Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 23
income 23 , 24 , 25 and the prestige 23 , 26 but more concerned about the psychosocial issues
of their patients 19 , 26 , 27 , 28 , 29 .
Different demographic factors are linked with the attraction for general practice. The
gender, the age, the race, the marital status and the socioeconomic status are items to
be considered.
Female students view GP more positively than male students 22 , 23 , 24 , 30 , 31 . Women
have a propensity for relation-orientated, humanistic specialties, such as family medicine
20 , 21 , 25 , 32 , 33 , 34
.
Older age would be a factor favorably influencing the orientation towards general
practice according to some studies 20 , 21 , 23 , 26 , 34 , 35 5 . Other studies did not observe the
influence of age 19 , 36 .
No consensus is observed about the influence of ethnicity. One study suggests that
nonwhites might be more inclined than whites to select general practice 33 .
Being married and having children would positively influence the attraction for general
21 , 23 , 27 , 32 , 33 ,
practice according to some authors, in particular if the partner is also a GP
35 5
Several studies specify that a low socioeconomic status or low parental income or
education is related to the choice of family practice 20 , 21 , 37 .
PROFESSIONAL IDENTITY
The respected title of GP associated with a notion of prestige is an important factor:
the society considers actually the GP like a positive role model 34 , 38 , 39 , 40 , 41 , 42 , 43 , 44 . In
addition, the medical school has a clear influence on the attraction for general practice.
Several aspects include the school’s characteristics, the environment, the curriculum,
the role models suggested and the students' perception.
School characteristics and environment
From a macroscopic point of view, the global academic commitment towards general
practice influences the attraction of the student for that specialty 18 , in particular
according to the presence of a department of family medicine 41 , 45 , 46 79 . The size of the
department, just like its research activity also indicates of the importance conferred on
this discipline 45 .
The culture of the academic medicine impregnated or not by the mission to encourage
students to become GPs also plays a role in the attraction for the profession 26 , 45 , 47 77 .
The attraction of the job is therefore related to quantitative parameters as the
proportion of faculty in family medicine 32 , 41 .
The academic learning environment usually valued and promoted by the medical school
faculty favors specialty and subspecialty careers over GP careers. Moreover, the
creation of subspecialty-oriented or research-oriented academic environment has
unidirectional long-term effects on career decisions of medical graduates 26 .
Finally, the increasing representation and leadership by GPs on admission committees
has a beneficial effect on the applicants in general medicine 34 .
From a microscopic point of view, the direct environment of the student influences his
choice, like the class size 45 and the proportion of matriculating students who express
an interest in family medicine 32 . In the US, the attendance of a public medical school
influences positively the choice to become a GP rather than a specialist: the public
medical schools have indeed more reacted to the social pressure to train a higher
number of primary care physicians than the private medical schools 21 , 32 , 33 .
Curriculum in general practice
The literature frequently points out that students have a positive attitude after
completing a course in GP 21 , 26 , 41 , 45 , 48 , 49 . Optional courses in primary care as well as