The reputation and professional identity of family medicine practice according to medical students: a Spanish case study

Abstract

Objective: Over the last decade, family medicine has been progressively rejected by medical students as a career choice in many Western countries. Our objective is to contribute to a better understanding of this phenomenon by examining the reputation of and identification processes with family medicine by medical students.

Design: A qualitative case study.

Methods: Focus groups and document analysis were used for generating empirical material. Focus groups (n=6) were conducted (2008-2009). Thematic analysis was adopted as the technique for analyzing data gathered.

Setting: A faculty of medicine of a Spanish university.

Participants: Second and sixth year undergraduate medical students (N=48).

Results: Family medicine appears to be largely devalued as a professional activity, among medical students, being viewed as a monotonous and non-technological medical practice with no intellectual challenge. Such a negative view, which already appears in early stages of medical training, leads to a lack of identification with this medical practice by students.

Conclusion: Misconceptions about the practice of family medicine, created and reproduced in health care system and societal contexts, encourage the practice of specialized medicine. In addition, the academic environment appears to promote organ- and disease-based medical knowledge, which goes against the holistic and patient-centered approach characteristic of the practice of family medicine. In order to improve the reputation of family medicine and for it to be considered as an attractive career path by medical students, it is recommended that family medicine is developed as an academic medical field, and that improvements are made in the conditions and status of this medical practice within the health care system.