66
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Who wants to become a general practitioner? Student and curriculum factors associated with choosing a GP career - a multivariable analysis with particular consideration of practice-orientated GP courses

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective. Because of the increasing shortage of general practitioners (GPs) in many countries, this study aimed to explore factors related to GP career choice in recent medical graduates. Particular focus was placed on the impact of specific practice-orientated GP courses at different stages of the medical undergraduate curriculum. Design. Observational study. Multivariable binary logistic regression was used to reveal independent associations with career choice. Setting. Leipzig Medical School, Germany. Subjects. 659 graduates (response rate = 64.2%). Main outcome measure. Choice of general practice as a career. Results. Six student-associated variables were found to be independently related to choice of general practice as a career: age, having family or friends in general practice, consideration of a GP career at matriculation, preference for subsequent work in a rural or small-town area, valuing the ability to see a broad spectrum of patients, and valuing long-term doctor–patient relationships. Regarding the curriculum, after adjustment independent associations were found with a specific pre-clinical GP elective (OR = 2.6, 95% CI 1.3–5.3), a four-week GP clerkship during the clinical study section (OR = 2.6, 95% CI 1.3–5.0), and a four-month GP clinical rotation during the final year (OR = 10.7, 95% CI 4.3–26.7). It was also found that the work-related values of the female participants were more compatible with those of physicians who opt for a GP career than was the case for their male colleagues. Conclusion. These results support the suggestion that a practice-orientated GP curriculum in both the earlier and later stages of undergraduate medical education raises medical schools’ output of future GPs. The findings are of interest for medical schools (curriculum design, admission criteria), policy-makers, and GPs involved in undergraduate medical education. More research is needed on the effectiveness of specific educational interventions in promoting interest in general practice as a career.

          Related collections

          Most cited references33

          • Record: found
          • Abstract: not found
          • Book: not found

          Applied Logistic Regression

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Determinants of primary care specialty choice: a non-statistical meta-analysis of the literature.

            This paper analyzes and synthesizes the literature on primary care specialty choice from 1987 through 1993. To improve the validity and usefulness of the conclusions drawn from the literature, the authors developed a model of medical student specialty choice to guide the synthesis, and used only high-quality research (a final total of 73 articles). They found that students predominantly enter medical school with a preference for primary care careers, but that this preference diminishes over time (particularly over the clinical clerkship years). Student characteristics associated with primary care career choice are: being female, older, and married; having a broad undergraduate background; having non-physician parents; having relatively low income expectations; being interested in diverse patients and health problems; and having less interest in prestige, high technology, and surgery. Other traits, such as value orientation, personality, or life situation, yet to be reliably measured, may actually be responsible for some of these associations. Two curricular experiences are associated with increases in the numbers of students choosing primary care: required family practice clerkships and longitudinal primary care experiences. Overall, the number of required weeks in family practice shows the strongest association. Students are influenced by the cultures of the institutions in which they train, and an important factor in this influence is the relative representation of academically credible, full-time primary care faculty within each institution's governance and everyday operation. In turn, the institutional culture and faculty composition are largely determined by each school's mission and funding sources--explaining, perhaps, the strong and consistent association frequently found between public schools and a greater output of primary care physicians. Factors that do not influence primary care specialty choice include early exposure to family practice faculty or to family practitioners in their own clinics, having a high family medicine faculty-to-student ratio, and student debt level, unless exceptionally high. Also, students view a lack of understanding of the specialties as a major impediment to their career decisions, and it appears they acquire distorted images of the primary care specialties as they learn within major academic settings. Strikingly few schools produce a majority of primary care graduates who enter family practice, general internal medicine, or general practice residencies or who actually practice as generalists. Even specially designed tracks seldom produce more than 60% primary care graduates. Twelve recommendations for strategies to increase the proportion of primary care physicians are provided.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Applied Logistic Regression.

                Bookmark

                Author and article information

                Contributors
                Journal
                Scand J Prim Health Care
                Scand J Prim Health Care
                PRI
                Scandinavian Journal of Primary Health Care
                Informa Healthcare (Stockholm )
                0281-3432
                1502-7724
                March 2015
                March 2015
                : 33
                : 1
                : 47-53
                Affiliations
                Department of Primary Care, Leipzig Medical School , Leipzig, Germany
                Author notes
                Correspondence: Tobias Deutsch, Department of Primary Care, Leipzig Medical School , Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany. Tel: 00 49 341 97 15 710. Fax: 00 49 341 97 15 719. E-mail: tobias.deutsch@ 123456medizin.uni-leipzig.de
                Article
                1020661
                10.3109/02813432.2015.1020661
                4377739
                25761999
                4d42994a-37d9-4c5b-a9eb-a3c544bc1f30
                © 2015 The Author(s)

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0)

                History
                : 15 July 2014
                : 04 February 2015
                Categories
                Original Article

                career choice,curriculum,general practice,germany,primary care physician shortage,undergraduate medical education

                Comments

                Comment on this article