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CONTEXTDistance learning, supported with supervised clinical work, has been successful in helping doctors located in remote rural areas to practice effectively. Graduates of Christian Medical College (CMC), Vellore, India, have a 2-year service obligation to work in small hospitals mainly located in rural areas. The Fellowship in Secondary Hospital Medicine (FSHM) program is a year-long blended on-site and distance learning program, designed by CMC to support and provide education opportunities for its recent graduates working in small hospitals in rural areas. The FSHM program was designed to help junior doctors develop the knowledge and skills to practice effectively in rural hospitals.ISSUESThe FSHM program consists of 15 paper-based distance learning modules focused on helping to develop knowledge to practice in rural hospitals; three contact sessions at CMC, which focused on developing the necessary skills; project work focused on improving local health services; and networking between peers and with faculty. Two years after implementation of the FSHM program in 2007, the vast majority of students (81%) and faculty (80%) rated the distance learning modules as very good or excellent in helping students develop the knowledge to practice in secondary hospitals. Also, most of the students (88%) and faculty (87%) rated the contact sessions as good or very good in helping students to apply what they had learned in secondary hospitals. Focus group discussions revealed that all of the program participants recognized that the distance learning modules and contact sessions helped them in providing patient care in rural hospitals.LESSONS LEARNEDWell-designed distance learning modules, supported with contact sessions by medical school faculty members, help junior doctors to practice effectively in rural hospitals and reduce their isolation.

Blended distance education program for junior doctors working in rural hospitals in India