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. 2021 Dec;53(10):102153.
doi: 10.1016/j.aprim.2021.102153. Epub 2021 Jul 21.

[Elements influencing the election of Family and Community Medicine]

[Article in Spanish]
Jasmine Elsie McGhie  1 , Anna Dalmau Roig  1 , Marta Florensa Puig  2 , Pau Silva Ruiz  1 , Gisela Oñate Ferriz  1 , Eva Maria Gracia Baño  1
Affiliations

[Elements influencing the election of Family and Community Medicine]

[Article in Spanish]
Jasmine Elsie McGhie et al. Aten Primaria. 2021 Dec.

Abstract
in English, Spanish

Aim: To analyze the perceptions, motives and reasons that influence the election of Family and Community Medicine (FCM) speciality, thus exploring possible proposals for change in the health system model and university training.

Design: Descriptive-interpretative qualitative research from a socio-constructivist perspective.

Emplacement: Medical speciality training departments in the Metropolitan Area of Barcelona.

Participants and context: 55 first year junior doctors belonging to the FCM Barcelona Ciutat ICS training department were contacted; 25 agreed to participate. They were segmented into two groups depending on if the choice of FCM had been their first option or not. Through snowball sampling 11 more junior doctors from other specialities were recruited.

Method: Three focus groups were formed: (a) first choice FCM, (b) not first choice FCM and (c) other specialities. Semi-structured 2-h long interviews took place with each of the groups. Literal transcription and inductive codification with a first triangulation within each group and a second one between the three of them and thematic content analyses.

Results: The choice of speciality is lived as an academic milestone and is thought determining professional and personally. It is a complex weave of influencing elements but some of main factors were university training, health system model, professional prospects and the social appreciation of the speciality. Analyzing the relation between these elements puts light on a phenomena we have called "the discredit of Primary Care (PC)".

Conclusion: The FCM specialty will not be attractive in a hospital-centric health and training system that does not bet on PC organizationally or economically.

Objetivo: Analizar las percepciones, motivaciones y razones que influyen al elegir la especialidad de Medicina Familiar y Comunitaria (MFyC), y explorar posibles propuestas de cambio sobre el modelo sanitario y la formación universitaria.

Diseño: Estudio cualitativo descriptivo-interpretativo de perspectiva socioconstructivista.

Emplazamiento: Unidades docentes del Área Metropolitana de Barcelona.

Participantes y contexto: Se contactó con 55 residentes de primer año de MFyC pertenecientes a la U.D. MFyC Barcelona Ciutat ICS vía telefónica, y se reclutaron 25 participantes que fueron segmentadas en dos grupos según hubieran escogido MFyC como primera opción o no. Mediante muestreo en bola de nieve, se reclutaron once residentes de primer año de otras especialidades.

Método: Constitución de tres grupos focales: (a) MFyC como primera opción, (b) no como primera opción y (c) otras especialidades. Desarrollo de entrevistas grupales semiestructuradas de dos horas de duración. Codificación inductiva con una primera triangulación intra-grupo y una segunda triangulación inter-grupo, posterior análisis de contenido temático.

Resultados: La elección de plaza MIR representa un gran hito académico y es pensado como determinante para el futuro tanto profesional como personal. Así, se dibuja como resultado de una compleja trama de elementos influyentes, destacando la formación universitaria, el modelo sanitario, las expectativas laborales y la valoración social de la especialidad. Poniendo en relación los diferentes factores, se pone de manifiesto el fenómeno llamado desprestigio de la AP.

Conclusión: La especialidad de MFyC no será atractiva en un sistema sanitario y formativo hospitalo-céntrico que no apuesta por la AP organizativa ni económicamente.

Keywords: Cualitativa; Elección; Election; Especialidad; Family medicine; MIR; Medicina de familia; Qualitative; Residency program; Specialization.

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Figures

Figura 1
Figura 1
Percepciones, motivación y razones para la elección de MFyC.
See this image and copyright information in PMC

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