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More than 80% of medical schools in Japan have introduced a special quota to address physician shortages in medically underserved areas (MUAs). In this program, called chiikiwaku, medical students who receive educational and financial support are placed in MUAs after graduation. The aim of this study was to investigate the willingness of chiikiwaku students to remain in MUAs after their obligatory practice period and to identify factors associated with willingness to stay. Methods: Subjects were first-year medical students in chiikiwaku programs at 38 medical schools in Japan. Between September 2010 and February 2011, a questionnaire about demographic characteristics, primary reasons for applying for chiikiwaku, factors influencing work preferences, stress and encouragement as a result of belonging to chiikiwaku, and willingness to work in MUAs after obligatory practice was administered. Results: There were 440 students who answered the questionnaire (valid response rate, 74.7%). Fifty-two percent of respondents were willing to remain in MUAs after obligatory practice. For 31% of chiikiwaku students, the primary reason for applying was to address the physician shortage issue in MUAs. In multivariate analysis, willingness to remain in MUAs was associated with eagerness to address the physician shortage issue as the primary reason for applying for chiikiwaku (odds ratio (OR), 4.4), feeling that chiikiwaku was encouraging (OR, 3.6), feeling that student loans affected their work preferences (OR, 1.7), and being raised in a rural area (OR, 1.8).

rural and remote health

Motives and factors associated with staying in medically underserved areas after the obligatory practice period among first-year Japanese medical students in a special quota system