Steinhäuser Jost, Paulus Jan, Roos Marco, Peters-Klimm Frank, Ledig Thomas, Szecsenyi Joachim, Joos Stefanie
Universitätsklinikum Heidelberg Abteilung Allgemeinmedizin und Versorgungsforschung, Heidelberg und Kompetenzzentrum Allgemeinmedizin Baden-Württemberg.
Z Evid Fortbild Qual Gesundhwes. 2011;105(2):89-96. doi: 10.1016/j.zefq.2010.11.003.
Due to the increasing lack of physicians, an ageing and thus multi-morbid society and a misdistribution of physicians in Germany primary care provided by general practitioners is at risk. Therefore, approaches to recruit more physicians for general practice are being sought. The aim of the present study was to explore individual motivations for choosing a career in general practice, vocational trainees' perspectives on the current situation of vocational training and to identify possible approaches to improve the situation with suggestions from vocational trainees in Germany.
A qualitative study was conducted by interviewing 13 trainees. The interviews that were based on a predefined interview guideline were recorded and transcribed. The analysis was performed according to Mayring supported by the software Atlas.ti.
In general, the reasons given for choosing general practice include the holistic view towards patients, the opportunity to see the direct impact of therapies and self-employment. Furthermore, general practice was perceived as a job with a positive work-life balance. Barriers to vocational training are the lack of structure of individual rotations and the low salaries during the rotation in practice. Furthermore, the basic conditions for working as a self-employed general practitioner in Germany were described as being a disincentive. A general suggestion for improvement was to promote professional recognition of general practice at universities. A qualification of vocational trainers was requested. Specific suggestions were: better payment, better-structured rotations and a specific preparation for the self-employed general practitioner.
The results of this study reveal that a single measure is insufficient for recruiting more young doctors for general practice. In fact, a package of measures is necessary to improve aspects of the vocational training but also general conditions for the profession.
由于德国医生日益短缺、社会老龄化导致多种疾病并存以及医生分布不均，全科医生提供的初级医疗面临风险。因此，正在寻求招募更多医生从事全科医疗的方法。本研究的目的是探讨选择全科医疗职业的个人动机、职业培训学员对当前职业培训状况的看法，并根据德国职业培训学员的建议确定改善现状的可能方法。
通过对13名学员进行访谈开展了一项定性研究。基于预先确定的访谈指南进行的访谈被录音并转录。在Atlas.ti软件的支持下，根据迈林的方法进行分析。
总体而言，选择全科医疗的原因包括对患者的整体观、看到治疗直接效果的机会以及自主创业。此外，全科医疗被视为一份工作与生活平衡良好的职业。职业培训的障碍包括个人轮转缺乏结构以及实习轮转期间薪资较低。此外，德国自主执业全科医生的基本条件被描述为一种阻碍因素。一项总体改进建议是在大学促进对全科医疗的专业认可。要求对职业培训师进行资格认证。具体建议包括：提高薪酬、优化轮转结构以及为自主执业全科医生提供专门培训。
本研究结果表明，单一措施不足以招募更多年轻医生从事全科医疗。事实上，需要一套措施来改善职业培训的各个方面以及该职业的总体条件。
