans is of particular interest to residency programs desiring to enhance recruitment, including primary care specialties. Previous survey studies of medical students indicate that amount of student debt influences choice of medical specialty. Research on this topic to date remains unclear, and few studies have included the average income of different specialties in analyses. The purpose of this study is to observe whether empirical data demonstrates an association between debt of graduating medical students and specialties into which students match. Methods This was a retrospective cross-sectional study of a public institution including data from graduation years 2010–2015. For each included student, total educational debt at graduation and matched specialty were obtained. Average income of each specialty was also obtained. Statistical hypothesis testing was performed to analyze any differences in average debt among specialties; subanalysis was performed assessing debt for primary care (PC) versus non-primary care (NPC) specialties. Correlation between student debt and average specialty income was also evaluated. Results One thousand three hundred ten students met the inclusion criteria and 178 were excluded for a final study population of 1132 (86%). The average debt was $182,590. Average debt was not significantly different among the different specialties (P = 0.576). There was no significant difference in average debt between PC and NPC specialties (PC $182,345 ± $64,457, NPC $182,868 ± $70,420, P = 0.342). There was no correlation between average specialty income and graduation debt (Spearman’s rho = 0.021, P = 0.482). Conclusions At our institution, student indebtedness did not appear to affect matched medical specialty, and no correlation between debt and average specialty income was observed. Different subspecialties and residency programs interested in recruiting more students or increasing diversity may consider addressing alternative factors which may have a stronger influence on student choices.

scholarly journals Assessing Initiatives for Rural Health Practices in South Carolina

2020 ◽  
Vol 17 (3) ◽  
pp. 61-72
Author(s):  
Aalia Soherwardy ◽  
Elizabeth Crouch
Keyword(s):  
South Carolina ◽  
Medical Students ◽  
Rural Area ◽  
Rural Areas ◽  
Financial Incentives ◽  
Medical Practitioner ◽  
Rural Practice ◽  
Incentive Programs ◽  
Personal Motivation ◽  
Loan Forgiveness

The purpose of this study was to determine which incentives are most effective in motivating medical students to practice in rural areas of South Carolina, which can be informative for the medical practitioner rural recruitment process. Medical students attending the University of South Carolina School of Medicine located in Columbia, South Carolina were surveyed about demographic information, motivations for rural practice, and considerations for choosing a practice location (n=109). Chi-square tests and bivariate analyses were used to test for significant differences. A significant relationship was found between previous residence in a rural area and personal motivation to practice in a rural area (p<0.001). It was also found that 86.2% of students who had previously lived, worked, or served in rural areas had a personal motivation to practice medicine in a rural area, confirming previous research. Loan forgiveness options were the most appealing personal incentive for the students in this study, closely followed by guaranteed minimum incomes and tax incentives; financial incentives were more preferred than non-financial incentives like reduced on-call work and accelerated residencies. The results of this study can be utilized to craft future state-supported incentive programs or to tailor current programs to more effectively recruit students to rural practice. KEYWORDS: Rural; Recruitment; Healthcare Provider; Shortage; Incentive Programs; Medical Student; Southern United States; Loan Forgiveness

US education debt and cost debate will rise pre-2020

2019 ◽  
Keyword(s):  
Tertiary Education ◽  
Student Loan ◽  
Election Campaign ◽  
Student Debt ◽  
Loan Repayment ◽  
Content Type ◽  
Form Part ◽  
Education Costs ◽  
Education Debt ◽  
Debt Levels

Subject The debate around US college fees and debt reduction. Significance The Democratic Party’s nominee for US president will be picked in 2020, but pre-campaigning by the current 22 contenders for the nomination is well underway. Two issues of inter-generational importance that all candidates are starting to talk about in hustings and public appearances is university tuition and student debt. Reducing student debt levels and tertiary education fees will form part of the 2020 election campaign. Impacts The Trump administration’s 2020 budget measures to alleviate education costs could fall prey to inter-party fighting. If universities are to lower charges, they will likely reduce services to plug the gap, potentially hitting education provision. Lowering university costs would also see universities seeking more outside investment, which could affect strategy decisions. Reducing student costs would help students avoid taking on new debt post-college: fees are not waived due to bankruptcy. Some candidates suggest fixed student loan repayment rates, which would reduce lenders’ profits.

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