Career intentions and perceptions of general practice on entry to medical school: baseline findings of a longitudinal survey at three UK universities.

Paul O Wilkinson,Diana F Wood,Efthalia Massou,Alys Burns,Roger Tisi,James Brimicombe,Richard Darnton,John Kinnear

doi:10.3399/bjgpo.2021.0120

Abstract

BackgroundMedical graduates from the universities of Oxford and Cambridge have a lower intention to become GPs compared with other UK medical graduates. It is not clear to what extent this difference is present on admission to medical school.AimTo compare the career intention and influencing factors of students on admission to different UK medical schools.Design & settingFirst year of a 6-year prospective cohort study of medical students admitted in autumn 2020 to the three East of England medical schools: University of East Anglia (UEA), University of Cambridge (UOC), and Anglia Ruskin University (ARU).MethodAn online survey instrument was administered at the beginning of the first year. This measured self-reported career interests and various influencing factors, including perceptions of general practice.ResultsUOC students declared a lower intention to become a doctor, a higher likelihood of choosing careers in pathology and public health, and a much lower likelihood of becoming a GP than students of UEA or ARU (all at P<0.001). In all three schools, the phrases least associated with general practice were 'opportunities for creativity/innovation' and 'research/academic opportunities', whereas the phrases most associated with general practice were 'favourable working hours' and 'flexibility'. However, research/academic opportunities were far more important, and favourable working hours far less important, to UOC students (P<0.001 for both) than to students of UEA or ARU.ConclusionUOC students’ lower intention to become a GP appears to be present on entry to medical school. This may be explained in part by these students placing a higher importance on research/academic opportunities, combined with the widely held perception that GP careers lack these opportunities.

Highlights

There is an imperative on UK medical schools to produce future GPs1,2 and UK medical schools vary in the proportion of their graduates who enter GP training.[3,4] Historically, the universities of Oxford and Cambridge are the furthest outliers in this regard, with very low numbers of their graduates entering GP training.[5]
The phrases least associated with general practice were 'opportunities for creativity/innovation' and 'research/academic opportunities', whereas the phrases most associated with general practice were 'favourable working hours' and 'flexibility'
Author Keywords: career choice, intention, medical schools, medical students, perception, primary healthcare, prospective studies, general practice. How this fits in Medical school curricula are thought to influence intention to choose GP careers

Summary

Introduction

There is an imperative on UK medical schools to produce future GPs1,2 and UK medical schools vary in the proportion of their graduates who enter GP training.[3,4] Historically, the universities of Oxford and Cambridge (collectively termed ‘Oxbridge’) are the furthest outliers in this regard, with very low numbers of their graduates entering GP training.[5]. There have been a number of cross-s ectional surveys investigating medical student career preferences and self-reported influencing factors,[7,8,9,10,11] and a few of these[7,10] have explored the degree to which medical students perceive GP careers as possessing these factors None of these surveys have included measures of intolerance of uncertainty,[12] which is significant, given that problem- based learning (PBL) is characterised by a response to uncertainty,[13] and medical schools that employ a PBL approach have been shown to produce more future GPs.[4]. It is not clear to what extent this difference is present on admission to medical school

Objectives

Methods

Results

Discussion

Conclusion