Abstract
Producing enough doctors working in general practice or rural locations, or both, remains a key global policy focus. However, there is a lack of evidence about doctors’ emerging commitment to these decisions. This study aimed to explore changes in the level of certainty about career interest in working in general practice and working rurally, as doctors pass through various early career stages. The participants were 775 eligible respondents to a 2019 survey of medical graduates of The University of Queensland from 2002–2018. Certainty levels of specialty choice were similar between GPs and specialists up until the beginning of registrar training. At that point, 65% of GPs compared with 80% of other specialists had strong certainty of their specialty field. Consistently (and significantly) less of those working rurally had strong certainty of the location where they wanted to practice medicine at each career time point. At the start of registrar training, a similar gap remained (strong certainty: 51% rural versus 63% metropolitan). This study provides new evidence that career intent certainty is more delayed for the cohort choosing general practice and rural practice than the other options. The low level of certainty in early career highlights the importance of regular positive experiences that help to promote the uptake of general practice and rural practice.
Highlights
The aim of this study is to explore changes in the level of certainty about career interest in working in general practice and working rurally, as doctors pass through various early career stages
When participants reflected about the timing of their specialty decision, the proportion reporting strong certainty varied enormously from the beginning of medical school through to the point of completing all specialty training (Figure 1)
At the start of their registrar training, more notable differences emerged, with around 65% of GPs compared with 80% of non-GP specialists having strong certainty of the specialty field they wanted to practice and this difference remained at 76% (GP specialists) versus 93%
Summary
Increasing the proportion of doctors who specialise in general practice (primary care), work rurally, or both, remain key global policy goals [1,2]. Primary care doctors play an important contribution to addressing most of the population’s health needs, as an effective and efficient way to improve health outcomes over relying on specialised services [3]; in many countries a high proportion of recent graduates are opting to pursue other specialties [4,5,6]. The main way to effect changes in these outcomes is to understand the dynamics of decisions around specialty and the location of work in a doctor’s early career, as the likelihood of changes to these both decrease with age [10]
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