Newly graduated doctors willingly pay fine to avoid three-year rural internship in state hospitals.
HEALTH: Doctor shortage is worsening by Apiradee Treerutkuarkul
The shortage of physicians is worsening throughout the country, particularly in the Northeast, according to a recent survey by the Public Health Ministry.
The problem was most acute in 26 community hospitals, mostly in northeastern provinces. Doctors from provincial hospitals have had to be rotated to the community hospitals, the survey said.
It also said there was only one full- time doctor at each community hospital and not enough medical professionals to provide primary health care services.
"Having only one or two doctors at each hospital is such a big burden for the hospital to bear," said Nongluck Pakaiya, manager of human resources for the Health Research and Development Office, who conducted the survey to monitor the growing doctor shortage.
Ms Nongluck said if the problem remained unresolved, it would affect the country's health-care system in the long term.
The survey also found three rural hospitals did not even have a full-time doctor. They were Bunnangsata hospital in a southernmost border province of Yala, Koh Kood hospital in the eastern province of Trat and Phu Kradueng hospital in Loei in the Northeast.
That was because many newly graduated doctors refused to work at state-run hospitals in far-flung areas during their three-year rural internship period, Ms Nongluck said.
Their excuses included the fact that the hospitals were too far away from their homes or were located in violence-torn provinces.
But if they drew lots to work at hospitals in remote areas where they did not want to go, their parents were willing to pay a huge fine to the ministry so as to terminate their contracts to work for three years at state-run hospitals after graduation, she said.
In 2008 there were a total of 1,189 newly graduated doctors and 356 of them resigned and paid a fine to the ministry for failing to complete their three-year internship programme, she said.
Dr Lalita Kongkham, of Maharaj Nakhon Ratchasima hospital, said the ministry should extend its project aimed at increasing the number of rural doctors where rural students are given the chance to study at nationwide medical schools.
The project began in 2004 and was about to end in 2013, she said.
Students with good grades are selected to study at medical schools for six years. After their graduation they must go back to serve a three-year internship at state-run hospitals in their communities.
She said the project had proved successful as rural doctors who graduated were proud to go back to work at hospitals in their communities when compared to those with an urban background forced to work under the ministry's three-year internship programme.
(Source: Bangkok Post, HEALTH, Doctor shortage is worsening, 23/05/2011, Apiradee Treerutkuarkul, link)
physician - medical doctor (See Wikipedia)
intern (noun) - an advanced student or recent graduated student being given practical on-the-job training under supervision (especially for doctors)
internship - the period of time that an "intern" receives their on-the-job training (See Wikipedia)
three-year rural internship period - the 3 years that doctors are required to work in the countryside after graduation
newly graduated doctors - doctors who just finished medical school (and must serve 3 years in rural areas after graduation)
community - the people living in one particular area ชุมชน
rural - in the countryside (farms, forests), not the city ชนบท, บ้านนอก
rural hospitals - hospitals in the countryside, in rural farming areas
state - government รัฐ
state-run hospitals - government hospitals (owned and operated by the government for all the people in Thailand)
shortage - situation when there is not enough of some good or service การขาดแคลน
acute - very serious and severe เฉียบพลันและรุนแรง
full-time - working at a job as your main job (8 hours a day)
part-time - working at a jobless than 8 hours a day
medical professionals - highly trained and skilled workers providing healthcare (doctors, nurses, physical therapists, radiological technicians, etc) (See Wikipedia)
rotated - when workers are moved between different positions (different work, different department, different hospital, different area, for example)
provide - to give someone something that they want or need
primary - first and most important
services - บริการต่างๆ things produced in service industries, not a physical good that can be bought (See Wikipedia on services and the goods and services continuum)
primary health care services - the doctors and clinics providing the "first contact" healthcare when people have a health problem, also known as "primary care" (See Wikipedia on Primary Care and Primary Healthcare and Google Definitions)
health-care system - all aspects of providing healthcare to the people of a whole country (the organization of people, institutions, and resources to deliver health care services), in some countries like Thailand the government provides much of the services, in other countries such as the US private businesses provide most of the services (See Wikipedia)
survey - gathering information about what people think about different subjects (public opinion) by asking large numbers of people questions and counting their answers, and then using statistics, graphs, and tables to present results (See Wikipedia) การสำรวจความเห็น
bear - to accept, tolerate or endure something unpleasant ทน
burden - a serious or difficult responsibility that you have to deal with ภาระ (See glossary)
resources - things such as money, workers and equipment that can be used to help achieve something ทรัพยากรที่มีอยู่
human resources - the employees of a company or organization (managed by the HR department in companies)
monitor - to regularly check something or watch someone in order to find out what is happening ตรวจสอบ ตรวจตรา
resolve a problem - solve a problem
a resolved problem - a problem that has been solved
an unresolved problem - a problem that has not been solved
problem remained unresolved - the problem has still not been resolved
border - the official line separating two areas, regions or countries เขตแดน อาณาเขต
excuses - reasons given for not doing something (they must do, they are required to do)
violence - physical force with the deliberate intention of causing damage to property or injury or death to people ความรุนแรง
violence-torn provinces - rural areas where there there is a war and lots of killing and bombing
draw lots - drawing lots, to choose people to do some task, people in a group take pieces of paper out of a container, the people who choose the marked papers have to do the task (See Wikipedia)
remote - far away from cities, difficult to get to ไกล, ที่ห่างไกลจากความเจริญ (ของเมือง)
fine - an amount of money that you have to pay because you have broken the law or an agreement ค่าปรับ
ministry - a government department dealing with an area of activity กระทรวง
terminate - to end or stop something ทำให้สิ้นสุด
contract - a written or spoken agreement
terminate contract - end a contract, end an agreement
resigned - formally and officially quit a job
extend - to add more time ยืดออกไป, ขยายออกไป
given the chance to - give the opportunity to
nationwide - throughout a whole country ทั่วทั้งประเทศ
urban - connected with towns and cities เขตเมือง
background - personal history and experience
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