The Results of Six Years Postgraduate Vocational Training for Primary Medical Care in Germany – Results of the KarMed-study (Part 2)

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Hendrik van den Bussche, Sigrid Boczor, Stephanie Siegert, Sarah Nehls, Susan Selch, Rüja-Daniela Kocalevent, Martin Scherer

Keywords: career choice family medicine gender differences postgraduate medical education primary care

Background: The background to the KarMed-study is the impending shortage of junior family physicians (FPs). The aim of the study is the longitudinal investigation of the career aspirations of graduates of medical undergraduate education in 2009 during the six-year postgraduate training phase for family medicine. This time span of investigation is one year longer than the minimum requirement of five years. We examined which factors influence the choice of family medicine. It was also analyzed to what extent future FPs intend to work outside the major cities. Methods: Annual standardized postal surveys of graduates of seven medical faculties from the practical year to a maximum of six years of further education. Response rates: 48 % in the first survey year, then 85 % and more in all surveys. Longitudinal analysis with descriptive statistical methods and regression analyses were applied.Results: The results show a considerable increase in the attractiveness of family medicine by female residents over the six years. The most striking features here were a) the increasing intention to work in an employment relationship instead of private practice, and b) the increasing tendency to work part-time. A growing preference for a FP-activity in smaller towns and the countryside was shown (14 % of doctors after vocational training preferred work in a rural area and a further 24 % in small towns). Regression analysis shows a clear correlation between the preference for family practice and parenthood. Conclusions: Some 70 % of future FPs will probably be female doctors. FP care will not only become a female sector, but also a parent sector. To ensure the provision of primary care will be more difficult in the future because the majority of interested female doctors would like to work part-time and as salaried employees. Alternative organizational models should be developed and tested in practice for this sample, not least from an economic point of view.

(State: 15.01.2019)

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