PM&R Scenario in Thailand

  Sukajan Pongprapai M.D.

Thai Rehabilitation Medicine Association

Demographic data : Thailand is located in Southeast Asia and devided into 76 provinces. With an area of 513,115 sq km (198,115 sq mi), the country is similar in size to France. By 2006 the total population had increased to 64,631,595, giving a population density of 126 persons per sq km (327 per sq mi), still one of the lowest in Asia. The proportion of the Thai population that is elderly has grown in recent decades, with 8 percent of the population age 65 or older in 2006. This number is expected to reach 14 percent by 2025. Infant mortality rate- is 6.5/1,000 , life expectancy is 65.2 years in male and 73.4 years in female. In 2001 The National Statistic Office together with the Ministry of Public Health conducted household disability survey and found 1,100,761 persons with disability ( 1.8% of population ). On the various types of disability, the survey ranked the following starting with the most common: a.       Mobility impairment at 19.6 per cent; b.      Hearing impairment at 13.2 per cent; c.       Intellectual impairment at 10 per cent; d.      Speech impairment at 5.4 per cent; e.       Visual impairment at 1.9 per cent.

  Rehabilitation Service: There were 343 physiatrists by the year 2006 and 60 percents were located in central Thailand. The first Thai law specifically dealing with persons with disabilities is the Rehabilitation for Disabled Persons Act 1991, this landmark Act was the result of a co-operative effort involving the government, the private sector, academic, and organizations of persons with disabilities and served as a starting point for persons with disabilities in their quest for greater participation and equality. Under the Act, people with disabilities have rights to the following services: medical, educational and occupational rehabilitation, job placement and community support. However, disabled persons who wish to receive such services have to register. Community-Based Rehabilitation services have been provided to all 76 provinces under training and management by Sirindhorn National Medical Rehabilitation Center , Division in Department of Medical Services , Minister of Public Health. Five percents of Thai Physiatrists have been working in private sectors.

Rehabilitation Training : There are 7 educational institutions qualified for Rehabilitation Medicine residency training in Thailand under Thai Medical Council and The Royal College of Physiatrists of Thailand. Three years of graduate medical education is necessary to train physicians in the field of Physical Medicine and Rehabilitation. The residents who complete and pass final evaluation for  Thai National Board Rehabilitation Medicine Examination will be certified for Thai Board of Rehabilitation Medicine. By the year 2007, there are quota of 33 Rehabilitation residency positions for application. National Residency Matching Program will be organized by The Royal College of Physiatrists of Thailand. There is no Rehabilitation subspecialty training nowadays but this will be the plan for the next decade. Recertification has not been yet done in Thailand but all physiatrist can collect CME credit through Continuing Medical Education Center under Thai Medical Council.