What factors influence intention towards a career in general practice?

We read with interest the article by Merrett et al¹ on young doctors’ attitudes towards a career in general practice and have collated complementary data from students. We surveyed all final-year medical students at Newcastle University, on completion of their rotation in general practice, over the last 2 academic years. Responses were received for 578 students (response rate = 85%). Students were asked whether they intended to pursue a career in general practice and which factors influenced their decision. One-hundred-and-ten (19%) reported an intention to become GPs and 189 (33%) stated it was one of their options.

We identified a range of themes that positively influenced career intention: specific practice-related factors such as good general practice role models (‘Dr X has shown me how important a good GP can be’); career-related factors such as work– life balance; and specialty-related factors such as variety of presentations encountered (‘Find general practice an interesting career with good opportunity to see a large variety of patients and build up a good rapport. However, main benefit for me was also the work–life balance’).

Negative influences on GP career intention included stress among GPs, lack of procedural skills, and lone working (‘I feel general practice is slightly exhausting, and there is not as much interaction with other professionals during the day’). Negative comments from hospital doctors were also cited (‘General practice has appealed to me in the past. However, the berating they get from hospital doctors (for reasons varied and often unsubstantiated) put me off’).

We believe these studies add to the crucial contemporary literature into why an individual may choose to pursue a career in general practice.² In addition to the recommendations raised by Merrett et al¹ around funding, workload, and respect, we would emphasise the key aspect of positive GP role models³ and the need to explore the perception of general practice as a lonely career. Finally, we must take seriously the recommendation in the Health Education England/Medical Schools Council report, quoted in the editorial of the same BJGP issue,⁴ that ‘[w]ork should take place to tackle undermining of general practice as a career across all medical school settings’.⁵ That work must start now.