title: Attracting doctors to rural areas: a case study of the post-graduate seat reservation scheme in andhra pradesh.
abstract: BACKGROUND
  Attracting doctors to rural posts is an ongoing challenge for health departments across different states in India. One strategy adopted by several states to make rural service attractive for medical graduates is to reserve post-graduate (PG) seats in medical colleges for doctors serving in the public sector.
  
  
  OBJECTIVE
  This study examines the PG reservation scheme in Andhra Pradesh to understand its role in improving rural recruitment of doctors and specialists, the challenges faced by the scheme and how it can be strengthened.
  
  
  METHODS
  Qualitative case study methodology was adopted in which a variety of stakeholders such as government officials, health systems managers and serving Medical Officers were interviewed. This was supplemented with quantitative data on the scheme obtained from the Health, Medical and Family Welfare Department in Andhra Pradesh.
  
  
  RESULTS
  The PG reservation scheme appears to have been one of the factors responsible in attracting doctors to the public sector and to rural posts, with a reduction in vacancies at both the Primary Health Centre and Community Health Centre levels. Expectedly, in-service candidates have a better chance of getting a PG seat than general candidates. However, problems such as the mismatch of the demand and supply of certain types of specialist doctors, poor academic performance of in-service candidates as well as quality of services and enforcement of the post-PG bond need to be resolved.
  
  
  CONCLUSIONS
  The PG reservation scheme is a powerful incentive to attract doctors to rural areas. However, better monitoring of service quality, strategically aligning PG training through the scheme with the demand for specialists as well as stricter enforcement of the financial bond are required to improve the scheme's effectiveness.
authors.affiliation: Public Health Foundation of India, New Delhi, India.
authors.forename: Zubin C
authors.initials: ZC
authors.lastname: Shroff
authors.forename: Seema
authors.initials: S
authors.lastname: Murthy
authors.forename: Krishna D
authors.initials: KD
authors.lastname: Rao
keywords: Andhra Pradesh; bond; medical education; post-graduate; rural service