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Medical students’ interest in general practice dips


Jolyon Attwooll


8/08/2023 3:34:31 PM

The proportion of final year students who signalled a preference for a career in general practice declined last year, according to a new report.

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A higher percentage of medical students used to go into general practice in previous decades compared to today.

The number of final year medical students whose first-choice career option is general practice has fallen to 13.1%, according to a large-scale survey carried out last year.
 
Produced by Medical Deans Australia, the survey was completed by more than half of the latest cohort of final year medical students, with 1999 respondents from a total of 3866.
 
It shows that while general practice remains the second highest ranked in terms of students who gave it their first preference, it represents another decline in the proportion looking to go into the specialty.
 
While the year-on-year fall this time was relatively slight – with the figure 12 months previously standing at 13.6% – it remains the lowest since 2011.
 
Numbers have oscillated in subsequent years, with a high of 17.8% registered in 2015, but the trend has generally been tracking downward.
 
The report authors write that when combined with the Rural Generalist category, general practice becomes the most preferred specialty – although the RACGP’s Rural Chair Associate Professor Michael Clements said that did not necessarily translate into reality after graduation.
 
‘There was a slight increase in interest in Rural Generalism [in this year’s survey], but this does not always convert to actual GP work as many are choosing rural generalism for the hospital roles,’ he told newsGP.
 
Associate Professor Clements said data suggests that interest in rural generalism drops ‘dramatically’ each year after medical school.
 
The most popular choice of speciality in 2022 was bracketed under the ‘Adult Medicine/Internal Medicine/Physician’ (15.5%), with surgery in the third place (12.1%). Marginally behind is anaesthesia (12%), which has shown a jump in popularity in the past three years.
 
Dr Sean Black-Tiong, Chair of the RACGP’s National Faculty for GPs in Training labelled the survey’s results as ‘disappointing’, although he said the interest in rural and remote medicine is reassuring.
 
He believes increasing student exposure to the work of GPs during their medical studies is a priority to address the trend.
 
‘Improving medical student access to general practice during medical school is key to not only giving them the chance to explore a future career option, but even for those keen on other specialties it provides insight into managing patients in the community rather than the outdated hospital-centric model,’ he told newsGP.
 
However, Dr Sean Black-Tiong remains upbeat about the appeal of general practice as a career, noting that RACGP Fellows are in high demand and that it is ‘a great time’ to pursue a career as a specialist GP.
 
‘While there are challenges at present with payroll tax and the funding structures of general practice, I have no doubt that there will always be a need for talented individuals in general practice who value holistic continuity of care and deliver better health outcomes in a cost-efficient way through judicious use of resources,’ he said.
 
Dr Black-Tiong stresses that the right supports need to be in place to allow the work of medical graduates going into general practice to have the most impact.
 
‘If GPs are resourced well in both funding and appropriate time to see patients, we see better outcomes for society than fragmented care driven by rigid adherence to protocols that fail to account for the infinite complexity of real-world patients,’ he said.
 
Concerns regarding future general practice workforce have been raised frequently in recent years, with analysis by the Deloitte consultancy firm predicting a shortfall of 11,392 full-time equivalent GPs by 2032.
 
Last year, Federal Health and Aged Care Minister Mark Butler referred to the lack of GPs in the pipeline as ‘probably the most terrifying trend’ in primary care.
 
A 2020 study published in the Medical Journal of Australia also suggests that the number of medical graduates going into general practice has dropped dramatically in recent decades.
 
Using AHPRA registration data, it found that 40% of 1985–87 medical graduates from one university were practising as GPs in 2019, compared to 15% of those who graduated from 2004–07.
 
A poll run this year also indicated that four in five newsGP readers experienced general practice being denigrated during their medical studies – a perception that RACGP President Dr Nicole Higgins warned is important to address.
 
‘Doctors going through medical school and hospital training can sometimes get a sense that general practice is a second-rate choice, and that really couldn’t be further from the truth,’ she told newsGP at the time.
 
The two factors that ranked highest for the first specialty preference are ‘Alignment with personal values’ and ‘Atmosphere/ work culture’.
 
Around 21% of medical graduates stated a preference to work in regional areas, smaller towns or small communities, a rate that was notably higher among domestic students.
 
The results are the latest to feed into the Medical Schools Outcome Database, a project which started in in 2005 and is designed to give insights into the background and intentions of medicine graduates.
 
It is viewed as one of the most comprehensive resources available to indicate the future work patterns of medical students once they graduate.
 
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Dr Gregory Parkin-Smith   9/08/2023 11:02:33 AM

Is anyone actually surprised by this result?