A report on the number of specialists in need over the country

The nation-wide study of the number of referrals to specialists in the year 1998

The survey of  health officials to estimate the number of specialists in need over the country in the year 2003

Health Workforce Studies Unit

Fall 1998

One of the principal duties of the Iranian Council for Graduate Medical Education is to determine the final distribution of residents within the clinical specialty programs. In order to achieve this goal, the Council should adopt a scientific process, compatible with the need for health and medical services over the country, to get an accurate estimation of the necessary number of residents in each specialty, and also to provide the structured curriculum for the training of skilled and knowledgeable residents. The method in use to define the number of residency program positions, seemingly didn't match the demands of the society. The announcement of available residency positions in hospitals or medical universities over the country was a mere reflection of health demands in educational sections or the decision made by managers, and not a true need for medical specialists. Considering the unprecedented increase in general practitioners, in order to avoid the same problem in the level of specialties and subspecialties, the decision was made to determine the number of residents in need for each of the clinical disciplines in a scientific way, using statistical methods and data collected. Due to the short time available, two short-term methods were chosen. We hope that by completion of the activities and implementation of the findings, the problems of shortage or surplus of specialists be resolved in the country.

A review over the medical workforce planning and the methods used to estimate the number of physicians in need

Authors: Dr A Ardalan, Dr AR Hosseinpoor, Dr F Alaedini, Dr R Fatemi, Dr K Golmohammadi, Dr N Nouri, Dr M Mohebtash, Dr AR Mirzasadeghi

Based on the necessity to scientifically determine the number of physicians in need over the country, Iranian Council for Graduate Medical Education established the Human Worforce Studies Unit to start its activities in this field. After the preliminary studies and surveys, the complexity and extent of the problem was revealed more than ever before. Due to the lack of technical knowledge and skillful staff for workforce planning, two main objectives were placed at the top of the agenda for Health Workforce Studies Unit:

   1- A literature review including collection of existing articles, books and texts in the field of medical workforce planning.

   2- Training talented staff for the field of medical workforce planning.

Fortunately the Unit achieved these objectives by the year 1999 and in addition to data collection, a group of physicians were trained to work on the issue. The report presented here is the result of a comprehensive review of the literature and also correspondence with experts from other countries. We hope that the Ministry of Health and Medical Education can finish the job it has started, which will be impossible to achieve if it's not back by the support from the headquarters of this ministry.

Evaluation of the rules, regulations and principles of fair distribution of general practitioners over the country

Supervisor of study team: Dr. F. Alaedini

Study team: Dr. E. Asghari, Dr. R. Fatemi, Dr. A.R. Hosseinpoor, Dr H. Ranjbaran Jahromi

Acknowledgments to: Dr S. Dabiri, Dr S. Khanahmadi

The goal of this project was to evaluate rules of the obligatory medical service for general practitioners, and to offer suggestions toward their modification and improvement. In this regard, measurements were performed to gain a better understanding of the relevant rules and regulations, the process and the method used for the distribution of physicians over the country, and also to study the possibility that this project can achieve its primary objectives. This report in fact includes the collection of studies that were planned and performed to achieve the goals mentioned above.

The scientific executive manual for the establishment of a performance-based system of management

Authors: Dr. A.R. Mirzasadeghi, Dr. S. Vatankhah, Dr. R. Fatemi

Summerized by: M. Bayat, R. Khalil Nejad, B. Salehi

Acknowledgements to: Dr. M.R. Maleki, Dr. F. Alaedini, and Dr. A.R. Maleki

Performance-based management has potential benefits in speeding up the executive processes and decreasing organizational expenses. This approach to management is a strong tool with increasing appeal for all kinds of organization.

Performance-based management, with goal-oriented utilization of other known tools such as: strategic planning, components of performance measurement, different methods for data collection and analysis, various ways for organizational improvement such as balance setting, quality management, and..., provides better chance of success for every organization in today's competitive market. As "responsiveness" has a more objective meaning in this system of management, much better grounds will be provided for different levels of the organization to participate in achievement of its goals.

The present manual is taken from the 7-volume book, titled: "A New Approach in Management of Human Resources: Performance-Based Management", published by the Undersecretary for Development of Management and Resources and Parliamentary Affairs in the Ministry of Health and Medical Education. This manual is summarized and published by the Health Researchers R&D Institute, and presents a useful summary of important points and establishment of this new management system in different organizations.

This manual is one of the products of the project titled: "Establishment of Performance-Based Management in the Emergency Room of the Ziaian Hospital".

The report of the project on the tendency of Iranian physicians for emigration and its affecting factors in the year 2001

Supervisor of study team: Dr. F. Alaedini

Study team: Dr. E. Asghari, Dr. R. Fatemi, Dr. A.R. Hosseinpoor, Dr H. Ranjbaran Jahromi

Acknowledgments to: Dr S. Dabiri, Dr S. Khanahmadi

Considering the selection of students in the universities’ entrance exam and the popularity of the medical profession over the society (which has of course decreased in recent years), the social impacts of the emigration of physicians, who are among the most intelligent and talented students, are plausible. The emigration of this group from the country, means massive loss of talented human resources who could have participated in the scientific and professional development of the country and could have made a better outlook for Iranian citizens. Additionally, the long duration of medical education and its high expenses show that the departure of each physician has huge financial impact on our health system.

The factors that influence the emigration of scholars from developing countries, can be categorized in 2 general groups: the initial factors in the countries of origin, and the attracting ones in the countries of destination. The immigrants face certain problems and obstacles in their pathway. Understanding each of these factors can help headquarters and policy-makers in their approach toward this problem and in finding effective solutions.

The report of the project on the extent and the reasons of unemployment among Iranian physicians in the year 2001

Supervisor of study team: Dr. F. Alaedini

Study team: Dr. E. Asghari, Dr. R. Fatemi, Dr. A.R. Hosseinpoor, Dr H. Ranjbaran Jahromi

Acknowledgments to: Dr S. Dabiri, Dr S. Khanahmadi

According to the report, published by the current head of the medical organization, 30000 physicians over  the country are reported to be unemployed. Currently, there is increasing evidence for the lack of professional positions and employment for physicians, especially young physicians. Therefore, an important issue in this regard is the unemployment of physicians in the society, and the other issue is their part-time or temporary employment, which will bring about their dissatisfaction and lack of professional security. Besides, a group of physicians, by changing their career or complete resignation from medicine, will take on certain jobs that don't need the long, hard, and expensive medical education. Unemployment, or employment out of the medical profession, wastes on the one hand, the national resources that have been spent for physicians' training, and on the other hand, has deleterious effects on their social and mental conditions. Therefore, the unfavorable consequences of the un/underemployment of physicians should be evaluated on the one hand, for their social and economical impacts, and on the other hand, for their impacts on the health system and in particular, their impacts on planing for human resources. Achievement of exact statistics and data in this regard, is as such, of highest priorities.