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The collaborative project between the University of Las Palmas de Gran Canaria and the public University of Mozambique, UniZambeze, aims to strengthen the institutional and training capacities of its Faculty of Medicine located in Tete to provide new medical graduates. The essence of the program, training doctors, has the objective of improving the healthcare system and making it sustainable for the integration of new graduates into the staff of the faculty. In this work, we determine the cost of education for a new doctor and we evaluate the social benefit of the program in terms of the human capital. The program has led to the training of 199 new doctors in the 11 years of operation and is leading the way for 100 more in the next four years. The incorporation of some of them into the faculty's staff will generate new doctor graduates in the near future with a cost below 6000 EUR each in normal circumstances. These results can help to determine how much traditional international aid healthcare programs can save when investing in the education of new doctors. This program is an alternative policy for the international aid financing budgets of donor countries. Supporting teachers and native doctors in the future with private and public patronage programs can raise the efficiency per EUR spent.

In Spain's 'MIR' system, medical school graduates are ranked by their performance on a national exam and then sequentially choose from the available residency training positions. We took advantage of a unique survey of participants in the 2012 annual MIR cycle to analyze preferences under two different choice scenarios: the residency program actually chosen by each participant when it came her turn (the 'real') and the program that she would have chosen if all residency training programs had been available (the 'counterfactual'). Utilizing conditional logit models with random coefficients, we found significant differences in medical graduates' preferences between the two scenarios, particularly with respect to three specialty attributes: work hours/lifestyle, prestige among colleagues, and annual remuneration. In the counterfactual world, these attributes were valued preferentially by those nearer to the top, while in the real world, they were valued preferentially by graduates nearer to the bottom of the national ranking. Medical graduates' specialty preferences, which we conclude, are not intrinsically stable but depend critically on the 'rules of the game'. The MIR assignment system, by restricting choice, effectively creates an externality in which those at the bottom, who have fewer choices, want what those at the top already have. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Spain has gone from a surplus to a shortage of medical doctors in very few years. Medium and long-term planning for health professionals has become a high priority for health authorities.Methods: We created a supply and demand/need simulation model for 43 medical specialties using system dynamics. The model includes demographic, education and labour market variables. Several scenarios were defined. Variables controllable by health planners can be set as parameters to simulate different scenarios. The model calculates the supply and the deficit or surplus. Experts set the ratio of specialists needed per 1000 inhabitants with a Delphi method.Results: In the scenario of the baseline model with moderate population growth, the deficit of medical specialists will grow from 2% at present (2800 specialists) to 14.3% in 2025 (almost 21 000). The specialties with the greatest medium-term shortages are Anesthesiology, Orthopedic and Traumatic Surgery, Pediatric Surgery, Plastic Aesthetic and Reparatory Surgery, Family and Community Medicine, Pediatrics, Radiology, and Urology.Conclusions: The model suggests the need to increase the number of students admitted to medical school. Training itineraries should be redesigned to facilitate mobility among specialties. In the meantime, the need to make more flexible the supply in the short term is being filled by the immigration of physicians from new members of the European Union and from Latin America. [ABSTRACT FROM AUTHOR]