Future medical student practice intentions: the South Africa experience

Amy Clithero-Eridon,Andrew Ross,Cameron Crandall

doi:10.1186/s12909-020-02361-5

Amy Clithero-Eridon, Andrew Ross + Show 1 more

Open Access

https://doi.org/10.1186/s12909-020-02361-5

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Abstract

BackgroundPrimary care is a broad spectrum specialty that can serve both urban and rural populations. It is important to examine the specialties students are selecting to enter, future community size they intend to practice in as well as whether they intend to remain in the communities in which they trained.AimThe goals of this study were to characterize the background and career aspirations of medical students. Objectives were to (1) explore whether there are points in time during training that may affect career goals and (2) assess how students’ background and stated motivations for choosing medicine as a career related to intended professional practice.SettingThe setting for this study was the Nelson R. Mandela School of Medicine, located in Durban, South Africa.MethodsWe conducted a cross-sectional survey of 597 NRMSM medical students in their first, fourth, or sixth-year studies during the 2017 academic year.ResultsOur findings show a noticeable lack of interest in primary care, and in particular, family medicine amongst graduating students. Altruism is not as motivating a factor for practicing medicine as it was among students beginning their education.ConclusionSelection of students into medical school should consider personal characteristics such as background and career motivation. Once students are selected, local context matters for training to sustain motivation. Selection of students most likely to practice primary care, then emphasizing family medicine and community immersion with underserved populations, can assist in building health workforce capacity. There are institutional, legislative, and market pressures influencing career choice either toward or away from primary care. In this paper, we will discuss only the institutional aspects.

Highlights

Primary care is a broad spectrum specialty that can serve both urban and rural populations
Our findings show a noticeable lack of interest in primary care, and in particular, family medicine amongst graduating students
Our findings suggest that altruistic motivation may be a factor for studying medicine at the beginning of medical school that is not sustained in subsequent years

Summary

Introduction

Primary care is a broad spectrum specialty that can serve both urban and rural populations. Clithero-Eridon et al BMC Medical Education (2020) 20:434 at both an individual and a community level. They are expert generalists who are trained to care for the majority of health problems seen over the life span in both clinics and district hospitals. Training physicians to meet the needs of communities requires a multipronged approach beginning with student selection, continuing with placement in appropriate contexts, and emphasizing primary care throughout the curriculum. Specific indicators include whether matriculating students selected into the training program demographically mirror the population served and whether graduating students choose to practice primary care and intend to practice in areas of high need such as underserved and rural areas [6]

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