How well are Swiss French physicians prepared for future practice in primary care?

Abstract

BackgroundMoving from postgraduate training into independent practice represents a major transition in physicians’ professional life. Little is known about how Swiss primary care graduates experience such a transition. The aim of this study was to explore the extent to which primary care physicians who recently set up private practice felt prepared to work as independent practitioners.MethodsWe conducted 7 focus groups among recently established (≤ 5 years) primary care physicians in Switzerland. Questions focused on positive and negative aspects of setting up a practice, and degree of preparedness. Transcripts were analysed according to organisational socialisation and work role transition frameworks.ResultsParticipants felt relatively well prepared for most medical tasks except for some rheumatologic, minor traumatology, ENR, skin and psychiatric aspects. They felt unprepared for non clinical tasks such as office, insurance and medico-legal management issues and did not anticipate that the professional networking outside the hospital would be so important to their daily work. They faced dilemmas opposing professional values to the reality of practice which forced them to clarify their professional roles and expectations. Adjustment strategies were mainly informal.ConclusionAlthough the postgraduate primary care curriculum is longer in Switzerland than in most European countries, it remains insufficiently connected with the reality of transitioning into independent practice, especially regarding role development and management tasks. A greater proportion of postgraduate training, with special emphasis on these issues, should take place directly in primary care.

How group coaching contributes to organisational understanding among newly graduated doctors

“…Internationally, blueprints in specialist training of doctors stress the importance of gaining medical expert competence, as well as acquiring a broad range of competencies such as collaboration skills, intercollegial and interprofessional communication and leadership skills coupled with organisational knowledge and systems thinking, [1][2][3][4]. To practice at an expert level, doctors need to develop understanding of the organisation, communication and leadership skills [5][6][7][8][9][10][11]. Therefore, teaching leadership and understanding of the organisation should be part of specialist training.…”

Conceptualizing “Preparedness for Practice”: Perspectives of Early-Career Family Physicians

“…Competencies as elements of competence [36][37][38][39][40][41][42] were the most reported dimension in the studies (n=24/34, 70.5%). 2,[36][37][38][39][40][41][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] Confidence, with its related terms, was the second most cited dimension of preparedness in the literature. Self-confidence was identified in 10 studies (n=10/34, 29%) 37,40,41,44,46,51,54,55,59 , referring to the feeling of having a required skill or knowledge.…”

“…2,[36][37][38][39][40][41][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] Confidence, with its related terms, was the second most cited dimension of preparedness in the literature. Self-confidence was identified in 10 studies (n=10/34, 29%) 37,40,41,44,46,51,54,55,59 , referring to the feeling of having a required skill or knowledge. In the studies, self-confidence was used interchangeably with self-concept (n=1/34, 3%) 44 and self-efficacy (n=4/34, 12%).…”

“…40,44,51,59 Adaptability, the third dimension of preparedness for practice, refers to an individual's capacity to deal with and undertake actions in specific contexts that are new, changing, uncertain, or ambiguous. 41,46,60 Wiener-Ogilvie et al (2014) indicated that training in different contexts fosters adaptability by providing exposure to managerial approaches, clinical care approaches, and patient populations. 41 Capability, the fourth dimension, emerged in seven studies.…”

Transition entre la formation postgraduée et l’installation en cabinet : peut-on faire mieux ?

“…14 Les besoins de formation en pédiatrie et gynécologie étaient décrits comme variables en fonction de leur lieu d'installation. Les expériences en policlinique universitaire (orientation médecine de premier recours et communautaire) et en assistanat au cabinet semblaient complémentaires, le milieu universitaire offrant une formation plus complète dans certains domaines (evidence-based medicine, complexité psychosociale et maladies chroniques) et une supervision plus étroite, alors que la formation en cabinet permettait d'être exposé à une plus large variété de patients et de problèmes cliniques, de développer davantage d'autonomie et de pouvoir se familiariser avec des pratiques de gestion de cabinet.…”