Career destination and reason for career destination preferences among medical graduates from Christian Medical College Vellore – Does rural service obligation increase retention of medical graduates in rural service?

OBJECTIVES: To find out the career destination of a cohort of doctors who have graduated from Christian Medical College (CMC) and to identify the reasons for their choice. BACKGROUND: CMC is a training institution for medical graduates among a network of mission hospitals in India. After their graduation, most students complete a sponsorship obligation of 2 years in primary or secondary, rural and semi-urban hospitals. METHODS: STUDY POPULATION: The study population was obtained from the electronic database of the medical graduates. The batches of medical graduates from 1966 to 1995 were analyzed. Quantitative data regarding the career destination were obtained from this database. SURVEY INSTRUMENT: A structured qualitative questionnaire was devised with both open and closed questions regarding their present area of work and the reason for their choice. This questionnaire was sent via email and posted to others who did not have email access; 17.5% responded to this questionnaire. RESULTS: Data revealed that 57.4% of our alumni were working in India and 42.3% were working abroad. In India, 29% were working in the corporate sector, 21% in CMC, and 10% in rural hospitals. The pull factors for the doctors who stayed in India and in rural area were a felt need to serve. The pull factors for doctors to go abroad were pursuit of academic excellence and perceived better quality of life. The push factors against the pursuit of rural career were prior adverse experiences in the rural hospitals they had worked in. CONCLUSION: The career destinations depend mainly on satisfaction with work and familial expectations.