CONICET | Buscador de Institutos y Recursos Humanos

Introduction: Previous research has explored the effect of motivations, incentives and working conditions on willingness toaccept jobs in rural and remote areas. These studies demonstrated that difficult working conditions, low job satisfaction andremuneration, and poor security, predisposed new medical graduates to select cities instead of rural districts. Since Argentina has acritical shortage of health staff in rural and low-income marginal suburban settings, and limited qualitative and quantitative localresearch has been done to address this issue, the present study was developed to assess the factors associated with the willingness ofmedical students to work in low-resource underprivileged areas of the country after graduation.Methods: A cross-sectional descriptive design was used with data collected from a self-administered questionnaire and usingquantitative analysis methods. A total of 400 eligible second-year medical students were invited to participate in a survey focused onsociodemographic characteristics, incentives and working conditions expected in deprived areas, extrinsic and intrinsic motivations,university medical education and government promotion policies.Results: Twenty-one per cent of medical students showed a strong willingness to work in a deprived area, 57.3% manifested weakwillingness and 21.5% unwillingness to work in a low-resource setting. Being female, of older age, not having a university-trainedprofessional parent, previous exposure or service in a poor area, choice of pediatrics as a specialty and strong altruistic motivations were highly associated with the willingness to practice medicine in rural or underprivileged areas. Only 21.5% of respondentsconsidered that medical schools encourage the practice of medicine in poor deprived regions. Likewise, only 6.2% of studentsconsidered that national public health authorities suitably stimulate physician distribution in poorer districts.Conclusions: One-third of students expressed high altruistic motivations and should therefore be encouraged during their careers.Better remuneration and the assurance of a position at an urban hospital in the future may tip the choice in favor of underprivilegedregions. Since most respondents said that neither government nor medical schools sufficiently encourage the practice of medicine inpoor deprived regions, government policy-makers should recommend changes in resource allocation to better promote officialproposals and opportunities to work.

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