Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232, Singapore.
Faculty of Medicine, Imperial College London, South Kensington Campus, London, SW7 2AZ, UK.
BMC Med Educ. 2022 Apr 11;22(1):266. doi: 10.1186/s12909-022-03298-7.
Like many other countries, Singapore needs to support its ageing population by attracting more doctors into general practice (GP) and family medicine (FM). To achieve this requires a better understanding of what attracts or deters medical students. We conducted a cross-sectional survey among medical students in Singapore.
An online survey was distributed to students from all three medical schools to understand their likelihood of choosing primary care careers, what they valued in their careers, their attitude towards different aspects of general practice and family medicine relative to other medical fields, and the positive and negative perceptions of primary care held by themselves, their lecturers, and clinical mentors. They were able to elaborate the negativity encountered in the open-ended questions. Quantitative data was analyzed with descriptive statistics, principal component analysis, and linear regression; qualitative data was analyzed thematically.
The survey was completed by 391 students. Slightly over half indicated a likelihood of choosing a career in primary care. For their own careers, the students valued job satisfaction and career development opportunities the most. They perceived careers in primary care as being most likely to offer reasonable hours and close patient relationships, but least likely to offer career advancement potential relative to other medical fields. Their likelihood of choosing primary care careers was significantly predicted by what they value in their own career and their attitudes toward GP/FM relative to other medical fields, but not by the perceptions of GP/FM by others. Free-text responses illustrated how students encounter derogatory comments about GP/FM: the work being "mundane and repetitive", the careers non-competitive, and the doctors poor in clinical competence.
While the shortage of primary care doctors is a global issue, our findings highlight the value of situating inquiries in localized contexts. Medical curriculum should emphasize the critical role of primary care in the healthcare system and primary care doctors should be given due recognition to build a strong and motivated primary care workforce to serve the future healthcare needs of the population.
与许多其他国家一样，新加坡需要通过吸引更多医生从事全科医学（GP）和家庭医学（FM）来支持其老龄化人口。要实现这一目标，需要更好地了解是什么吸引或阻碍医学生。我们对新加坡的医学生进行了横断面调查。
我们向所有三所医学院的学生发放了在线调查，以了解他们选择初级保健职业的可能性、他们在职业生涯中重视的内容、他们对全科医学和家庭医学相对于其他医学领域的不同方面的态度，以及他们自己、讲师和临床导师对初级保健的正面和负面看法。他们可以在开放式问题中详细说明遇到的消极情况。使用描述性统计、主成分分析和线性回归分析对定量数据进行分析；对定性数据进行主题分析。
该调查由 391 名学生完成。略超过一半的学生表示有可能选择从事初级保健工作。对于他们自己的职业，学生最看重工作满意度和职业发展机会。他们认为初级保健工作最有可能提供合理的工作时间和与患者的密切关系，但与其他医学领域相比，职业发展潜力最小。他们选择初级保健职业的可能性与他们在自己的职业中看重的东西以及他们对全科医学和家庭医学相对于其他医学领域的态度显著相关，但与他人对全科医学和家庭医学的看法无关。自由文本回复说明了学生是如何遇到贬低全科医学和家庭医学的评论的：工作“平凡且重复”，职业没有竞争力，医生的临床能力差。
虽然初级保健医生短缺是一个全球性问题，但我们的研究结果强调了在本地化背景下进行调查的重要性。医学课程应强调初级保健在医疗保健系统中的关键作用，并给予初级保健医生应有的认可，以建立一支强大且有动力的初级保健劳动力队伍，以满足未来人口的医疗保健需求。
