Every year, about three hundred medical students graduate from our two medical schools. When they change from university student life to full-time clinical practice, they need to make new choices and face new opportunities and challenges. They need to decide on their career path especially in terms of specialty training.
In a study of junior doctors' perceptions of general practice as a career in the UK, it was found that junior doctors perceived general practice as a negative choice.1 Factors such as the relatively lack of status and stressful lifestyle contributed towards this perception.2-4 However, studies in the USA suggested that medical students choosing a career in a specialty other than general practice did not necessarily have a negative attitude towards family medicine.2 In fact, these studies revealed that some students in the USA believed general practice to be challenging, comprehensive, and had an intellectual content comparable to other specialties.
A more recent paper conducted in the UK involving two medical schools exploring the attitude of medical students towards general practice and general practitioners attempted to shed more light on this topic. It was found that attitudes towards general practice were more encouraging than previously thought.3 Statistically, the students' overall attitude towards general practice differed significantly from the first-year to the fifth-year. The fifth-year medical students had a more positive attitude towards general practice as a distinct specialty as compared with their first-year counterparts. Fifth-year students were more likely to intend to become a general practitioner than the first-year students. The students' recent exposure to general practitioners during their general practice clerkship in the fourth or final year of the curriculum was suggested to be a factor contributing towards the observation.3 However, as previously found, the positive attitude after completing a course in general practice could be short-lived.5 Assuming that these research findings could be translated for the local scene, how can this positive attitude be sustained then?
Changes in the undergraduate medical curriculum in recent years have paved the way to give primary care a more prominent position. More undergraduate students are being sent to general practitioners' clinics to gain first hand experience in primary care clinical practice. Coupled with that, the scale of vocational training in family medicine has also been escalating. With closer collaborations among family physicians across the private, public and academic sectors, family medicine training programmes have intensified to match the speed of their expansion. Is there anything else we can do?
How about starting from within ourselves as role models for the future generation of general practitioners or family doctors? It is often taken for granted that we as doctors can be more influential than we thought. We can exert a positive influence towards the fresh undergraduate students. At the same time, this influence can also be easily felt, by our patients in the consultation room. In order to sustain the positive attitudes towards general practice or family medicine, the students, the patients, and the society as a whole should be constantly reminded of the values and importance of quality family care practice. The choice is yours and ours.
D V K Chao, MBChB, MFM(Monash), FRCGP, FHKAM(Family Medicine)
Family Medicine Cluster Coordinator (KE),
Department of Family Medicine, United Christian Hospital.
Correspondence to : Dr D V K Chao, The Hong Kong College of Family Physicians, 7th Floor, HKAM Jockey Club Building, 99 Wong Chuk Hang Road, Hong Kong.
References
- Petchey R, Williams J, Baker M. 'Ending up a GP': a qualitative study of junior doctors' perceptions of general practice as a career. Fam Pract 1997;14:194-198.
- DeForge BR, Richardson JP, Steward DL. Attitudes of graduating seniors at one medical school towards family practice. Fam Med 1993;25:111-113.
- Hendersen E, Berlin A, Fuller J. Attitude of medial students towards general practice and general practitioners. Br J Gen Pract 2002;52:359-363.
- Garret EA, Dietrich AJ. Students' evolving attitudes towards family medicine and specialty choices at one medical school. Acad Med 1991;68:625-627.
- Morrison JM, Murray TS. Career preferences of medical students : influence of a new four-week attachment in general practice. Br J Gen Pract 1996;46:721-725.