Chan Sook Ching, Ganeson Jaya Vinoshairine, Ong Jee Tat, Sugathan Sandheep
Community Based Department, Faculty of Medicine, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, Malaysia.
Hospital Sultanah Bahiyah, Alor Setar, Kedah Darul Aman, Malaysia.
Fam Med Community Health. 2020 Mar 4;8(1):e000188. doi: 10.1136/fmch-2019-000188. eCollection 2020.
To explore the perception of medical students from a private medical college in Perak, Malaysia, on primary care practice and induce the factors influencing their perception and willingness to consider primary care as a career pathway.
Qualitative study using focus group discussions. Participants' responses were audio recorded, transcribed, grouped under various domains and listed out and analysed.
A private medical college in Perak state, Malaysia.
Forty-six medical students from years 2 to 5 were included. Eight focus groups were formed with two focus groups from each academic year (six students each in seven groups and four students in one group). Students were informed through their respective student leader of each year and received a participant information sheet and an informed consent form which were completed and returned if they decided to participate in the focus group discussions.
The participants had different levels of understanding of primary care depending on their level of exposure to primary care. Senior students with more exposure had a better understanding about primary care and its services. Attractive factors towards choosing primary care as a career included short working hours with a more balanced family and social life, being able to treat patients as a whole with continuity of care and closer relationship with patients. Unattractive factors included routine, unchallenging and boring practice, poor salary, work overload and administrative work in government clinics, being less recognised by other specialties; and the poor perception by other doctors that those pursuing primary care were not 'brilliant enough' for more 'sophisticated disciplines like surgery or paediatrics'.
This study showed that the medical students' level of exposure to primary care played a crucial role in determining their understanding of primary care practice and their choice of career in primary care. Issues to be addressed include remuneration, workload and the prejudice against primary care as a career pathway. Suggestions included introducing early exposure to fun and challenging primary care postings in the medical curriculum and producing well trained, skilled and enthusiastic role models.
探讨马来西亚霹雳州一所私立医学院的医学生对基层医疗实践的认知，并归纳影响其认知以及将基层医疗视为职业道路意愿的因素。
采用焦点小组讨论的定性研究。对参与者的回答进行录音、转录，归类到不同领域并列出分析。
马来西亚霹雳州的一所私立医学院。
纳入了46名二至五年级的医学生。组成了8个焦点小组，每个学年有两个焦点小组（7个小组每组6名学生，1个小组4名学生）。通过各年级的学生代表通知学生，他们收到了一份参与者信息表和一份知情同意书，如果决定参加焦点小组讨论，需填写并返还。
参与者对基层医疗的理解程度因接触基层医疗的程度而异。接触较多的高年级学生对基层医疗及其服务有更好的理解。选择基层医疗作为职业的吸引人的因素包括工作时间短，家庭和社会生活更平衡，能够持续地全面治疗患者以及与患者关系更密切。不吸引人的因素包括日常、缺乏挑战性且枯燥的实践，薪资低，工作负担过重以及政府诊所的行政工作，不被其他专科认可；以及其他医生认为从事基层医疗的人对于外科或儿科等更“复杂的学科”来说不够“出色”。
本研究表明，医学生接触基层医疗的程度在决定他们对基层医疗实践的理解以及选择基层医疗职业方面起着关键作用。需要解决的问题包括薪酬、工作量以及对基层医疗作为职业道路的偏见。建议包括在医学课程中尽早安排有趣且具有挑战性的基层医疗实习，并培养训练有素、技能娴熟且热情高涨的榜样。
