What determines medical students' career preference for general practice residency training?: a multicenter survey in Japan

Kenya Ie; Akiko Murata; Masao Tahara; Manabu Komiyama; Shuhei Ichikawa; Yousuke C Takemura; Hirotaka Onishi

doi:10.1186/s12930-018-0039-9

What determines medical students' career preference for general practice residency training?: a multicenter survey in Japan

Asia Pac Fam Med. 2018 Jan 27:17:2. doi: 10.1186/s12930-018-0039-9. eCollection 2018.

Authors

Kenya Ie^{1

2}, Akiko Murata³, Masao Tahara⁴, Manabu Komiyama⁵, Shuhei Ichikawa⁶, Yousuke C Takemura^{2

6}, Hirotaka Onishi⁷

Affiliations

¹ 1Department of General Internal Medicine, Kawasaki Municipal Tama Hospital/St. Marianna University School of Medicine, 1-30-37 Shukugawara, Kawasaki, Kanagawa 214-8525 Japan.
² 2Department of Family Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu-shi, Mie 514-8507 Japan.
³ Family Practice Center of Okayama, 292-1 Toyosawa, Katsuta-gun, Nagi-cho, Okayama 708-1323 Japan.
⁴ Iwakura Station Tahara Clinic, 291-1 Chuzaiji, Iwakura, Sakyo-ku, Kyoto-shi, Kyoto 606-0021 Japan.
⁵ Thank You All, Family Clinic Hiratsuka, 215-3 Okazaki, Hiratsuka-shi, Kanagawa 259-1212 Japan.
⁶ 6Department of Education and Research in Family and Community Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi, Mie 514-8507 Japan.
⁷ 7International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan.

Abstract

Background: Few studies have systematically explored factors affecting medical students' general practice career choice. We conducted a nationwide multicenter survey (Japan MEdical Career of Students: JMECS) to examine factors associated with students' general practice career aspirations in Japan, where it has been decided that general practice will be officially acknowledged as a new discipline.

Methods: From April to December 2015, we distributed a 21-item questionnaire to final year medical students in 17 medical schools. The survey asked students about their top three career preferences from 19 specialty fields, their demographics and their career priorities. Multivariable logistic regression was used to determine the effect of each item.

Results: A total of 1264 responses were included in the analyses. The top three specialty choice were internal medicine: 833 (65.9%), general practice: 408 (32.3%), and pediatrics: 372 (29.4%). Among demographic factors, "plan to inherit other's practice" positively associated with choosing general practice, whereas "having physician parent" had negative correlation. After controlling for potential confounders, students who ranked the following items as highly important were more likely to choose general practice: "clinical diagnostic reasoning (adjusted odds ratio (aOR): 1.65, 95% CI 1.40-1.94)", "community-oriented practice (aOR: 1.33, 95% CI 1.13-1.57)", and" involvement in preventive medicine (aOR: 1.18, 95% CI 1.01-1.38)". On the contrary, "acute care rather than chronic care", "mastering advanced procedures", and "depth rather than breadth of practice" were less likely to be associated with general practice aspiration.

Conclusions: Our nationwide multicenter survey found several features associated with general practice career aspirations: clinical diagnostic reasoning; community-oriented practice; and preventive medicine. These results can be fundamental to future research and the development of recruitment strategies.

Keywords: Career choice; Family practice; General practice; Medical students; Primary care; Surveys and questionnaires.