Career aspirations of and perceptions of family medicine as a specialty by newly qualified doctors (interns and community service doctors) in southern Gauteng province

Ubabukoh, Samuel Ozioma
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Introduction: As many recently qualified South African doctors pursue specialisation and sub-specialisation, projections indicate that the critical mass of medical practitioners required to support primary healthcare will continue to dwindle, with wholly inadequate numbers to sustain the country's proposed National Health Insurance plan. Little is known, however, about what newly qualified doctors on the verge of making career choices think of the speciality of Family Medicine (FM) and how these young doctors actually decide on what career options to pursue. Objectives: This study describes the career intentions of newly qualified doctors working in the four southern districts of Gauteng Province, the factors that influence their career aspirations, and their views on FM as a specialty. Methods: This is a descriptive cross sectional study using a self-administered questionnaire, which targeted 502 participants (interns N=396 and community service doctors N=106) in 2013. Results: Out of 368 questionnaires returned, 342 were eligible for analysis. More than two thirds (68%) of the respondents graduated from medical schools located in Gauteng Province. Only 5.3% were working in primary healthcare (PHC) facilities. The most chosen specialties were: surgical (32.2%), internal medicine (14.3%), and paediatrics (12.9%). FM was the least chosen specialty by only eight respondents (2.3%). Only 44% had ever considered FM as a career. Of these, 77% agreed that they were not well enough informed about the FM registrar-training programme to select this discipline. Only 16.8% thought they would be job satisfied working in a PHC facility, while 53.4% believed that FM would not be financially rewarding. Conclusions: A serious human resource shortage looms large in primary healthcare if most newly qualified doctors have no desire to enter general medical practice or work in PHC settings. This study highlights the need to urgently address current undergraduate, internship and registrar training programmes in South Africa with a view to marketing FM and making generalism attractive.
Aspirations of and perceptions of family medicine, Newly qualified doctors, Interns and community service doctors