Dr Likke Putri grew up in an urban area of Indonesia and studied at an urban-based medical school, where most students also came from urban areas.

“As medical students, we were always ‘terrified’ to hear words like ‘rural or remote health facilities’ because it represented poor career development, poor infrastructure, and inferiority.”

During her training and early academic career, Dr Putri noted that Indonesia had tried a number of strategies over past decades to improve recruitment and retention of doctors in rural areas, without addressing rural backgrounds of medical students.

“None of the strategies touched the educational stage of the medical students, despite the evidence worldwide about the impact of rural training pathway to the increased rural doctor supply.”

Dr Putri wanted to undertake doctoral study to determine whether rural training pathway policies would work in Indonesia, and if medical students in Indonesia recruited from rural areas, or with rural exposure during their training, return to practice in rural areas.

Dr Putri chose to undertake her PhD at Monash Rural Health, under the supervision of Dr Belinda O’Sullivan, Dr Deborah Russell and Dr Rebecca Kippen— who are world-leading researchers in rural training pathways and other evidence-based policies for increasing the number of doctors practising in rural areas.

Dr Putri undertook a review of policy and research definitions of ‘urban’, ‘rural’ and ‘remote’ in Indonesia, as well as policies in Indonesia and globally to increase rural doctor supply. A national survey of early-career Indonesian doctors was then undertaken, to determine what factors are associated with rural, remote or urban practice for these doctors, with a view to informing future Indonesian government policy. This was followed by consultation with Indonesian academics working in medical workforce capacity building, and Indonesian Ministry of Health personnel.

The evidence-based survey questions were developed in English, then translated into Bahasa Indonesian for implementation through the Indonesian Ministry of Health. The subsequent 2019 Indonesian Early-Career Doctors Survey received 5,199 responses.

Major findings are that rural background and rural exposures during training are strongly associated with rural practice for early-career Indonesian doctors, and remote background and remote exposures during training are strongly associated with remote practice. The findings of her research have been shared with the Indonesian government, who are focusing on increasing the distribution of specialist doctors by promoting collegium-based specialist education in rural areas, as opposed to university-based education in urban areas. Collegium-based specialist education provides more specialist training in more rural areas, and the importance of locating medical schools in more rural locations is now acknowledged.

Dr Putri spoke about the personal difficulties she had to overcome undertaking this research, as well as the support she received from her supervisors at Monash Rural Health.

“My supervisors at Monash Rural Health not only guided me about conducting research and writing peer-reviewed articles, but also about surviving PhD degrees. I was pregnant during my first year and I remember the advice my supervisor gave "PhD is not your entire life, it is just a part of life, and in the process of completing PhD you can still have your life, you can have kids, you can take care of your family, you can have another kid if you like, and so on".

I felt very much respected in the topics I chose, the opinion I shared, the decisions I made, and most importantly, the way that I'd finally developed my research project.”

Published peer-reviewed materials from Dr Putri’s thesis have already been cited by researchers in the Philippines, Nepal, Thailand, Australia, and Europe. Dr Putri also presented her thesis results at a national public health association conference where she won the second prize for best oral presentation in 2022.

“The 4 years of PhD experience taught me the 4 key ingredients of a successful postgraduate research degree: supervisors, funding, colleagues, and family support. I had 3 of those fulfilled by Monash Rural Health.”

Learn more about Research degrees with Monash Rural Health.