RESEARCH Open Access Issues and challenges in recruitment for government doctors in Gujarat, India Bhaskar Purohit 1* and Tim Martineau 2 Abstract Background: India faces a critical shortage of government doctors in rural and underserved areas. Several measures have been introduced to address the shortage, but significant problems still remain. The main aim of the current research was to understand the existing recruitment-related policies and systems in place for government doctors in Gujarat and to identify issues that prevent effective recruitment of doctors that could have implications for doctors’ shortage in the state. The research also aims to fill the knowledge gap in the existing literature on why recruitment in civil services is an important HR function to address the shortage of doctors. Methods: The study aimed at identifying the existing recruitment policies and practices for government Medical Officers (MOs) from Gujarat state in India. The analysis is based on document review to understand the existing policies, 19 in-depth interviews with MOs to understand the systems in place for recruitment of MOs, construction of job histories from interviews to understand various nuances in the recruitment system and five interviews with Key Informants to understand recruitment policies and their actual implementation. Thematic framework approach was used to analyse qualitative data using NVivo. Results: While the state has general recruitment guidelines called the Recruitment Rules (RRs), these rules are very wide-ranging and fragmented. The MOs were neither briefed about them nor received copies of the rules at any time during the service suggesting that RRs were not transparent. The recruitment system was considered to be slow and very sporadic having possible implications for attraction and retention of MOs. The study results indicate several other system inefficiencies such as a long time taken by the health department to provide salary benefits and service regularization that has a negative effect over MOs’ motivation. The study also found unequal opportunities presented to different categories of MOs in relation to job security, salary benefits and in recognizing their previous work experience leaving MOs unclear about their future thereby influencing the attraction and retention of MOs to government jobs negatively. Conclusions: If long-term solutions are to be sought, the health department needs to have an effective recruitment system in place with the aim to (1) address the slow and sporadic nature of the recruitment system (that is likely to attract more doctors and prevent loss of any doctors during recruitment) and (2) address the job insecurity issue that MOs have which also influences their other employment benefits such as salary, pension and recognition for the years of service they have given to the health department. Addressing these issues can improve motivation among doctors and prevent loss of doctors through voluntary turnover leading to better retention. Keywords: Gujarat, India, Medical Officers, Civil Service, Recruitment, Public Service Commission, Attraction and Retention, Human Resource Management * Correspondence: bpurohit@iiphg.org 1 Indian Institute of Public Health Gandhinagar (IIPHG), Sardar Patel Institute Campus, Drive in Road, Thaltej, Ahmedabad 380054, India Full list of author information is available at the end of the article © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Purohit and Martineau Human Resources for Health (2016) 14:43 DOI 10.1186/s12960-016-0140-9