What factors influence British medical students’ career intentions? A primary care response

Dear Sir

We read with interest the article by Ibrahim et al. (2014) on the factors that influence British medical students’ career intentions. In particular, we noted the finding that clinical attachments in many specialities, including General Practice, did not appear to increase the desire to pursue that speciality.

We have collected data over the last 10 years of cohorts of final year medical students at one university suggesting otherwise. We found that completing a primary care rotation had a strongly positive effect on students’ stated intention to pursue a GP career. Over the 10-year period we asked 2563 students, after their final year primary care rotation, what their intentions had been before and after their attachment. On average, 37% (range 31–44%) of students every year had not considered GP as an option before the rotation, but did so afterwards.

Conversely, only 2% of students’ GP career intentions changed negatively. The remaining students’ intentions were unchanged, with 20% intending to pursue a GP career, 16% not intending to, and 25% remaining undecided. Overall, our results show that prior to the final year primary care attachment 20% of medical students intended to pursue a career in general practice, compared to 57% of medical students afterwards.

Reasons given by the students for their positive change in career intention as a result of the primary care attachment included personal factors (such as developing skills in dealing with uncertainty), GP career related factors (such as job flexibility), and factors related to experiences at their specific attachment practice (such as positive atmosphere).

This area is crucial, as Health England have set a target of 50% of graduates becoming General Practitioners, with the current figure being static at roughly 35% (General Medical Council 2014). Our findings suggest that a rotation in primary care positively influences students’ stated intention to become General Practitioners. Further work is imperative to explore why the willingness of students to become General Practitioners appears to decline between final year at medical school and the time of choosing their career options.

Declaration of interest: The authors report no conflicts of interest.