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“只是个全科医生”:英国对破坏全科医生职业选择的混合方法研究。

'Just a GP': a mixed method study of undermining of general practice as a career choice in the UK.

机构信息

Newcastle School of Medical Education, The Faculty of Medical Sciences, Newcastle University, Newcastle, UK.

Durham Tees Valley GP training Programme, Health Education North East Lead Employer Trust, Newcastle upon Tyne, UK.

出版信息

BMJ Open. 2017 Nov 3;7(11):e018520. doi: 10.1136/bmjopen-2017-018520.

Abstract

OBJECTIVES

Failure to recruit sufficient applicants to general practice (GP) training has been a problem both nationally and internationally for many years and undermining of GP is one possible contributing factor. The aim of our study was to ascertain what comments, both negative and positive, are being made in UK clinical settings to GP trainees about GP and to further explore these comments and their influence on career choice.

METHODOLOGY

We conducted a mixed methods study. We surveyed all foundation doctors and GP trainees within one region of Health Education England regarding any comments they experienced relating to a career in GP. We also conducted six focus groups with early GP trainees to discuss any comments that they experienced and whether these comments had any influence on their or others career choice.

RESULTS

Positive comments reported by trainees centred around the concept that choosing GP is a positive, family-focused choice which facilities a good work-life balance. Workload was the most common negative comment, alongside the notion of being 'just a GP'; the belief that GP is boring, a waste of training and a second-class career choice. The reasons for and origin of the comments are multifactorial in nature. Thematic analysis of the focus groups identified key factors such as previous exposure to and experience of GP, family members who were GPs, GP role models, demographics of the clinician and referral behaviour. Trainees perceived that negative comments may be discouraging others from choosing GP as a career.

CONCLUSION

Our study demonstrates that negative comments towards GP as a career do exist within clinical settings and are having a potential impact on poor recruitment rates to GP training. We have identified areas in which further negative comments could be prevented by changing perceptions of GP as a career. Additional time spent in GP as undergraduates and postgraduates, and positive GP role models, could particularly benefit recruitment. We recommend that undermining of GP as a career choice be approached with a zero-tolerance policy.

摘要

目的

多年来,未能招募到足够的普通科医生(GP)培训申请人一直是国内外的一个问题,削弱 GP 是一个可能的促成因素。我们的研究目的是确定在英国临床环境中,对 GP 培训生关于 GP 的哪些评论(包括负面和正面的),并进一步探讨这些评论及其对职业选择的影响。

方法

我们进行了一项混合方法研究。我们调查了英格兰教育卫生局(HEE)一个区域内的所有基础医生和 GP 培训生,了解他们在职业选择 GP 方面所经历的任何评论。我们还与六位早期 GP 培训生进行了六次焦点小组讨论,讨论他们所经历的任何评论,以及这些评论是否对他们或其他人的职业选择产生了影响。

结果

培训生报告的正面评论集中在选择 GP 是一个积极的、以家庭为中心的选择,可以实现良好的工作与生活平衡的概念上。工作量是最常见的负面评论,还有“只是一个 GP”的观念;认为 GP 无聊、浪费培训和是二等职业选择。评论的原因和来源是多方面的。焦点小组的主题分析确定了一些关键因素,如以前接触和体验过 GP、有 GP 家庭成员、GP 榜样、临床医生的人口统计学特征和转诊行为。培训生认为,负面评论可能会劝阻其他人选择 GP 作为职业。

结论

我们的研究表明,临床环境中确实存在对 GP 作为职业的负面评论,并且对 GP 培训的招聘率产生了潜在影响。我们已经确定了一些领域,可以通过改变对 GP 作为职业的看法来防止进一步的负面评论。在本科生和研究生阶段增加 GP 方面的时间投入,以及积极的 GP 榜样,可以特别有助于招聘。我们建议对削弱 GP 作为职业选择的行为采取零容忍政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28fb/5722080/bed46c7f2e6e/bmjopen-2017-018520f01.jpg

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