Pain medicine specialists in compulsory service: Struggles, limitations, and policy needs

Objectives: Compulsory service programs aim to improve healthcare equity by distributing specialists to underserved regions. However, pain medicine specialists face unique challenges, including professional isolation, limited resources, financial dissatisfaction, and restricted career growth. This study evaluates their experiences and explores potential policy improvements.
Methods: A cross-sectional survey was conducted among pain medicine specialists who have completed or are fulfilling compulsory service. The survey included multiple-choice, Likert-scale, and open-ended questions assessing demographics, workload, resource availability, financial compensation, career impact, and job satisfaction. Descriptive statistics and thematic analysis were applied using SPSS 20.0.
Results: Forty-nine specialists participated, with an average of 15.1 years in practice. Reported challenges included inadequate access to essential medical equipment (36.8%), lack of trained support personnel (67.3%), and professional isolation (63.3%). Financial dissatisfaction was high (48.9%), and 65.3% lacked additional housing or travel support incentives. Career limitations were notable, with 40.8% reporting restricted access to continuous education and 45.7% feeling that compulsory service negatively impacted their professional growth. Safety concerns, including workplace security and encounters with drug-seeking patients, were raised by 27.7% of respondents.
Conclusion: Compulsory service poses significant challenges, affecting job satisfaction, career advancement, and service effectiveness. Policy improvements should include structured financial incentives, better resource allocation, support for continued education, and enhanced workplace security to improve retention and care quality in underserved areas.