Do medical students want a career in general practice? A rich mix of influences!

The paper examined the relative importance of factors which influenced final year medical students to consider or discount general practice as a career option. A questionnaire was administered to three cohorts of approximately 30 final year medical students at Barts and The London (Queen Mary's School of Medicine) on the first and last day of their four-week Final Year General Practice Module. In addition, three focus groups explored in further depth the influences on students' views of general practice as a career. There was a significant increase in the number of students who said they would consider a career in general practice following the Final Year General Practice Module (47.5% before compared to 68.1% after). Influencing factors were both intrinsic and extrinsic to the MBBS curriculum with perceptions of a 'GP lifestyle' emerging as the most important factor for those considering general practice, with a preference for hospital careers the most important reason for those not. Qualitative results demonstrated prevalent pre-existing negative perceptions of general practice as a career, with the Final Year General Practice placement in particular 'tipping the balance' back toward considering general practice. Other important factors were the lack of opportunities as an undergraduate to experience the long-term rewards of general practice, how students perceived the hierarchy in medicine and what factors they felt were the most important to have control over in their careers. Most undergraduates in our study were not ready to commit to any definite career plans, instead postponing this for a time when they had real experience and a greater understanding of what being a general practitioner would be like. This has implications for the usefulness of the Foundation Year 2 posts in providing tasters in general practice, but also highlights that the Modernising Medical Careers structure may restrict those in our study who wished to retain flexibility, and would consider general practice after having worked in other specialties.