BackgroundIn Switzerland, the mean age of GPs in 1993 was 46. In 2015, it had increased to 55, and GPs over 65 made up 15% of the workforce of the about 6000 GPs. As older, self-employed GPs retire, young doctors will be needed to fill their positions and eventually take over their practices. We set out to determine what kind of employment young GPs wanted, if they thought their preference would change over time, and the working conditions and factors most important in their choice of practice.MethodsWe administered a cross-sectional online survey to members of the Swiss Young General Practitioners Association (n = 443). Our survey relied on closed questions, ratings of attractiveness of fictional job ads, and an open question to capture participants’ characteristics, and their preferred type of practice and working conditions.ResultsWe received 270 (61%) replies. Most were women (71%) and wanted to work in the suburbs or countryside in small GP-owned group practices, with up to five colleagues. Most intended to work part-time: mean desired workload was 78% for men and 66% for women. Positive working climate was a major factor in choosing a GP practice. Most participants projected a career arc from employment to ownership or co-ownership of a practice within five years; only 7–9% preferred to remain employees.ConclusionsYoung and future GPs in Switzerland want to work part-time in small, GP-owned group practices. Practices should offer them employment opportunities with a path to (co-)ownership.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-017-0591-7) contains supplementary material, which is available to authorized users.

Survival on chronic haemodialysis treatment in Switzerland compares favourably to international reference values. Dialysis withdrawal and the frequency of kidney transplantation impact long term patient outcome and should be adjusted for when comparing mortality analysis.

BackgroundThe American Fistula First Breakthrough Initiative currently aims for a 66% arterio-venous fistula (AVF) rate, while in the UK, best practice tariffs target AVF and arterio-venous graft (AVG) rates of 85%. The present study aims to assess whether these goals can be achieved.MethodsWe conducted a retrospective cohort study on patients who initiated haemodialysis from 1995 to 2006. Outcomes were the final failure-free survival of the first permanent access and the type of second access created. Prevalent use rates for the access types were calculated on the 1st January of each year for the second half of the study period.ResultsTwo hundred and eleven out of 246 patients (86%) received an AVF, 16 (6%) an AVG and 19 (8%) a permanent catheter (PC) as the first permanent access. Eighty-six (35%) patients had final failure of the primary access. One- and 3-year final failure-free survival rates were 73 and 65% for AVF compared with 40 and 20% for AVG and 62 and 0% for PC, respectively. In patients with primary AVF, female sex {hazard ratio (HR) 2.20 [confidence interval (CI) 1.29–3.73]} and vascular disease [HR 2.24 (CI 1.26–3.97)] were associated with a poorer outcome. A similar trend was observed for autoimmune disease [HR 2.14 (CI 0.99–4.65)]. As second accesses AVF, AVG and PC were created in 47% (n = 40), 38% (n = 33) and 15% (n = 13). The median prevalent use rate was 80.5% for AVF, 14% for AVG and 5.5% for PC.ConclusionsThe vascular access targets set by initiatives from the USA and UK are feasible in unselected haemodialysis patients. High primary AVF rates, the superior survival rates of AVFs even in patient groups at higher risk of access failure and the high rate of creation of secondary AVFs contributed to these promising results.

Overall, medical students and young physicians found similar features attractive in the general and GO-GP curriculum, regardless of region or gender, and thought an attractive curriculum would attract more young doctors to the GP specialty. Key points An attractive postgraduate training program in general practice can attract more young physicians to become GPs. In this study cross-sectional survey including medical students (n = 242) and young physicians (n = 312) we presented general features for a curriculum and a model curriculum for general practice training, for evaluation of attractiveness to our study population. General practice training curriculum provides flexibility in choice of rotations, access to short rotations in a wide variety of medical specialties, training in specialty practices as well, mentoring and career guidance by GPs and guidance in choosing courses/certificate programs necessary for general practice. These findings help building attractive postgraduate training programs in general practice and fight GP shortage.

Zusammenfassung. Gemäss einer früheren Prognose wird erwartet, dass bis 2025 in der Schweiz 5000 Hausärzte fehlen werden, da nur 10–20 % der Medizinstudierenden diesen Beruf wählten. Unsere Umfrage bei allen fortgeschrittenen Medizinstudierenden hatte zum Ziel, deren Karrierewunsch neu zu erheben. Neben der Wahrscheinlichkeit, Hausarzt zu werden und dem Zeitpunkt des Karriereentscheids wurden Faktoren rund um die Hausarztmedizin (Arzt-Patienten-Beziehung, Karrieremöglichkeiten, etc.) erhoben. Die Resultate zeigten, dass sich Massnahmen zur Stärkung der Hausarztmedizin gelohnt haben: 60 % der Befragten sind potenziell zukünftige Hausärzte (20 % entschlossen, 40 % interessiert), 15 % sind unsicher, 25 % entschlossen Nicht-Hausärzte. Für Hausarztmedizin sprachen: Arbeitsautonomie, Arzt-Patienten-Beziehung, Möglichkeit der Teilzeittätigkeit, ärztliche Tätigkeit. Dagegen sprachen: Einkommen, Reputation, politische Rahmenbedingungen. Hier muss angesetzt werden, um Hausarztkarrieren mit attraktiven Weiterbildungsprogrammen und Praxisbedingungen weiter zu fördern.