Collaborative  Project  to  Increase  Production    of  Rural  Doctors    

(CPIRD)  

Rajin Arora, MD FRTCOG, Diploma in Med Ed (Dundee)

Deputy Director of CPIRD Ministry of Public Health, Thailand

Dr Rajin Arora, Deputy Director of CPIRD, MOPH, Thailand

CPIRD Faculty Development Program

ECME Essential Course for

Medical Educator“12 Expected Outcomes”

!!!!!

Rajin Arora, MD ECME Course Director

Collaborative  Project  to  Increase  Production  of  Rural  Doctors     (CPIRD)  

Rajin Arora, MD FRTCOG, Diploma in Med Ed (Dundee)

Deputy Director of CPIRD Ministry of Public Health, Thailand

WHO  report  :  Density  of  physician (total  number  per  1,000  population,  latest  available  year)

http://gamapserver.who.int/gho/interactive_charts/health_workforce/PhysiciansDensity_Total/atlas.html

Density  of  Physicians per  1,000  population

JAPAN  IN  20082.140

THAILAND  IN  2004  0.298

http://www.who.int/gho/health_workforce/physicians_density/en/

CPIRD• Lack  of  rural  physician  in  1994  • Ministry  of  Public  Health  (MOPH)  started  CPIRD  in  1995    

• Collaboration  with  Ministry  of  Education    • Medical  students  (MS)  selected  from  their  rural  domicile  

• Pre-­‐clinical  programs  taught  in  14  collaborated  universities

CPIRD

• Clinical  subjects  taught  in  37  MECs  • In  2005,  “One  District  One  Doctor”  (ODOD)  program  started  selecting  MS  from  more  rural  areas  

• CPIRD  graduates  obliged  to  work  in  rural  hospitals  for  3  years  and  ODOD  for  12  years

Network of 37 MECs & 14 Universities

=Siriraj=Chula

=Thammasat

No. of MEC divided into service network (NW)!!NW1=5  MECs!NW2=3  MECs!NW3=2  MECs!NW4=1  MECs!NW5=1  MECs!NW6=4  MECs!NW7=4  MECs!NW8=1  MECs!NW9=4  MECs!NW10=2  MECs!NW11=4  MECs!NW12=6  MECs!!!Total of 37 MEC in Thailand

=Chieng mai=Sonkla=Khon Khan=

=Maha sarakam Payao

=Suranaree

=Ubonratchathani=

=Faculty of science ,Mahidol U

=

=Narasuan

=Walailak=Narathiwat=Burapa

7

Outcomes  of    CPIRD    

Medical  Students

Outcome from 1995-2013

Planned  no.  of  students Actual  no.  of  students

14,727 11,213  (76.1  %)

9

CPIRD & ODOD graduates 2000-2012

10

Total  of  4,154  graduates

Graduation  results 2000-­‐2013

11

Average % !Graduation rate

!95.6%

!Passing rate for NT 1-3*

!99.4%

!Honors graduation

!8.52%

*NT  =  National  License  Testing  part  1-­‐3

Increasing  number    of  rural  physicians  for    

MOPH

Physicians  entering  rural  hospitals 2000-­‐2013

13

14

NW 12 (224 : 947) 19.1%

NW5 (209 : 1,066)16.4%

NW 1 (334 : 1,232) 21.3%

NW 8 (246 : 731) 25.2%

NW9 (416 : 1,082) 27.8%

NW2 (397 : 740) 34.9%

NW6 (140 : 1,075) 11.5%

NW11 (208 : 848) 19.7%

NW 10 (188 : 663)22.1%

NW3 (324 : 518)38.5%

NW4 (277 : 882) 23.9%

12 Health Network of Thailand  CPIRD : Normal track physician

NW 7 (230 : 808) 22.2%

15Year  of  graduation  2012-­‐2003

Retention of CPIRD graduates

16

CPIRD  graduates  continue  working  in  the  rural  areas  after  3  years    

1.14  times  >  regular  graduates  (HR  0.14,  p<0.001)

Regular  graduates  resign  from  MOPH  before  3  years    1.5  times  >  CPIRD  graduates  

(HR  0.66,  p<0.001)

Nongluck  Pakaiya.  Retention  of  CPIRD  graduates.  Journal  of  Health  System  Research  .  2012:  6(2);  219-­‐27.    

Thank you