Why other specialties, why not family medicine specialization?
Aim: The uneven distribution of specialties among physicians is a worldwide problem. For a high quality primary healthcare system, the number of family physicians should be increased. This study was carried out in order to determine last year medical students’ career choices, the factors affecting their decision and to evaluate their views on family medicine specialization.
Material and Methods: A cross-sectional and descriptive study of 132 students from the sixth year of Gaziantep University Faculty of Medicine was completed between September 2018 and October 2018. A questionnaire was distributed to the participants asking their reasons for choosing medicine, their plans for specialization and affecting factors, and their opinions about family medicine specialization.
Results: After graduation, 10.6% of the students wanted to work as family physicians. The top three specialties for male students are ENT, internal medicine, ophthalmology, while female students end to prefer dermatology, internal medicine, and child and adolescent psychiatry. While only 7.5% of the students picked family physician specialization as one of their top three specialties, 21.2% of them had even planned their subspecialties. It was found that 56% of the students thought there was “very little difference” between working directly as a family physician right after medical school and after completing family physician specialization. 9% of the students indicated that they want to specialize in family medicine while 31% indicated that they will only continue if they cannot get in too their residencies. Family medicine expertise was evaluated by the students as “good” based on financial stabilization by 58.3%, good work-social/private life balance by 84.8%, a convenience in terms of no night shifts by 88.6%, being a valuable part of society by 48.4%, and a low risk and low liability by 67.4% of the students. It was found that the student’s family medicine specialization was “not good” in terms of prestige (46.2%), academic career choices (43.9%) and being interesting (non-monotonous) (56.8%).
Conclusion: It was found that students wanted to specialize in medicine and they even planned their subspecialties and had low interest in family medicine specialization. Family medicine specialization should be emphasized during basic medical education. As being the cornerstone of primary healthcare system, family medicine specialty should be more appealing by improving the negative conditions and mind sets that render it unattractive. Further research should be performed to increase the prestige by the society.
- Sezer Ö. Dağdeviren H.N. Mezuniyet öncesi eğitimde kırsal hekimlik. Turkiye Klinikleri Journal of Family Medicine Special Topics 2018;9(4):241-4.
- Allen J, Gay B, Crebolder H et al. The European Definition of General Practice/Family Medicine. WONCA EUROPE 2011 Edition; 2002:8-12.
- Ünlüoğlu İ, Özcan, S. Dünyada ve Türkiye’de aile hekimliği, Aile doktorları için kurs notları 1. aşama, Sağlık Bakanlığı, Ankara, 2004; 23-29.
- T.C. Sağlık Bakanlığı Sağlık Araştırmaları Genel Müdürlüğü. Sağlık İstatistikleri Yıllığı 2016 https://dosyasb.saglik.gov.tr/Eklenti/13183,sy2016turkcepdf.pdf?0 sayfasından 24.09.2018 tarihinde erişilmiştir.
- Rakel RE. The Family Physician. In: The Textbook of Family Medicine. Rakel RE, Rakel DP (editors) 8th ed. Philadelphia: Saunders; 2011:2-19.
- Starfield B, Shi L, Macinko J. Contribution of Primary Care to Health Systems and Health, 2005; 83(3): 457–502.
- Canbaz S, Sünter AT, Aker S, Pekşen Y. Tıp fakültesi son sınıf öğrencilerinin kaygı düzeyi ve etkileyen faktörler. Genel Tıp Dergisi 2007;17 (1):15-9.
- Ergin A, Dikbaş E, Bozkurt Aİ, Atçeken G, Gürbüz H, Yılmaz C. ve ark. Tıp fakültesi öğrencilerinin mezuniyet sonrası kariyer seçimi ve etkileyen faktörler. Tıp Eğitimi Dünyası 2011;32:8-17.
- Dikici MF, Yarış F, Topsever P, Filiz TM, Gürel FS, Çubukçu M. et al. Factors affecting choice of specialty among first- year medical students of four universities in different regions of Turkey. Croat Med J 2008;49(3):415-20.
- Köksalan B. Üniversite öğrencilerinin meslek seçimini etkileyen bazı faktörler. İnönü Üniversitesi Eğitim Fakültesi Dergisi 2007;8(14):49-63.
- Köksal S, Vehid S, Tunçkale A, Çerçel A, Erginöz E, Kaypmaz A. ve ark.Cerrahpaşa Tıp Fakültesi öğrencilerinin tıp eğitimi ve mezuniyet sonrası ile ilgili tutumları. Cerrahpaşa J Med 1999;30(4): 251-8.
- Khader Y, Al-Zoubi D, Amarin Z, Alkafagei A, Khasawneh M, Burgan S, et al. Factors affecting medical students in formulating their specialty preferences in Jordan. Bmc Medical Education. 2008;23:8-32.
- Azzizadeh A, Mccollum CH, Miller CC, Holliday KM, Shilstone HC, Lucci A. Factors influencing career choice among medical students interested in Surgery. Current Surgery. 2003;60(2):210-13.
- Kara IH, Çelik S, Keyif MF, Demir A, Baltacı D, Mayda AS. Düzce Üniversitesi Tıp Fakültesi 5. ve 6. sınıf öğrencilerinin branş tercihleri ve Tıpta Uzmanlık Sınavı’na bakışlarının incelenmesi. Konuralp Tıp Dergisi 2014;6(2):11-18.
- Yalçınoğlu N, Kayı İ, Işık Ş, Aydın T, Zengin Ş, Karabey S. İstanbul Üniversitesi İstanbul Tıp Fakültesi son sınıf öğrencilerinin tıp eğitimi ile ilgili görüşleri. İstanbul Tıp Fakültesi Dergisi 2012; 75(3): 41-5.
- Buddeberg-Fischer B, Klaghofer R, Stamm M, Marty F, Dreiding P, Zoller M, et al. Primarycare in Switzerland – no longer attractive for young physicians? Swiss Med Wkly 2006;136:416-24.
- Aydin S, Yaris F, Sahin ME, Ozer C, Ozkomur E. Students’ perceptions of their under graduate medical education. Saudi Med J. 2005;26:1484-6.
- Baboolal NS, Hutchinson GA. Factors affecting future choice of specialty among first-year medical students of the University of the West Indies, Trinidad. Med Educ 2007;41:50-6.
- Kara İH, Üzüm HG, Deler MH, Yılmaz A, Baltacı D, Gürel FS. Düzce Üniversitesi Tıp Fakültesi internlerinin branş tercihleri ve TUS kazanma durumlarının incelenmesi. Euras J Fam Med 2013;2(1):11-18
- Henderson E, Berlin A, Fuller J. Attitude of medical students towards general practice and general practitioners. Br J Gen Pract 2002;52(478):359–63.
- Mariolis A, Mihas C, Alevizos A, Gizlis V, Mariolis T, Marayiannis K. et.al.General practice as a career choice among undergraduate medical students in Greece. BMC MedEduc 2007;1(7):15.
- Scott I, Wright B, Brenneis F, Brett-MacleanP, McCaffrey L. Why would I choose a career in family medicine?: Reflections of medical students at 3 universities. Can Fam Physician 2007;53(11):1956-7.
- Aktaş EÖ, Çakır G. Aile hekimlerinin, aile hekimliği uygulaması hakkındaki görüşleri: bir anket çalışması. Türkiye Ege Tıp Dergisi 2012;51(1):21-29.
- Shrestha D, Joyce CM. Aspects of work-life balance of Australian general practitioners: determinants and possible consequences. Aust J Prim Health. 2011;17:40-7.
- Durmuş H, Timur A, Yıldız S, Çetinkaya F. Erciyes Üniversitesi hastanesi polikliniklerine başvuran hastaların Aile Hekimliği uygulamasından memnuniyet durumu. Türkiye Aile Hekimliği Dergisi 2018;22(1):2-11.
- Tanır F. Aile hekimliği uygulamalarının Doğankent Sağlık, Eğitim ve Araştırma Bölgesindeki durumu. Turkish Journal of Public Health 2014;12(2):91-9.
- Yıkılkan H, Aypak C, Görpelioğlu S. Aile hekimliği uzmanı olmak için öğrencilerin motivasyonları ve aile hekimliği uzmanlarının iş doyumları: literatür taraması. TJFMPC 2012; 6: 36-41.