A study on what influence medical undergraduates in Hong Kong to choose family medicine as a career

Abstract

Objective: To evaluate the preferred medical specialties among Hong Kong’s final year medical students when they graduate from medical schools, and the factors they considered in making their choices, especially those associated with the decision of whether to choose family medicine, as a career. Design: A cross-sectional survey with anonymous self-reporting questionnaires Subjects: All final year (5th year) medical students from the University of Hong Kong and the Chinese University of Hong Kong. Main outcome measures: The top 3 specialty choices, the 3 strongest reasons to consider when students make their specialty choice, and the students’ opinion towards family medicine, the key influential factors for choosing or not choosing family medicine. Results: From an overall response rate of 94% or 200 valid questionnaires received, 18 (9%) respondents put family medicine as their first choice. Seventy-five (37.5%) included family medicine in their top 3 career choices. Interest was a major factor considered in the choice of specialty. Female sex (OR 2.264; 95% C.I. [1.276 – 4.016], adequate opportunity to interact with patients (OR 3.733; 95% C.I. [1.991 – 6.996]) and less stressful working environment (OR 2.723; 95% C.I. [1.329 – 5.582]) were factors independently associated with the choice of family medicine. Lack of a well-developed primary care system in Hong Kong, perceived lack of intellectual stimulation and perceived inferiority of family medicine to other specialties were the top three reasons which discouraged medical students from choosing family medicine. Conclusion: Family medicine remains the third popular choice of specialty for final year medical students in Hong Kong. Efforts to build up family medicine as a preferred career choice for medical undergraduates should be explored although it may take a system change in healthcare delivery that enhances the delivery of quality of primary care to arouse more interest in family medicine.

目的： 評估香港醫科畢業生首選的醫療專業，以及影響他們作出選擇的因素，特別是與是否選擇家庭醫學（FM）的相關考慮原因。

設計: 自我報告的匿名問捲橫斷面調查。

對象: 所有最後一年（第五年）的香港大學和香港中文大學醫學生。

主要測量內容： 前3位的專業選擇，3大影響學生選擇專業的原因，學生對家庭醫學（FM）的觀感，選擇或不選擇FM主要考慮因素。

結果: 總回覆率為94％。200份有效問卷中，18（9％）位受訪者把家庭醫學作為他們的首選。75（37.5％）位，把FM括入其前3名的職業選擇。興趣是專業選擇的主要考慮因素。女性（OR2.264;95％CI[1.276-4.016]，與患者互動的時間充足（OR3.733;95％CI[1.991-6.996]）和工作環境壓力較小（OR2.723;95％CI[1.329-5.582 ]）是選擇家庭醫學的獨立關連因素。香港缺乏發展良好的基層醫療系統，感覺專業知識的水準不夠高和認為家庭醫學較其他醫療專業地位低是阻攔醫學生選擇家庭醫學的三個最重要原因。

結論: 家庭醫學仍然是香港應屆醫科畢業生的第三熱門專業。應該努力去探索鼓勵醫科生以家庭醫學作為首選專業，雖然它可能需要醫療服務體系的改變，增強基層醫療服務的質量，以喚醒醫科畢業生對家庭醫學的興趣。