How Experiences in a Medical School Affect Medical Students’ Attitudes Toward Family Medicine as a Career Choice: A Mixed-Method Study

Mapping Intimacies ◽

10.21203/rs.3.rs-110365/v1 ◽

2020 ◽

Author(s):

Kwanchanok Homsangpradit ◽

Saipin Hathirat ◽

Sutida Sumrithe

Keyword(s):

Medical Students ◽

Family Medicine ◽

Medical School ◽

Career Choice ◽

Family Physician ◽

Mixed Method ◽

Family Physicians ◽

Holistic Care ◽

Mixed Method Study ◽

Students Attitudes

Abstract Background: Family practice is the key element of a primary care system. A shortage of family physicians is an important issue in Thailand. However, Thai medical students still show low interest in pursuing a career in family medicine. The objective of this research is to study how a curriculum, an extra-curricular activity, and a hidden curriculum in a medical school affect medical students’ attitude toward family medicine as their career choice.Methods: This research is a mixed-method study with a sequential-explanatory design. The quantitative part is an online questionnaire to obtain a distribution of interest in a career of family physician. It was distributed among 181 senior medical students of Ramathibodi medical school; out of which 64 have participated. In the qualitative part, a total of 14 students who met the inclusion criteria were chosen from the questionnaire and from a snowball sampling to participate in an in-depth interview. Thereafter, a content analysis was done to identify themes.Results: Four out of 64 participants showed interest in a career of family physician, but only one participant was strongly interested. As the whole curriculum focuses mostly on specialty contents, only the family medicine department teaches holistic care and students find it difficult to understand. Some students perceive that a psychosocial assessment intrudes too much into a patient’s personal life and is not a physician task. The examination-based curriculum causes them to lack spare time to participate in any extra-curricular activity. The students received both positive and negative comments about family physicians from other specialists. However, this hidden curriculum does not have a direct impact on the student’s decision to choose their career path. Important factors that influence the decision are their personal interests, masteries, family factors, a work-life balance, and a humanized environment. Conclusions: Experiences in medical school have an impact on medical students’ attitudes toward family physician as a career choice. A disease-oriented care model is still dominating Thai medical education. Therefore, the curriculum needs to be reformed to promote the importance of holistic care. This will lead to an increase in the production of Thai family physicians.

Download Full-text

Medical Students’ Attitudes towards Careers in Primary Care in Singapore

10.21203/rs.3.rs-34481/v1 ◽

2020 ◽

Author(s):

Humairah Zainal ◽

Helen Elizabeth Smith

Keyword(s):

Primary Care ◽

General Practice ◽

Medical Students ◽

Family Medicine ◽

Medical School ◽

Medical Schools ◽

School Experience ◽

Ageing Population ◽

Family Doctors ◽

Students Attitudes

Abstract Background: Singapore needs more family doctors to care for its ageing population and their chronic conditions. To boost the recruitment of doctors within primary care, we need to better understand medical students’ attitudes and experience of General Practice and Family Medicine. While many studies have explored the facilitators and barriers to teaching undergraduate medical students in this field of medicine from the perspectives of GP teachers and trainers, few have examined students’ exposure to primary care in medical schools. Although there are works on factors influencing students’ attitudes towards primary care careers, the roles of medical schools, professional bodies and state institutions tend to be discussed independently of one another. This article explores medical students’ perceptions towards careers in primary care and how different stakeholders might collaborate in strengthening the medical school experience. Methods: Six focus groups involving 54 students from three medical schools in Singapore were conducted. Discussions focussed on their primary care experience, their professional and career aspirations, and perceptions towards the opportunities and challenges of primary care careers. Thematic analysis was used to interpret the qualitative data. Results: 15 key themes emerged from the discussions; 10 reflected key concerns of pursuing primary care careers whereas 5 others highlighted their positive aspects. The former include society’s perceptions of primary care professions as sub-standard, specialists’ negative attitudes towards family doctors, the emphasis on the lifestyle benefits of primary care careers rather than their professional characteristics, mundane case mix, limited professional opportunities, lack of continuity of care, limited consultation time, low remuneration, need for business acumen, and conflicts created by business in clinical care. However, the respondents also articulated positive views, including its lifestyle benefits, autonomy of private practice and better patient care, opportunities for entrepreneurialism and a portfolio career, breadth of clinical problems presented, and an improved future for General Practice and Family Medicine. Conclusion: The findings demonstrate that coordinated initiatives from multiple stakeholders would help to increase the attractiveness of primary care as a career choice among students. Improvements in the medical school experience will significantly enhance the prestige of General Practice and Family Medicine.

Download Full-text

Association of Family Medicine Interest at Matriculation to Medical School and FMIG Participation With Eventual Practice as a Family Physician

Family Medicine ◽

10.22454/fammed.2019.239373 ◽

2019 ◽

Vol 51 (8) ◽

pp. 682-686 ◽

Cited By ~ 1

Author(s):

Amanda Kost ◽

Kimberly Kardonsky ◽

Jeanne Cawse-Lucas ◽

Tomoko Sairenji

Keyword(s):

Family Medicine ◽

Medical School ◽

Family Physician ◽

Family Physicians ◽

The United States ◽

Specialty Choice ◽

Odds Ratios ◽

Binary Logistic Regression Model ◽

University Of Washington ◽

Predicted Probability

Background and Objectives: An adequate family medicine workforce is needed to improve health and health care outcomes in the United States, yet few medical students in the US become family physicians. Indicators of family medicine interest upon medical school matriculation exist. Family medicine interest groups (FMIGs) may influence student choice. This study examines the association of FMIG participation with various matriculation interest indicators to predict which students go on to become family physicians. Methods: The American Medical Association Masterfile was used to identify the practice specialty of 601 graduates of the University of Washington School of Medicine who matriculated between 2003 and 2007. Graduates’ scores on the Family Medicine Interest Survey (FMIS) and whether a student listed family medicine as their top choice upon matriculation along with FMIG participation and demographic characteristics were used in a binary logistic regression model to predict eventual practice. The model output was used to calculate odds ratios and predicted probabilities of family medicine practice given initial family medicine interest and FMIG participation. Results: FMIG participation was associated with higher odds ratios and increased predicted probability of becoming a family physician regardless of initial interest although the magnitude of the difference varied. FMIG participants who listed family medicine as their top specialty had a 68% predicted probability of entering family medicine compared to 8% probability if they did not list family medicine first and did not participate in FMIG. FMIG participation was associated with odds ratios between 3.27-4.19 for entering family medicine regardless of FMIS score. Conclusions: Among University of Washington students with family medicine as their top specialty choice upon matriculation, FMIG participation was associated with higher odds of entering the specialty. The same was true, although to a lesser degree, for students who had a high score on the FMIS.

Download Full-text

Do non-terminally ill adults want to discuss the end of life with their family physician? An explorative mixed-method study on patients’ preferences and family physicians’ views in Belgium

Family Practice ◽

10.1093/fampra/cmx125 ◽

2017 ◽

Vol 35 (4) ◽

pp. 495-502 ◽

Cited By ~ 9

Author(s):

Aline De Vleminck ◽

David Batteauw ◽

Tijs Demeyere ◽

Peter Pype

Keyword(s):

End Of Life ◽

Family Physician ◽

Mixed Method ◽

Terminally Ill ◽

Family Physicians ◽

Mixed Method Study ◽

Ill Adults

Download Full-text

Long-term evaluation of undergraduate family medicine curriculum in Slovenia

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0806274s ◽

2008 ◽

Vol 136 (5-6) ◽

pp. 274-279 ◽

Cited By ~ 6

Author(s):

Igor Svab ◽

Marija Petek-Ster

Keyword(s):

Medical Students ◽

Family Medicine ◽

Medical School ◽

Career Choice ◽

Curriculum Reform ◽

Learning Objectives ◽

Career Preference ◽

Term Evaluation

Introduction In 1994, as a result of curriculum reform, the Ljubljana medical school established its first department of family medicine and introduced its first curriculum of family medicine. The new subject was well accepted by the students and the medical school. Nevertheless, there was no comprehensive analysis of the curriculum during this period. Objective Our aims were to assess the quality of teaching based on fulfilled expectations, pre-defined learning objectives and satisfaction in a 10-year period, and to measure changes in career preference towards family medicine. Method An analysis of two sets of questionnaires, routinely given to medical students in academic years 1997/1998 and 2006/2007, was made. Results Most of the students' expectations were met, and the level increased over ten years. The level of achievement of learning objectives has been high and increased over the ten-year period. Family medicine still receives high scores in students' satisfaction. Although there is evidence that the family medicine curriculum is well accepted and that it improves some of the attitudes towards family medicine, it does not influence the career choice of students. Conclusion The level of achievement of learning objectives increased with the experiences of the teachers. We improved the attitude of medical students toward general practice and general practitioners. We have not been successful in influencing career choice of students, which is an objective that is probably outside our reach.

Download Full-text

Psychosocial Beliefs of Medical Students Planning to Specialize in Family Medicine

Psychological Reports ◽

10.2466/pr0.1997.80.3.987 ◽

1997 ◽

Vol 80 (3) ◽

pp. 987-992 ◽

Cited By ~ 1

Author(s):

Fred W. Markham ◽

James J. Diamond

Keyword(s):

Internal Medicine ◽

Medical Students ◽

Family Medicine ◽

Family Physicians ◽

Female Students ◽

Further Training ◽

Senior Year ◽

Family Doctors ◽

Fourth Year Medical Students ◽

Belief Scale

The psychosocial orientation of fourth-year medical students planning careers in family medicine was compared to those selecting other specialities using the Physician Belief Scale. This scale has shown that practicing family physicians have a greater psychosocial orientation than those in other specialities such as internal medicine. The current study was done to see whether students choosing family medicine already have this greater orientation before they begin training as residents. 664 fourth-year medical students received surveys during their senior year and 378 (57%) returned completed surveys. Female students had a significantly greater psychosocial orientation than their male peers, but there were no significant differences between students planning residencies in family medicine and those selecting other residencies. The greater orientation of family doctors would appear to be a product of further training and experience either during residency or later during the actual practice of family medicine.

Download Full-text

Emergency medicine as a career choice: a descriptive study of Canadian medical students

CJEM ◽

10.1017/s1481803500011210 ◽

2009 ◽

Vol 11 (03) ◽

pp. 196-206 ◽

Cited By ~ 12

Author(s):

Ian M. Scott ◽

Riyad B. Abu-Laban ◽

Margot C. Gowans ◽

Bruce J. Wright ◽

Fraser R. Brenneis

Keyword(s):

Emergency Medicine ◽

Family Medicine ◽

Medical School ◽

Career Choice ◽

Demographic Data ◽

School Entry ◽

Social Orientation ◽

Scope Of Practice ◽

Medical Specialties ◽

Hospital Orientation

ABSTRACTBackground:Studies indicate that a student's career interest at medical school entry is related to his or her ultimate career. We sought to determine the level of interest in emergency medicine among students at the time of medical school entry, and to describe characteristics associated with students primarily interested in emergency medicine.Methods:We surveyed students in 18 medical school classes from 8 Canadian universities between 2001 and 2004 at the commencement of their studies. Participants listed their top career choice and the degree to which a series of variables influenced their choices. We also collected demographic data.Results:Of 2420 surveys distributed, 2168 (89.6%) were completed. A total of 6.1% (95% confidence interval 5.1%–7.1%) of respondents cited emergency medicine as their first career choice. When compared with students primarily interested in family medicine, those primarily interested in emergency medicine reported a greater influence of hospital orientation and a lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical specialties, those primarily interested in emergency medicine were more likely to report medical lifestyle and varied scope of practice as important influences. When compared with students primarily interested in the medical specialties, those who reported interest in emergency medicine were more likely to report that a hospital orientation and varied scope of practice were important influences, and less likely to report that social orientation was important.Conclusion:Students primarily interested in emergency medicine at medical school entry have attributes that differentiate them from students primarily interested in family medicine, the surgical specialties or the medical specialties. These findings may help guide future initiatives regarding emergency medicine education.

Download Full-text

On Teaching the Sum While Paying Attention to the Parts: Whole Person Care through Ethnography in Medical Education

International Journal of Whole Person Care ◽

10.26443/ijwpc.v2i2.96 ◽

2015 ◽

Vol 2 (2) ◽

Author(s):

Vasiliki Nataly Rahimzadeh ◽

David Lessard ◽

Peter Nugus

Keyword(s):

Medical Students ◽

Family Medicine ◽

Medical School ◽

Professional Identity ◽

Identity Formation ◽

Medical Training ◽

Academic Discipline ◽

Professional Identity Formation ◽

Patient Centered ◽

Whole Person

Objective—This article provides a reflection on medical teaching opportunities for whole person care based on our experiences mentoring 2nd-year medical students through an Ethnography Practicum at a Canadian university. Background—The Ethnography Practicum is a new addition to the Family Medicine Transition to Clinical Practice (TCP) curriculum introduced in the second year of medical school at McGill University. It involves 30 hours of instruction (6 hours in lectures with an instructor, and 24 hours in small-group tutorials with the authors), and 9 hours of fieldwork observations in various community health settings across Montreal, QC. The primary aims of the Practicum converge with those of the TCP generally in two important ways: to inculcate in students the concepts of patient centered care, and to promote family medicine as both an academic discipline and career option. Results and Discussion— Our experiences illustrate two tensions that shape students’ expectations and experiences throughout their involvement in the Practicum and, in turn, highlight the implications for teaching whole-person care. First, ethnography as a combination of different methods has itself been the locus of tensions between positivist and critical traditions in the three last decades. Second, the Practicum is situated precisely at the crossroads of key moments on the professional identity formation continuum for our students. Such a crossroads is disruptive to the status quo of medical traineeship characteristic of the first two years in medical school, and thus reorients professional identity formation. The above tensions reveal how ethnography is not only a revered research tradition in the humanities, but can also be a conduit to whole person care-inspired clinical practice.Conclusion—As instructors and mentors involved in this Ethnography Practicum, we are continually forging a new relevance for organizational ethnography in medical training, where medical students can reflect and act on competencies beyond clinical ones. The Practicum provides a space for students to wrestle with alternative epistemologies to understanding the social world in which medicine is embedded. We lastly provide pragmatic ways to better address these tensions in an effort to support students as they proceed through the (multifaceted) development of their professional identities as future physicians.

Download Full-text

Factors Associated with Choice of Career in Family Medicine Among Junior Doctors in Oman

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2020.20.03.014 ◽

2020 ◽

Vol 20 (3) ◽

pp. 337

Author(s):

Asma Ali Al-Salmani ◽

Asma Al-Shidhani ◽

Najlaa Jaafar ◽

Abdulaziz Al-Mahrezi

Keyword(s):

Family Medicine ◽

Career Choice ◽

Family Physicians ◽

Medical Specialty ◽

World Health ◽

Junior Doctors ◽

Myers Briggs Type Indicator ◽

Factors Influencing ◽

Type Indicator ◽

Myers Briggs

Objectives: The number of family physicians in Oman is far below that recommended by the World Health Organization. This study aimed to determine factors influencing junior doctors’ choice of a career in family medicine. Methods: This cross-sectional study was conducted between March and June 2018 and targeted applicants to Oman Medical Specialty Board residency programmes during the 2018–2019 academic year. Applicants were grouped according to their choice of either family medicine (n = 64) or other specialities (n = 81). A self-administered questionnaire was utilised to compare the applicants’ sociodemographic characteristics, factors influencing their choice of career and their Myers-Briggs Type Indicator® (MBTI) personality traits. Results: A total of 52 family medicine and 43 other residency applicants participated in the study (response rates: 81.3% and 53.1%, respectively). Most family medicine applicants were female (86.5%), married (65.4%) and resided in rural areas (73.1%); moreover, 19.2% were ≥30 years of age. Overall, emphasis on continuity of care, opportunity to deal with a variety of medical problems, the ability to use a wide range of skills and knowledge, early exposure to the discipline, opportunity to teach and perform research and the influence of family or friends were important factors in determining choice of a career in family medicine. Moreover, the MBTI analysis revealed that family medicine applicants were commonly extroverted-sensing-thinking-judging personality types. Conclusion: Knowledge of the factors influencing career choice among junior doctors may be useful in determining future admission policies in order to increase the number of family physicians in Oman.Keywords: Career Choice; Internship and Residency; Medical Specialty; Family Practice; Family Physicians; Myers-Briggs Type Indicator; Oman.

Download Full-text

Psychiatry as a career choice among medical students: a cross-sectional study examining school-related and non-school factors

BMJ Open ◽

10.1136/bmjopen-2018-022201 ◽

2018 ◽

Vol 8 (8) ◽

pp. e022201 ◽

Cited By ~ 1

Author(s):

Lee Seng Esmond Seow ◽

Boon Yiang Chua ◽

Rathi Mahendran ◽

Swapna Verma ◽

Hui Lin Ong ◽

...

Keyword(s):

Mental Illness ◽

Medical Students ◽

Medical School ◽

Career Choice ◽

Personality Traits ◽

Psychiatric Training ◽

Outcome Variable ◽

Personality Factors ◽

School Factors ◽

Cross Sectional

ObjectivesGiven the low recruitment to psychiatry worldwide, the current study aimed to examine how premedical and intramedical school factors, perception of career aspects, attitudes towards psychiatry, stigma towards mental illness and personality traits may affect the likelihood of psychiatry as a career choice.DesignCross-sectional online study.Participants502 medical students from two public medical institutions in Singapore.MethodsWe critically examined existing literature for factors identified to influence psychiatry as a career choice and explored their effects in a group of medical students in Singapore. To avoid overloading the regression model, this analysis only included variables shown to have significant association (p<0.05) with the outcome variable from the initial Χ2test and independent t-test analyses.ResultsA considerable number of non-medical school factors such as preschool influence and interest, personality traits and importance of a high status specialty in medicine were found to affect students’ choice of psychiatry as a career. Among medical school factors, attending a psychiatry/mental health club was the only influential factor. Negative attitudes towards psychiatry, but not stigma towards people with mental illness, significantly predicted the likelihood of not choosing psychiatry as a career.ConclusionsImproving educational environment or teaching practice in psychiatric training may aid in future recruitment for psychiatrists. While the changing of premedical school influences or personality factors may be infeasible, medical schools and psychiatry institutes could play a more critical role by enhancing enrichment activities or clerkship experience to bring about a more positive attitudinal change towards psychiatry among students who did consider a career in psychiatry.

Download Full-text