Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

58 Making General Practice Attractive: Encouraging GP attraction and Retention KCE Reports 90
their close family. Students whose parents are physician tend to choose non-primary
care/general practice specialties. This may be a reflection of the socioeconomic status,
increased knowledge on the specialties, the relative status of primary care/general
practice in the medical community and the family support for their choices 17 , 21 , 133 The
multivariate model clarified the importance of the profession of the father and the
importance of having a mother GP in relation with the future specialty choice. There is
a negative relationship between having a specialist as a father and becoming a GP and a
positive relationship between having a mother GP and becoming a GP. The educational
level of the mother also plays a role: GP students have more often mothers with higher
secondary degree or short-term non-university higher educational degree. The effect of
the education of the father was not statistically significant, as already found in the
literature 20 , 37 , 58 .
Future GP students tend to be female: the literature shows indeed that female students
22 , 24 , 30 , 31
seem to view the GP more positively than male students.
3.7.2.3 Decision to become a GP: few change during the curriculum
At the beginning of their studies about one third (29%) of future GP students already
had the idea of becoming a GP. One fifth (17%) had another specialization in mind but
changed their mind during education. The rest of the GP students started their studies
without having any specific specialty in mind made their choice during their curriculum.
The recruitment during the curriculum is therefore important, but a preference for
family medicine/general practice at matriculation is a powerful predictor for the
estimated numbers of students in general practice six years later 20 , 21 , 134 . It has
therefore been recommended to use recruitment and selection processes to select
students who will choose family medicine/general practice 135 .
3.8 FACTORS DURING THE CURRICULUM RELATING TO
SPECIALTY CHOICE
The role model of the GPs, the clerkships and the impact of general practice in the
18 ,
curriculum influence the choice for general practice. In Belgium as in other countries
21 , 42 , 45 , 47 77
not only the “official” curriculum but also the culture within the medical
faculty of influence. The bivariate quantitative study shows that the specialty choice,
most importantly for students opting for a specialty, becomes clearer during the
process of medical education.
3.8.1.1 Perception of general practice during medical training
General practice is perceived as a difficult profession with a lot of uncertainties during
the clinical decision making process. Many specialist students considered it as less
intellectual challenging with a lot more routine work than the clinical specialties. It is
also considered as a lonely working professional (especially by specialist students),
having a high workload without any attractive financial aspect.
On the other hand the GP profession is appreciated for its variety in the work,
autonomy and the privilege of working with patients in different stages of their life.
These attracting and discouraging perceptions are in line with the literature findings of
the literature review 28 , 61 , 62 , 63 , 64 , 65 . The only difference in this study is the
complexness of the job which represents a positive aspect of the GP profession in the
literature 54 , 61 , 64 , 66 but is less clear in our findings and differs between both groups of
students.
It is obvious that the GP profession deals with an image problem. Students who do not
see the future opportunities of the profession tend to choose another specialty. This
perception problem about the content and opportunities of the GP profession was
already described by Coppens & Panhuyzen 2005 136 .
GP students and non-GP students hold different views on the GP profession. GPs tend
to like the variety of work and tend to cope better with the uncertainties of the job,
whereas the non-GP students rather observe the difficulty of uncertainties and the