Factors influencing career development of Australian general practitioners

To evaluate factors influencing career experiences and career choices made by former general practitioner registrars and to ascertain the reasons for these career decisions.

A postal questionnaire was sent to all former registrars who completed the RACGP Training Program between 1994 and 1996. In addition 21 selected respondents were interviewed to obtain deeper insights into the comments recorded in returned questionnaires. All data were analysed for variance according to age, gender, state and locality of current general practice (i.e. whether metropolitan, rural or remote).

Altogether, 472 of the 988 questionnaires distributed were completed and returned. Of the respondents, 62.3% were female and 36.4% male; 68% were aged 30-34 years. Most (85.4%) lived with a partner, and 53.8% had at least one child. The majority (87.9%) of respondents gained their primary medical qualification in Australia. In addition to the FRACGP, 35.6% had also gained a Diploma of Obstetrics and Gynaecology. A number of other qualifications were recorded. Three-quarters (75.6%) of participants were currently working as group GPs, two-thirds of whom were employees; 5.9% were solo GPs; 3.4% locums; and 1.3% rural hospital medical officers. About one-third (32.4%) held a second job; most of these were in subspecialty clinics or attachments. Sixty-six percent were currently in metropolitan practice, 17.6% in rural and 2.7% in remote practice. The two highest ranked career options were continued professional development (70.8%) and performance of minor procedures (67.2%). Family and domestic circumstances stood out as the most influential factor for 79.0% of GPs. The majority (75.8%) felt that vocational training had exerted a positive effect on their careers through, for example, exposure to varied practice types and good overall clinical training.

While general practice experience in undergraduate education is an important factor in career choice, vocational training strongly influences preparation for, and the type of general practice undertaken. Nevertheless, family circumstances were reported as the most important consideration, although male and female work patterns differed markedly. It is concluded that these differences reflect different priorities in balancing professional and personal demands. The particular needs of the growing proportion of female practitioners have strong implications for future educational and workforce planning.