title: The effect of Community Based Education and Service (COBES) on medical graduates' choice of specialty and willingness to work in rural communities in Ghana.
abstract: BACKGROUND
  Career choices and placements of healthcare professionals in rural areas are a major problem worldwide, and their recruitment and retention to these areas have become a challenge to the health sector. The purpose of this study was to investigate the effect of Community Based Education and Service (COBES) on medical graduates' choice of specialty and willingness to work in a rural area.
  
  
  METHODS
  This cross sectional survey was conducted among 56 pioneering graduates that followed a Problem Based Learning/Community Based Education and Service (PBL/COBES) curriculum. Using a mixed methods approach, open-and closed-ended questionnaire was administered to 56 graduates. Cross tabulation using Chi-square test were used to compare findings of the quantitative data. All qualitative data analysis was performed using the principles of primary, secondary and tertiary coding.
  
  
  RESULTS
  All 56 graduates answered and returned the questionnaire giving a 100 % response rate. 57.1 % (32) of them were male. Majority of them lived in towns (41.1 %) and cities (50 %) prior to medical school. A significant number of graduates (53.6 %,) from the cities, without any female or male predominance said COBES had influenced their choice of specialty. Again, a significant proportion of graduates from the towns (60.9 %,) and cities (67.8 %,), indicated that COBES had influenced them to work in the rural area. However, there was no significant difference between males and females from the towns and cities regarding the influence of COBES to work in the rural area. Qualitative data supported the finding that COBES will influence graduates willingness to work in the rural area
  
  
  CONCLUSIONS
  The majority of graduates from the towns and cities in Ghana, with a male predominance, indicated that COBES may have influenced their choice of specialty and willingness to practice in the rural areas despite their town or city based upbringing.
authors.affiliation: University for Development Studies (UDS), School of Medicine and Health Sciences (SMHS), Tamale, Ghana. amalbaanthony@yahoo.com.|Department of Health Professions Education and Innovative Learning, School of Medicine and Health Sciences, University for Development Studies, P. O. Box 1883, Tamale, Ghana. amalbaanthony@yahoo.com.
authors.forename: Anthony
authors.initials: A
authors.lastname: Amalba
authors.affiliation: School of Health Professions Education, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands. w.van.mook@mumc.nl.
authors.forename: Walther Nicolaas Karel Anton
authors.initials: WN
authors.lastname: van Mook
authors.affiliation: University for Development Studies (UDS), School of Medicine and Health Sciences (SMHS), Tamale, Ghana. mogrevictor@yahoo.com.
authors.forename: Victor
authors.initials: V
authors.lastname: Mogre
authors.affiliation: School of Health Professions Education, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands. a.scherpbier@maastrichtuniversity.nl.
authors.forename: Albert Jakob Johannus Antonius
authors.initials: AJ
authors.lastname: Scherpbier
mesh_terms: D002321:Career Choice; D003430:Cross-Sectional Studies; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D005260:Female; D005869:Ghana; D006801:Humans; D008297:Male; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D019035:Rural Health Services; D011795:Surveys and Questionnaires; D000078329:Workforce