Abstract
BackgroundGeneral practice in the UK and other parts of the world is facing a recruitment crisis with insufficient numbers of medical students selecting it as a career choice. Denigration of general practice has been postulated as one of the contributing factors.AimTo explore comments about general practice as a career made by clinical teachers from the medical student’s perspective, and in doing so to further understand the current difficulties of recruiting into general practice.Design & settingA qualitative, explorative study of three focus groups of medical students from two medical schools in northern England.MethodA semi-structured interview format was utilised. The following four questions were posed to the participants about choosing general practice as a career: had they heard negative comments? Had they heard positive comments? Do they think comments influence student career decisions or is it a problem? Could they suggest any solutions to the issue? Results were analysed using thematic analysis.ResultsStudents reported hearing both positive and negative comments about general practice as a career choice. They perceived the comments to potentially influence student career choice. Three underlying themes emerged: the individual (personal characteristics of students affecting the influence that comments have on them); the curriculum (presence and content of general practice teaching); and culture (in the medical school and profession). These were used to postulate a model that may explain how negative comments shape students’ perceptions of general practice.ConclusionDenigration of general practice is an ongoing problem within the medical profession and strategies to address it must be developed or recruitment to the specialty will continue to decline. This study suggests a model that can help to understand the complex relationship between different factors that result in negative comments being taken on board by medical students.
Highlights
In recent years, there has been a significant increase in the primary care workload in the UK and internationally.[1]
In response to the questions that were posed to the participants, students reported hearing both positive and negative comments about general practice;. they perceived the comments to potentially influence career choice; and they raised some potential solutions to combat denigration
Many examples were reported of clinical teachers making comments that denigrate general practice as a career choice (FGp = focus group 1, 2, or 3):
Summary
There has been a significant increase in the primary care workload in the UK and internationally.[1]. Studies carried out in Australia and New Zealand have reported similar factors that influence the career choices of medical students They highlight the influence of negative comments about general practice on medical student career choice.[9,10] Focus groups and surveys of junior doctors have explored this issue and participants in these studies reported that exposure to this phenomenon started as an undergraduate.[11,12] Work from the US suggested that students attending medical schools with higher levels of denigration produced fewer primary care clinicians,[13] but this has not been explored in depth with medical students themselves. This study suggests a model that can help to understand the complex relationship between different factors that result in negative comments being taken on board by medical students
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