Krit Pongpirul12, Seelwan Sathitratanacheewin2
doi: http://dx.doi.org/10.5195/ijms.2018.298
Volume 6, Number 3: 118-119
Received 07 08 2018: Accepted 15 08 2018
Clinical practice is affected by factors beyond the doctor-patient level including healthcare systems. Since 2001, the introduction of Thailand’s Universal Coverage Scheme has not only led to the successful expansion of population coverage and improvement of major health indicators but has also stressed the importance of health systems perspective in clinical practice. Thai medical students now have to understand how to offer optimal treatment choices to a patient that concur with the payment policy of the responsible health insurance schemes. Likewise, American medical students are expected to demonstrate competence in “system-based practice” by understanding cost containment, practicing cost-effective medicine and resource allocation, assisting patients in navigating the complexities of the health systems, and coordinating with other providers.1 According to the World Health Organization, a health system consists of all organizations, people and actions whose primary interest is to promote, restore or maintain health.2
The current cohort of medical students is comprised mostly of the millennial generation (or Generation Y; born between 1980 and 1999) who are the generational demographic cohort following the Generation X (born between 1965 and 1979). Known for being self-reliant, inquisitive, and technologically advanced beyond any other age group3, the millennial generation of medical students would not welcome the traditional approach to integrating a new perspective into the currently overwhelming medical curriculum. With collaborative efforts of key national authorities, the Medical Students for Health Systems and Services (MS-HSS) was launched as an innovative program to introduce health systems perspective to medical students in Thailand. This paper describes program characteristics, outcomes, and lessons learned from the first year of implementation with specific examples.
The intervention was systematically developed to be an incentive-based program to help medical students understand and integrate health system perspectives into their basic science and clinical competencies. A budget for essential expenses for conducting projects relevant to health systems or health services and presenting the findings in international conferences was set aside. A committee was formed, consisting of faculty members nominated by students, to oversee the program and make decisions on budget allocation.
Medical students voluntarily participated in the program after they were informed through word of mouth about associated incentives, such as an opportunity to attend international conferences. A committee member was then assigned to be the student mentor. The responsible mentor conducted an initial discussion with each group of students to identify a potential health systems research topic that concurs with their current knowledge and career goal of medical training. Some class assignments were also used as a starting point. A few tailored lectures were conducted to fill in potential gaps of essential knowledge, such as conducting a literature review, data collection, data analysis, and abstract and manuscript preparation.
Ten projects were launched in the first year. One student received the Prince Mahidol Award for a project on system-wide improvement of critical care, and one project on comparative analysis of medical licensing examination systems across Southeast Asian Nations was orally presented and won the Patil Award at AMEE 2013. Another national survey project exploring factors affecting the decision of newly graduated physicians in choosing potential practice areas was chosen, financially supported by the Second Global Symposium on Health Systems Research in Beijing. Both works were successfully published in international and domestic journals.4-5
Key principles that led to the program’s success were voluntary participation and blending recruitment, tailored schedules and lectures, incentive systems, special financing mechanisms, and support by faculty members. As these components exist in any context, the generalization of our experience is possible; however, the following concerns should be addressed. Firstly, providing financial and non-financial support to this incentive-based extracurricular program is challenging in the absence of collaborative efforts between the understanding financing authority and the adaptive medical school management team. Secondly, identifying and recruiting the faculty members who are not only knowledgeable in health systems but also good mentors is critical. Finally, it is not known whether or not health systems perspectives are sustained and long-term and thus follow-up of this cohort of medical students is required.
The nature of this voluntary, extracurricular activity for medical students is experience sharing rather than scientific research. While the names of participating medical students may be identifiable through online internet searches, the information is publicly available and does not incur additional risk to the medical students. The content of this work has not been published previously in whole or part; however, it was orally presented at the Third Global Symposium on Health Systems Research, September 30 – October 3, Cape Town, South Africa, to which the first author was awarded full support for registration, travel, and accommodation from the Symposium Secretariat.
None.
The Authors have no funding, financial relationships or conflicts of interest to disclose.
Conceptualization: KP, and SS. Methodology: KP. Writing – Original Draft: KP, and SS. Writing – Review & Editing: KP, and SS. Supervision: KP. Project Administration: KP.
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Krit Pongpirul, 1 Thailand Research Center for Health Services System (TRC-HS), Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Seelwan Sathitratanacheewin, 2 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Mihnea-Alexandru Găman, Editor
About the Author: Krit Pongpirul is an Assistant Professor at the Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Correspondence: Krit Pongpirul, Address: Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Email: doctorkrit@gmail.com
Cite as: Pongpirul K, Sathitratanacheewin S. Incentive-based Strategy for Introducing Health Systems Perspective to Medical Students. Int J Med Students. 2018 Sep-Dec;6(3):118-119.
Copyright © 2018 Krit Pongpirul, Seelwan Sathitratanacheewin
This work is licensed under a Creative Commons Attribution 4.0 International License.
International Journal of Medical Students, VOLUME 6, NUMBER 3, December 2018