Medical students’ attitudes towards careers in primary care in Singapore

Abstract

Background: Singapore needs more family doctors to care for its ageing population and their chronic conditions. While there is a shifting of care from acute care settings to more community care, this has not been reflected in the primary care training in local medical schools. Furthermore, no research has explored how different aspects of the medical school curricula in Singapore influence students’ perceptions of careers in General Practice and Family Medicine- a gap that is filled by this study. Methods: Six focus groups involving 54 students from all three medical schools in Singapore were conducted. Discussions focused on their primary care experience, their professional and career aspirations, and perceptions towards the opportunities and challenges of primary care careers. Qualitative content analysis was used to interpret the data. Results: The respondents shared eight key concerns of pursuing primary care careers including limited professional opportunities, emphasis on lifestyle benefits rather than professional characteristics, need for business acumen, conflicts created by business in clinical care, mundane case mix, lack of continuity of care, limited consultation time, and specialists’ negative attitudes towards family doctors. The positive views articulated included the opportunities for entrepreneurialism and a portfolio career, breadth of clinical problems presented, and an improved future for primary care. Conclusions: Improving students’ perceptions of careers in primary care in Singapore would benefit from a concerted effort from multiple stakeholders; medical schools, healthcare providers, professional and regulatory bodies, and government.