Students' motivation in choosing general practice for their career pathway: a middle-income country report, Indonesia.

Hikmawati Nurokhmanti Hikma,Ova Emilia Ova,Mora Claramita Mora

doi:10.5116/ijme.6209.1974

Hikmawati Nurokhmanti Hikma, Ova Emilia Ova + Show 1 more

Open Access

https://doi.org/10.5116/ijme.6209.1974

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Abstract

ObjectivesTo understand the medical students’ perspectives and influential factors on their career pathway decision to be a General Practitioners (GP) in Indonesia. MethodsThis research used sequentially mixed methods. The qualitative study was conducted using focus group discussions with 30 third-year students, followed by in-depth interviews with 15 students from one Indonesian institution with the highest level of accreditation. The qualitative data, together with the literature review, were used to construct an online questionnaire with three types of questions. ResultsThe survey response rate reached 81% from 2,240 students across 64 faculties of medicine in Indonesia. Responses indicated that GP is not preferred as the leading career choice, and 67% of students prefer to become hospital specialists. The qualitative data revealed several influencing factors in choosing GP as their ultimate career choice: more family time, being closer to the community, and interest in bio-psycho-social subjects. Meanwhile, the reasons not to choose GP as a career choice were: imbalance in work and life, less authority, being at the lowest level position in the health care system, high uncertainty, and low financial incentives. ConclusionsGP is not an interesting career option for most medical students in this study. Considering GP works strategically in primary care settings aiming at better health outcomes and optimizing the health care financial system with greater patient satisfaction, influential positive factors to be GP should be nurtured in the medical curriculum.

Highlights

Starfield (1998) defined the term primary care as an integrated and accessible health care service with clinicians who are capable of dealing with community health care needs, building sustainable relationships with patients, and practicing under family and community circumstances.[1]
Primary care services are essential for all countries, including the Indonesian health care system, which must deal with the triple burden of diseases: non-communicable and communicable diseases along with low to non-existent resources.[5]
Becoming General Practitioner would only be a temporary option for them before they choose specialties in medicine: “general practitioner (GP)....it is something positive but how to explain....it is positive as a starting career....” (FGD)

Summary

Introduction

Starfield (1998) defined the term primary care as an integrated and accessible health care service with clinicians who are capable of dealing with community health care needs, building sustainable relationships with patients, and practicing under family and community circumstances.[1]. This discipline requires specific clinical skills to manage and identify undifferentiated symptoms and match patients’ needs with health care resources.[2]. Those specific characteristics in primary health care services are essential for a general practitioner (GP) or family physician. Primary care services are essential for all countries, including the Indonesian health care system, which must deal with the triple burden of diseases: non-communicable and communicable diseases along with low to non-existent resources.[5]

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