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Weiss K, Di Gangi S, Inauen M, Senn O, Markun S. Changes in the attractiveness of medical careers and career determinants during the bachelor's program at Zurich medical schools. BMC MEDICAL EDUCATION 2024; 24:693. [PMID: 38926866 PMCID: PMC11210091 DOI: 10.1186/s12909-024-05693-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/21/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Monitoring the career intentions of medical students during their undergraduate studies could help to address the shortage of physicians, particularly in general practice. This study aimed to investigate changes in medical students' career openness, attractiveness and determinants of medical career choice during their bachelor's studies. METHODS The design was cross-sectional, recruiting all medical students who started a bachelor's program in one of the four different educational tracks in Zurich, Switzerland, in the fall of 2019 (first survey) and completed it in the summer of 2022 (second survey). Students' perceptions of the attractiveness and determinants of different medical career options were assessed using a structured online questionnaire. Absolute changes between the two-time points were reported in percentage points overall and by educational track. Regression analysis was used to examine the association of student characteristics and determinants of career options with the attractiveness of each option. RESULTS We surveyed 354 medical students at the beginning and 433 at the end of the bachelor's program (participation rate: 71.1% and 86.9%, respectively). Overall, the proportion of students open to all proposed medical career options decreased (from 52.8% to 43.8%, p = 0.004). The attractiveness of outpatient gynecology or pediatrics increased (from 27.4% to 43.4%, p < 0.001), whereas the attractiveness of both general and specialized inpatient care decreased (from 47.8% to 40.3%, p = 0.05 and from 71.1% to 61.1%, p = 0.006 respectively). There was an increase in the proportion of students who perceived part-time work, autonomy and relationships with patients as important career determinants (from 47.3% to 64.7%, p < 0.001; from 63.3% to 77.8%, p < 0.001; from 80.8% to 89.3%, p = 0.002 respectively), while the importance of reputation and career opportunities decreased (from 42.6% to 26.2%, p < 0.001; from 79.2% to 63.6%, p < 0.001 respectively). The importance of part-time work and relationships with patients were positively associated with the attractiveness of general practice. CONCLUSIONS During the bachelor's program, the attractiveness of a career in general practice tended to decrease, but the importance of part-time work, autonomy and relationships with patients as career determinants increased. Helping students understand how these determinants relate to general practice may increase their interest in the profession. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Katja Weiss
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland
| | - Stefania Di Gangi
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland.
| | - Markus Inauen
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland
| | - Stefan Markun
- Institute of Primary Care, University of Zurich and University Hospital of Zurich, Pestalozzistrasse 24, Zurich, 8091, Switzerland
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Markun S, Tandjung R, Rosemann T, Scherz N, Senn O. Attractiveness of medical disciplines amongst Swiss first-year medical students allocated to different medical education tracks: cross-sectional study. BMC MEDICAL EDUCATION 2022; 22:252. [PMID: 35392880 PMCID: PMC8986963 DOI: 10.1186/s12909-022-03313-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND As most countries, Switzerland is experiencing a shortage of physicians especially in general practice and new medical education tracks with respective focusses have been started in response. This study investigated Swiss medical students' career openness and attractiveness of different medical disciplines as well as the concordance of students' career intentions with assigned medical education tracks. METHODS Cross-sectional study surveying first year medical students assigned to four different Swiss medical education tracks with distinctive additional education focuses (ETH Zurich: medical technology and engineering, University of St. Gallen and University of Lucerne: primary healthcare and University of Zurich: no distinctive focus). RESULTS We surveyed 354 medical students (response rate across all included medical education tracks 71.1%), 64.8% female, mean age 20 years. Regarding career openness, we found that 52.8% of medical students had neither a strong commitment nor a strong reservation for any of the proposed career options and 17.0% had a strong commitment. Among medical disciplines, medical subspecialties were attractive to the largest part of students (inpatient subspecialties attractive for 71%, outpatient for 58%), attractiveness of general practice was moderate (30%), academic (22%) and industrial sector (17%) careers were least attractive. Proportions of medical students attracted to general practice were similar at medical education tracks with focus on primary healthcare compared to other medical education tracks (32.2% vs. 25.8%, p = 0.391). Conversely, proportions of medical students attracted to academic or industry careers were significantly higher at the ETH Zurich compared to other medical education tracks (37.2%, vs. 13.1%, p < 0.001 and 31.9%, vs. 8.8%, p < 0.001 respectively). CONCLUSION While most first-year medical students were open to careers in many medical disciplines, attractiveness of disciplines varied strongly. Students attracted to academic or industrial careers accumulated at the medical education track with concordant teaching focus but students attracted to general practice did not accumulate at medical education tracks focused on primary healthcare. For medical education tracks with primary care teaching focus this is both a challenge and an opportunity to specifically counteract the shortage of general practitioners in Switzerland.
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Affiliation(s)
- Stefan Markun
- Institute of Primary Care, University and University Hospital Zurich, Zurich, Switzerland.
| | | | - Thomas Rosemann
- Institute of Primary Care, University and University Hospital Zurich, Zurich, Switzerland
| | - Nathalie Scherz
- Institute of Primary Care, University and University Hospital Zurich, Zurich, Switzerland
- Division of Internal Medicine, Centre Hospitalier de Bienne, Bienne, Switzerland
| | - Oliver Senn
- Institute of Primary Care, University and University Hospital Zurich, Zurich, Switzerland
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Avian A, Poggenburg S, Schaffler-Schaden D, Hoffmann K, Sanftenberg L, Loukanova S, Bachler H, Gehrke-Beck S, Petek Ster M, Becker A, Herrmann M, Frese T, Gerlach F, Zelko E, Flamm M, Roos M, Freitag M, Schirgi J, Rieder A, Siebenhofer A. Attitudes of medical students to general practice: a multinational cross-sectional survey. Fam Pract 2021; 38:265-271. [PMID: 33251543 DOI: 10.1093/fampra/cmaa126] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A shortage of general practitioners (GPs) is common to many European countries. To counteract this, it is essential to understand the factors that encourage or discourage medical students from choosing to become a GP. OBJECTIVE To evaluate medical students' attitudes towards general practice and to identify factors that discourage them from considering a career as a GP. METHODS In this multinational cross-sectional online survey, 29 284 students from nine German, four Austrian and two Slovenian universities were invited to answer a questionnaire consisting of 146 closed and 13 open-ended items. RESULTS Of the 4486 students that responded (response rate: 15.3%), 3.6% wanted to become a GP, 48.1% were undecided and 34.6% did not want to be a GP. Significant predictors for interest in becoming a GP were higher age [odds ratio (OR) = 1.06; 95% confidence interval (CI) = 1.02-1.10], positive evaluation of the content of a GP's work (OR = 4.44; 95% CI = 3.26-6.06), organizational aspects (OR = 1.42; 95% CI = 1.13-1.78), practical experience of general practice (OR = 1.66; 95% CI = 1.08-2.56) and the country of the survey [Slovenian versus German students (Reference): OR = 2.19; 95% CI = 1.10-4.38; Austrian versus German students (Reference): OR = 0.50; 95% CI = 0.32-0.79]. CONCLUSION Strategies to convince undecided students to opt for a career as a GP should include a positive representation of a GP's work and early and repeated experience of working in a general practice during medical school.
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Affiliation(s)
- Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Stephanie Poggenburg
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Dagmar Schaffler-Schaden
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Kathryn Hoffmann
- Center for Public Health, Department of General Practice and Family Medicine, Medical University of Vienna, Vienna, Austria
| | - Linda Sanftenberg
- Institute of General Practice and Family Medicine, Munich University Hospital LMU Munich, Munich, Germany
| | - Svetla Loukanova
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Herbert Bachler
- Institute of General Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Sabine Gehrke-Beck
- Institute of General Practice Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Marija Petek Ster
- Department of Family Medicine, Medical Faculty, University of Ljubljana, Ljubljana Slovenia
| | - Annette Becker
- Institute of General Practice, Preventive and Rehabilitation Medicine, Philipps-University Marburg, Marburg, Germany
| | - Markus Herrmann
- Institute of General Practice and Family Medicine of the Medical Faculty, Otto-von-Guericke-University, Magdeburg, Germany
| | - Thomas Frese
- Institute of General Practice at the Medical Faculty of Martin Luther University Halle-Wittenberg, Halle-Wittenberg, Germany
| | - Ferdinand Gerlach
- Institute of General Practice, Goethe University, Frankfurt am Main, Germany
| | - Erika Zelko
- Faculty of Medicine University of Maribor, Maribor, Slovenia
| | - Maria Flamm
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Marco Roos
- Institute of General Practice, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen-Nürnberg, Germany
| | - Michael Freitag
- Institute of General Practice, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Julia Schirgi
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Anita Rieder
- Center for Public Health, Department of General Practice and Family Medicine, Medical University of Vienna, Vienna, Austria
| | - Andrea Siebenhofer
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria.,Institute of General Practice, Goethe University, Frankfurt am Main, Germany
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Cronin FM, Clarke N, Hendrick L, Conroy R, Brugha R. Factors influencing specialty choice and the effect of recall bias on findings from Irish medical graduates: a cross-sectional, longitudinal study. BMC MEDICAL EDUCATION 2020; 20:485. [PMID: 33267801 PMCID: PMC7709240 DOI: 10.1186/s12909-020-02405-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/26/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND Despite being a vital part of medical workforce planning and development, how medical students and graduates choose their career specialty is still not well understood. This study aimed to identify the factors medical graduates consider important influences in their choice of specialty after their first year of practice, and to test the validity of relying on respondent recall to measure changes in specialty choice. METHODS The baseline survey was administered online to all final year students in Ireland's six medical schools. Those who consented to follow-up (n = 483) were surveyed 18 months later (June 2018), during the final month of first year of practice. RESULTS The baseline survey had a 67% (n = 483) response rate. At the follow-up survey, (n = 232, 48% response rate) the top specialty choices were: Medicine, n = 54 (26%); Surgery, n = 34 (16%); General Practice, n = 28 (13%); Anaesthesia, n = 16 (8%) and Paediatrics, n = 14 (7%). Of the 49 respondents (28%) reporting a change of specialty since baseline, 13 (27%) selected the same specialty in both surveys; of the 121 (69%) reporting no change, 22 (18%) selected a different specialty at follow-up. Over 90% of respondents rated as 'important or 'very important': 'Own aptitude', 'Work-life balance' and 'What I really want to do'. Over 75% rated as 'not at all', or 'not very important' 'Current financial debt' and 'Inclinations before medical school'. When adjusted for sex and age, compared with Medicine, General Practice rated as more important: continuity of patient care (RRR 3.20 CI(1.59-6.41), p = 0.001); working hours/conditions (RRR 4.61 CI(1.03-20.60), p = 0.045) and a career that fit their domestic circumstances (RRR 3.19 CI(1.27-8.02), p = 0.014). Those choosing Surgery rated as less important: patient contact (RRR 0.56 CI(0.33-0.95), p = 0.033) and working hours/conditions (RRR 0.55 CI(0.31-0.96), p = 0.035). CONCLUSIONS The different demographic and motivational profiles by specialty choice are consistent with other studies suggesting a distinct profile for doctors intending to enter General Practice. In addition, our results suggest longitudinal study designs guard against recall bias and so provide more robust medical workforce models to inform and direct recruitment drives and interventions in future medical workforce planning.
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Affiliation(s)
| | - Nicholas Clarke
- School of Psychology, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Louise Hendrick
- Dr Steevens' Hospital, Health Service Executive, Dublin 8, Ireland
| | - Ronan Conroy
- Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Ruairi Brugha
- Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Diallo B, Rozsnyai Z, Bachofner M, Maisonneuve H, Moser-Bucher C, Mueller YK, Scherz N, Martin S, Streit S. [Not Available]. PRAXIS 2019; 108:779-786. [PMID: 31530123 DOI: 10.1024/1661-8157/a003300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
How Many Advanced Medical Students Aim for a Career as a GP? Survey among Swiss Students Abstract. According to an earlier prognosis for 2025, Switzerland will lack 5000 general practitioners (GP), since only 10-20 % of medical students wanted to choose this profession at the time of the survey. The aim of our investigation among advanced medical students was to record their career intentions anew. Beside the probability of becoming a GP, we looked at the time point of this decision and at factors around family medicine (doctor-patient relation, career possibilities, etc.) influencing this decision. The results showed that measures to promote family medicine have been successful: 60 % of interrogated students are possible GPs (20 % decided, 40 % interested), 15 % are undecided, 25 % have decided not to become a GP. The favorable factors to become a GP were: autonomy, doctor-patient relationship, possibility of part-time work, work content. Less favorable were: income, reputation, political situation. These are the points where action is required to promote careers in family medicine with attractive training and practice conditions.
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Affiliation(s)
- Beatrice Diallo
- Berner Institut für Hausarztmedizin (BIHAM), Universität Bern
| | - Zsofia Rozsnyai
- Berner Institut für Hausarztmedizin (BIHAM), Universität Bern
| | | | | | - Cora Moser-Bucher
- Universitäres Zentrum für Hausarztmedizin beider Basel (uniham-bb) Basel
| | - Yolanda Kathrin Mueller
- Abteilung Hausarztmedizin, Universitätszentrum für Allgemeinmedizin und Gesundheitswesen, Unisanté, Lausanne
| | | | - Sebastien Martin
- Cursus romand de médecine de famille (CRMF), Abteilung Hausarztmedizin, Universitätszentrum für Allgemeinmedizin und Gesundheitswesen, Unisanté, Lausanne
| | - Sven Streit
- Berner Institut für Hausarztmedizin (BIHAM), Universität Bern
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Rozsnyai Z, Tal K, Bachofner M, Maisonneuve H, Moser-Bucher C, Mueller Y, Scherz N, Martin S, Streit S. Swiss students and young physicians want a flexible goal-oriented GP training curriculum. Scand J Prim Health Care 2018; 36:249-261. [PMID: 29943627 PMCID: PMC6381531 DOI: 10.1080/02813432.2018.1487582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/22/2018] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND A growing shortage of general practitioners (GPs), in Switzerland and around the world, has forced countries to find new ways to attract young physicians to the specialty. In 2017, Switzerland began to fund hundreds of new study places for medical students. This wave of young physicians will soon finish University and be ready for postgraduate training. We hypothesized that an attractive postgraduate training program would encourage interested young physicians to pursue a GP career. METHODS This is a cross-sectional survey of young physicians from the Swiss Young General Practitioners Association (JHaS), members of Cursus Romand de médecine de famille (CRMF), and all current medical students (5th or 6th years) (n = 554) in Switzerland, excluding students indicating definitely not to become GPs. We asked all if they were likely to become a GP (Likert: 1-10), and then asked them to score general features of a GP training curriculum, and likely effects of the curriculum on their career choice (Likert scale). They then rated our model curriculum (GO-GP) for attractiveness and effect (Likert Scales, open questions). RESULTS Most participants thought they would become GPs (Likert: 8 of 10). Over 90% identified the same features as an important part of a curriculum ("yes" or "likely yes"): Our respondents thought the GO-GP curriculum was attractive (7.3 of 10). It was most attractive to those highly motivated to become GPs. After reviewing the curriculum, most respondents (58%) felt GO-GP would make them more likely to become a GP. Almost 80% of respondents thought an attractive postgraduate training program like GO-GP could motivate more young physicians to become GPs. CONCLUSIONS 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.
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Affiliation(s)
- Zsofia Rozsnyai
- Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland
| | - Kali Tal
- Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland
| | | | - Hubert Maisonneuve
- Primary Care Unit, Faculty of medicine, University of Geneva, Geneva, Switzerland
| | - Cora Moser-Bucher
- Center for Primary Care Medicine, University of Basel, Basel, Switzerland
| | - Yolanda Mueller
- Department of Ambulatory Care and Community Medicine, University Institute of Family Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nathalie Scherz
- Institute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland
- Arud Centres for Addiction Medicine, Zurich, Switzerland
| | - Sebastien Martin
- Department of Ambulatory Care and Community Medicine, French-speaking Switzerland Curriculum of Family Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sven Streit
- Institute of Primary Health Care Bern (BIHAM), University of Bern, Bern, Switzerland
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