title: What impedes working in rural areas? A study of aspiring doctors in the National Capital Region, India.
abstract: BACKGROUND
  The rural health system in India has long been disadvantaged by a shortage of health staff, including doctors. Providing medical students with a rural clinical placement has been suggested as one strategy to overcome this shortage. This study examined the attitudes of and inclination to rural healthcare careers among medical students.
  
  
  METHODS
  A cross-sectional study was performed on 201 students (147 males and 54 females) from two medical colleges in the National Capital Region (NCR) of India. A pre-tested semi-open-ended questionnaire was used to obtain information about students' socio-demographic characteristics and their views about a rural health career. Students' open-ended responses were collated and coded into broad categories.
  
  
  RESULTS
  Of the respondents, 160 (79.6%) had a rural background. The current status of rural health services in India was rated as unsatisfactory by 178 students (88.6%). In total 110 (54.7%) indicated an interest in working in a rural area after graduation with 68 (33.8%) willing to set up their practice in a rural area. Students with a rural background were more likely to be willing to practice in a rural area. Those whose parents were highly qualified (postgraduate education or higher) were significantly less likely to practice in a rural area (p=0.004). Potential benefits of working in a rural area included 'health services for the poor/ benefit for the nation', and 'gain of knowledge about rural people and their diseases'. Potential drawbacks included 'lack of infrastructural facilities', 'less salary' and 'low standard of living'. A majority of the students believe the undergraduate medical curriculum needed modification to improve student awareness of rural needs.
  
  
  CONCLUSIONS
  The medical students surveyed had a positive view of the importance of rural health care. However, factors such as infrastructure and salary were perceived as potential barriers to a career in rural health. The findings are a starting point to understanding the attitude of medical students towards rural health care and designing specific strategies to overcome the shortage of rural doctors in India.
authors.affiliation: Department of Community Medicine, University College of Medical Sciences, Delhi, India. sainink@hotmail.com
authors.forename: Narender K
authors.initials: NK
authors.lastname: Saini
authors.forename: Rahul
authors.initials: R
authors.lastname: Sharma
authors.forename: Rupali
authors.initials: R
authors.lastname: Roy
authors.forename: Ramesh
authors.initials: R
authors.lastname: Verma
mesh_terms: D000328:Adult; D002321:Career Choice; D003430:Cross-Sectional Studies; D005260:Female; D006280:Health Workforce; D006801:Humans; D007194:India; D008297:Male; D019035:Rural Health Services; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult