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Related Experiment Video

Updated: Mar 18, 2026

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Modeling solutions to Tanzania's physician workforce challenge.

Alex J Goodell1, James G Kahn2, Sidney S Ndeki3

  • 1School of Medicine, University of California San Francisco, San Francisco, CA, USA; alexgoodell@gmail.com.

Global Health Action
|July 1, 2016
PubMed
Summary

Tanzania faces significant physician attrition, with over half of recent medical graduates not practicing by 2025. Interventions like public sector absorption and rural training tracks are crucial for retaining doctors where they are most needed.

Keywords:
Tanzaniadoctor shortagemodelingworkforce

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Area of Science:

  • Health Workforce Research
  • Medical Education Policy
  • Public Health Planning

Background:

  • Tanzania faces a critical shortage of physicians, with a low ratio of 0.31 per 10,000 individuals in 2012, particularly in rural areas.
  • Despite increased medical school enrollment, high attrition rates among graduates, including emigration and shifts to non-clinical roles, exacerbate the physician deficit.

Purpose of the Study:

  • To estimate the future number of physicians in Tanzania by modeling medical student and physician career trajectories.
  • To assess the potential impact of interventions aimed at improving physician retention in underserved areas.

Main Methods:

  • A Markov process model with 92 states was developed to track 25,000 medical students and physicians from 1990 to 2025.
  • The model incorporated various career pathways, including rural/urban and public/private clinical practice, non-clinical work, and emigration.
  • Model calibration utilized a 2005/2006 national physician survey, graduation records, and graduate tracking data.

Main Results:

  • The model projects substantial losses from clinical practice between 2016 and 2025, with an estimated 56% of students enrolled 2011-2020 not practicing medicine in Tanzania by 2025.
  • Despite projected attrition, the physician-to-population ratio is forecast to increase to 1.4 per 10,000 by 2025.
  • Strategies such as increasing public sector employment for graduates and establishing rural training tracks show potential to reduce attrition in critical areas.

Conclusions:

  • Tanzania's substantial investment in medical education is at risk of being undermined by poor physician retention.
  • Implementing targeted employment and retention strategies is essential to safeguard the return on investment in medical training and address the physician shortage.