Download the report (150 p.) - KCE
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<strong>KCE</strong> Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 23<br />
income 23 , 24 , 25 and <strong>the</strong> prestige 23 , 26 but more concerned about <strong>the</strong> psychosocial issues<br />
of <strong>the</strong>ir patients 19 , 26 , 27 , 28 , 29 .<br />
Different demographic factors are linked with <strong>the</strong> attraction for general practice. The<br />
gender, <strong>the</strong> age, <strong>the</strong> race, <strong>the</strong> marital status and <strong>the</strong> socioeconomic status are items to<br />
be considered.<br />
Female students view GP more positively than male students 22 , 23 , 24 , 30 , 31 . Women<br />
have a propensity for relation-orientated, humanistic specialties, such as family medicine<br />
20 , 21 , 25 , 32 , 33 , 34 .<br />
Older age would be a factor favorably influencing <strong>the</strong> orientation towards general<br />
practice according to some studies 20 , 21 , 23 , 26 , 34 , 35 5 . O<strong>the</strong>r studies did not observe <strong>the</strong><br />
influence of age 19 , 36 .<br />
No consensus is observed about <strong>the</strong> influence of ethnicity. One study suggests that<br />
nonwhites might be more inclined than whites to select general practice 33 .<br />
Being married and having children would positively influence <strong>the</strong> attraction for general<br />
21 , 23 , 27 , 32 , 33 ,<br />
practice according to some authors, in particular if <strong>the</strong> partner is also a GP<br />
35 5<br />
Several studies specify that a low socioeconomic status or low parental income or<br />
education is related to <strong>the</strong> choice of family practice 20 , 21 , 37 .<br />
PROFESSIONAL IDENTITY<br />
The respected title of GP associated with a notion of prestige is an important factor:<br />
<strong>the</strong> society considers actually <strong>the</strong> GP like a positive role model 34 , 38 , 39 , 40 , 41 , 42 , 43 , 44 . In<br />
addition, <strong>the</strong> medical school has a clear influence on <strong>the</strong> attraction for general practice.<br />
Several aspects include <strong>the</strong> school’s characteristics, <strong>the</strong> environment, <strong>the</strong> curriculum,<br />
<strong>the</strong> role models suggested and <strong>the</strong> students' perception.<br />
School characteristics and environment<br />
From a macroscopic point of view, <strong>the</strong> global academic commitment towards general<br />
practice influences <strong>the</strong> attraction of <strong>the</strong> student for that specialty 18 , in particular<br />
according to <strong>the</strong> presence of a department of family medicine 41 , 45 , 46 79 . The size of <strong>the</strong><br />
department, just like its research activity also indicates of <strong>the</strong> importance conferred on<br />
this discipline 45 .<br />
The culture of <strong>the</strong> academic medicine impregnated or not by <strong>the</strong> mission to encourage<br />
students to become GPs also plays a role in <strong>the</strong> attraction for <strong>the</strong> profession 26 , 45 , 47 77 .<br />
The attraction of <strong>the</strong> job is <strong>the</strong>refore related to quantitative parameters as <strong>the</strong><br />
proportion of faculty in family medicine 32 , 41 .<br />
The academic learning environment usually valued and promoted by <strong>the</strong> medical school<br />
faculty favors specialty and subspecialty careers over GP careers. Moreover, <strong>the</strong><br />
creation of subspecialty-oriented or research-oriented academic environment has<br />
unidirectional long-term effects on career decisions of medical graduates 26 .<br />
Finally, <strong>the</strong> increasing representation and leadership by GPs on admission committees<br />
has a beneficial effect on <strong>the</strong> applicants in general medicine 34 .<br />
From a microscopic point of view, <strong>the</strong> direct environment of <strong>the</strong> student influences his<br />
choice, like <strong>the</strong> class size 45 and <strong>the</strong> proportion of matriculating students who express<br />
an interest in family medicine 32 . In <strong>the</strong> US, <strong>the</strong> attendance of a public medical school<br />
influences positively <strong>the</strong> choice to become a GP ra<strong>the</strong>r than a specialist: <strong>the</strong> public<br />
medical schools have indeed more reacted to <strong>the</strong> social pressure to train a higher<br />
number of primary care physicians than <strong>the</strong> private medical schools 21 , 32 , 33 .<br />
Curriculum in general practice<br />
The literature frequently points out that students have a positive attitude after<br />
completing a course in GP 21 , 26 , 41 , 45 , 48 , 49 . Optional courses in primary care as well as