General practice specialty decision making: a system-level Australian qualitative study

Area of Science:

• Medical Education
• Health Workforce Research
• Career Development

Background:

• Global shortages of general practitioners (GPs) are exacerbated by increasing healthcare demands and pandemic conditions.
• System-level understanding of influences on GP career decisions throughout medical training is lacking.
• Investigating factors influencing GP specialty choice is critical for workforce planning.

Purpose of the Study:

• To explore the rationales behind general practice specialty choices.
• Utilized career selection narratives from recently registered Australian GPs.
• Adopted a system-level perspective to analyze decision-making influences.

Main Methods:

• Employed semi-structured interviews for in-depth exploration of GP specialty choice rationale.
• Conducted online interviews with GPs who completed training within the last 10 years.
• Utilized deductive framework analysis with career counselling constructs and inductive thematic analysis on verified transcripts.

Main Results:

• Career counselling constructs illuminated system-level understanding of GP specialty decision-making.
• Participants reported significant gaps in information about general practice careers during medical training.
• Positive experiences within GP communities and work provided insights into the flexibility and person-specialty fit of general practice, often overcoming negative career narratives.

Conclusions:

• Work experiences and personal connections within general practice can effectively counteract negative career narratives.
• A critical barrier identified is the lack of systemic and regular exposure to general practice during medical training.
• Sustained policy and professional interventions are needed to address this exposure gap and improve GP recruitment.