Abstract
BackgroundAgainst the background of the recruitment crisis in general practice, we aimed to determine what United Kingdom (UK) medical students value in their future careers, how they perceive careers in general practice (GP) and what influences them.MethodsCross-sectional survey of 280 final and penultimate year medical students at the University of Oxford, with questions relating to career choices, factors of importance when choosing a career and attitudes towards general practice as a career. Quantitative methods included cluster analysis, chi squared tests of independence and logistic regression analysis. Qualitative data were analysed thematically using the Framework method.ResultsResponse rate was 89% (280/315). 40% of participants said that general practice was an attractive or very attractive career option. Respondents valued job satisfaction, work-life balance and close relationships with patients. However, fewer than 20% of respondents agreed that community-based working was important to them and many (often citing particular GPs they had observed) felt that general practice as currently structured may not be satisfying or fulfilling because of high workload, financial pressures and externally imposed directives. 63% perceived GPs to have lower status than hospital specialties and 49% thought the overall culture of their medical school had negatively influenced their views towards general practice. Some respondents considered that general practice would not be intellectually challenging or compatible with a research career; some appeared to have had limited exposure to academic primary care.ConclusionsWith the caveat that this was a sample from a single medical school, medical students may be put off careers in general practice by three main things: low perceived value of community-based working and low status of general practice (linked to a prevailing medical school culture); observing the pressures under which GPs currently work; and lack of exposure to academic role models and primary care-based research opportunities. To improve recruitment of the next generation of GPs, medical schools must provide high quality placements in general practice, expose students to academic role models and highlight to policymakers the links between the current pressures in UK general practice and the recruitment crisis.
Highlights
Against the background of the recruitment crisis in general practice, we aimed to determine what United Kingdom (UK) medical students value in their future careers, how they perceive careers in general practice (GP) and what influences them
Over 30% of responders had attended nonselective state schools, 20% selective state schools and 43% private schools in the UK; 6% had attended secondary school outside of the UK, and 1% did not fit into these categories. 80% of responders provided some freetext responses (1066 comments in total), providing a very rich set of qualitative data
The median number of career choices selected was 3, from a list of 15, with 45% of respondents indicating that they were considering a career in general practice
Summary
Against the background of the recruitment crisis in general practice, we aimed to determine what United Kingdom (UK) medical students value in their future careers, how they perceive careers in general practice (GP) and what influences them. Health Education England has mandated that 50% of medical graduates should enter general practice [1] but no medical school is close to achieving this. This reflects a worldwide trend in which generalism is becoming less popular than specialism, with reports of shortages of GPs or family doctors in the United States (US) [2], Canada [3], Australia [4] and elsewhere. The formal curriculum may favour specialities through the disproportionate amount of time spent in hospital placements This in turn limits exposure to the informal curriculum (ad-hoc, unscripted, interpersonal teaching) within primary care. In the UK, certain medical schools have traditionally had low rates of progression to general practice [10] leading to accusations of “rank discrimination” against this career option [11]
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