At what stage in the undergraduate curriculum is it best to train in family medicine? A study from two medical schools in Spain

Abstract

Background: A course in family medicine (FM) could dispel the possibility of negative stereotyping about this speciality, and instil in students a greater interest. However, when is it preferable: at the beginning or at the end of undergraduate training? Objectives: To determine changes in knowledge and attitudes towards FM by medical students completing a course in primary care at the beginning or the end of the undergraduate training and whether those changes anticipate the choice of speciality. Methods: Students from Albacete and Seville medical schools (primary care course in second and sixth years, respectively) were asked to respond to the ‘valuation of attitudes towards and knowledge of family medicine questionnaire’ (CAMF). Students from Albacete answered before and after the course, and in Seville second-year students answered at the end of the first trimester. All students were invited to respond again at the end of their undergraduate training. Afterwards, we investigated the score on the speciality exam (order for the election from highest to lowest score) and their choice of speciality. The outcome measures were the MIR exam score, the number in the ranking, the chosen speciality and the result of the CAMF. Results: In Albacete 88 and 64 and in Seville 50 and 98 students responded in their second and sixth years, respectively. In Albacete, mean CAMF scores were 15.4, 22.7 before and after the course, and 21.8 at the end while in Seville, 13.9 in the second year, and 23.5 in the sixth year. Logistic regression analysis showed an association of the choice of FM only with the score on the speciality exam (OR: 0.667; 95%CI: 0.553–0.806). Conclusion: There were no significant differences between CAMF scores at the end of undergraduate training. Only the score on the speciality exam predicts FM choice: the higher the score, the lower the probability of choosing FM.

Medical students’ perception of general practice: a cross-sectional survey

“…We have been questioning whether our GP course comes too late in our curriculum. However, Lopez-Garcia showed that at the end of undergraduate training, there are no significant differences between students who have taken a GP-course in the second year and those who took such a course in the sixth year regarding their postgraduate interest in general practice [20]. The fact that 71% of Ma3 students in this survey were interested in general practice probably helps explain the 30% enrolment by our graduate doctors in the postgraduate general practice training, while the average for the Netherlands is 22% [21].…”

¿Por qué las personas graduadas en medicina no quieren trabajar en Atención Primaria?

“…Apenas una décima parte lo consideran su primera opción laboral en cursos preclínicos 5 , y esa proporción disminuye al final del grado 6 . Las actitudes de las y los estudiantes hacia la Medicina Familiar son similares independientemente de que se imparta una asignatura específica en cursos clínicos o preclínicos, y no predicen la elección posterior de la especialidad 7 .…”