Does Postgraduate Training Change the Attitude of Young Physicians Towards Working in Primary Care or in Specialized Internal Medicine?
Ergebnisse einer multizentrischen längsschnittlichen Untersuchung mit zweijährigem Intervallgerman translation / full article
A Longitudinal Multicenter Survey Study over Two Years in Germany
Background: Imminent shortage of young physicians in the statutory health sector.
Methods: Multicentre longitudinal cohort study of medical graduates of the class of 2009 and investigation of their long-term career plans during postgraduate training. Focus on the preference of ambulatory private practice and in particular of the disciplines of family and internal medicine. This was a standardized annual postal survey of graduates of seven medical faculties in Germany. Return rates on 2107 questionnaires were 48 % in the first, 87.1 % in the second and 88.8 % in the third year of the survey.
Results: Two years after initial survey, 30 % still preferred an activity as a specialist and less than 10 % still preferred a primary care activity. Especially women preferred to work as an employee in a health center. Family practice was preferred more often by women and by physicians with children. Almost one third of the respondents who preferred general internal medicine erroneously linked this to working as specialist. The wish for family practice and general internal medicine was characterized by a high proportion of respondents who had not clearly opted for these disciplines; however, they often regarded the other of the two subjects as their second choice. Less than one third abandoned their goal of becoming a primary care physician or an internal medicine specialist after two years, but rarely abandoned both subjects.
Conclusions: The results illustrate the future lack of primary care physicians and the demand for an effective and sustainable approach for the recruitment of physicians in primary care. Also, a clarification of terms and regulations concerning the statutory health sector seems to be necessary for physicians during postgraduate training.