Choosing to become a general practitioner - What attracts and what deters? An analysis of German medical graduates′ motives

Abstract

Background:To be able to counter the increasing shortage of general practitioners (GPs) in many countries, it is crucial to remain up-to-date with the decisive reasons why young physicians choose or reject a career in this field.Materials and Methods:Qualitative content analysis was performed using data from a cross-sectional survey among German medical graduates (n = 659, response rate = 64.2%). Subsequently, descriptive statistics was calculated.Results:The most frequent motives to have opted for a GP career were (n = 74/81): Desire for variety and change (62.2%), interest in a long-term bio-psycho-social treatment of patients (52.7%), desire for independence and self-determination (44.6%), positively perceived work-life balance (27.0%), interest in contents of the field (12.2%), and reluctance to work in a hospital (12.2%). The most frequent motives to have dismissed the seriously considered idea of becoming a GP were (n = 207/578): Reluctance to establish a practice or perceived associated risks and impairments (33.8%), stronger preference for another field (19.3%), perception of workload being too heavy or an unfavorable work-life balance (15.0%), perception of too low or inadequate earning opportunities (14.0%), perception of the GP as a distributor station with limited diagnostic and therapeutic facilities (11.6%), perception of too limited specialization or limited options for further sub-specialization (10.6%), rejection of (psycho-) social aspects and demands in general practice (9.7%), and perceived monotony (9.7%).Conclusion:While some motives appear to be hard to influence, others reveal starting points to counter the GP shortage, in particular, with regard to working conditions, the further academic establishment, and the external presentation of the specialty.

Medical students’ perspectives on earning opportunities of self-employed physicians — realistic and relevant for the process of career choice?

“…Our findings regarding the relevance of financial considerations are in line with international study results which reported an influence of income expectations on career decision making in medicine with a high consistency [2-4, 14, 15]. Also, for the German context it has been shown that the perceived financial conditions seem to play a crucial role for specialty choice and the decision of whether to establish one's own practice or not [6,7,10]. The participants in our study used all steps of our 10-point scale to quantify the influence of expected earnings on their personal career choice process, indicating fine inter-individual differences.…”

“…A recent study from Israel particularly emphasized the influence of a 'reasonable income to lifestyle ratio' on young physicians' career choice [9]. These findings are in line with results of a former study of our own research group, showing that the expectation of inadequate earning opportunities, in general or in relation to workload, was among the most frequently mentioned motives of German graduates to reject a career as a general practitioner (GP) [10]. However, according to data from a large German practice panel annually analysing the economic situation of physicians working self-employed in their own practices [11], the perception of a general and severe financial disadvantage for GPs compared to other specialists working self-employed or in hospital settings appears to be rather unfounded.…”

How a problem-based learning approach could help Japanese primary care physicians: a qualitative study

“…These drew on previous research about the reasons for choosing to become a GP, and gaps between GP training and subsequent clinical practice. 20,21,22,23 Three authors (MS, TJ, and HO) independently conducted the coding for SCAT Step 4. For themes and constructs where the assigned categories did not match, the three researchers discussed the issue and agreed on the final category allocation.…”

LeiKA: an optional German general practice teaching project for first-semester medical students: who is taking part and why? A cross-sectional study

“…It contained three sections addressing the following topics: sociodemographics, career preferences and job-related value orientations (an English translation is given in online supplementary file 1). A focus was set on sociodemographics and value orientations that have been described as typically associated with GP career choice in previous research 1 5 8 21…”