Medical Students’ Attitudes towards Careers in Primary Care in Singapore

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.

Experiences of doctors working in Singapore’s public primary healthcare clinics

“…Programmes like the Teamlet programme go some way to address concerns about the paucity of continuity of care to patients. A study by Zainal and Smith (2020), which explored the attitudes of 54 medical students from all three medical schools in Singapore towards careers in Family Medicine and General Practice, showed that lack of continuity of care forms a major concern of pursuing a career in these fields of medicine. Hence, introducing Teamlet‐type programmes may enhance the overall image of primary care as a potential career choice.…”