Why did You Choose not to be a Generalist? A Qualitative Study About Career Decision-Making Among Physicians who were Interested in General Practice but Chose to be a Specialist / 日本プライマリ・ケア連合学会誌

ABSTRACT

Background: There is an increasing demand for general practitioners capable of examining patients from a broad perspective. Although the training of such doctors is urgently needed, the accreditation system was only recently put into place.Purpose: Our aim was to identify factors that influence career decision-making among doctors who were interested in general practice but chose to be specialists, in addition to finding methods to improve general practitioner training in the future.Method: From April 2017 to April 2018, we conducted semi-structured interviews with five subjects to understand the process leading up to the selection of their current careers. The verbatim records were analyzed using the modified grounded theory approach.Results: The reasons given for choosing specialist careers included "attraction as a field of study", "being relied upon by other doctors", and "the sense of security from having a specialty". Cited barriers to entering general practice included "uncertainty about the future" and "criticism from specialists".Conclusion: Improving the training curriculum for general practitioners will require improvement of the quality of community-based medical education and the general practice board certification system, in addition to the implementation of general practice retraining for specialists.