ABSTRACT
OBJECTIVES: To identify the preferred specialties, salary perception and other factors that influence the choice of a career in primary care among last-year medical students or social service students in Central America. METHODS: A cross-sectional, multicenter study using a survey that investigated demographic information, preferred specialty, salary perception, and other factors that influence the choice of a specialty. RESULTS: A total of 1 722 students from 31 universities participated and identified as future specialties: surgery (11.7%), gynecology/obstetrics (10.3%), pediatrics (9.9%) and internal medicine (6.6%). General medicine was preferred by 3.8% and family medicine by 1.1%. On grouping them, the greatest interest was observed for medical specialties (49.7%), followed by surgical specialties (31.7%). Primary care registered an interest of 17.1%. Surgical specialties were perceived as having the highest income (USD 36 000); primary care was perceived as having the lowest income (USD 24 000). Income (23.6%), future work (19.7%) and "making a difference in people" (8.9%) were the main factors involved in the choice. "Working with people with low access" was significantly associated with preference for primary care. Preference for other specialties was influenced by "perceived prestige" and "enjoying life" (P < 0.05). Most participants who chose primary care were studying at a public university (P < 0.05), highlighting the role of public institutions of higher education. CONCLUSIONS: There is a combination of facilitating factors and barriers that affect the low interest in primary care careers. There is a need for strategies from academia and the government sector, as well as the definition of public policies, that support the choice of primary care.
ABSTRACT
[RESUMEN]. Objetivos. Identificar las especialidades preferidas, la percepción salarial y los factores que influencian la elección de una carrera en atención primaria en los estudiantes de último año de medicina o en servicio social de América Central. Métodos. Estudio multicéntrico de corte transversal con aplicación de una encuesta que investigó la información demográfica, la especialidad preferida, la percepción salarial y otros factores que influyen en la elección de la especialidad. Resultados. Participaron 1 722 estudiantes de 31 universidades que identificaron como futuras especialidades: cirugía (11,7%), ginecología/obstetricia (10,3%), pediatría (9,9%) y medicina interna (6,6%). Medicina general alcanzó 3,8% y medicina familiar 1,1%. Al agruparlas el mayor interés fue para las especialidades médicas (49,7%), seguido de las quirúrgicas (31,7%). Atención primaria registró un interés del 17,1%. Las especialidades quirúrgicas fueron percibidas como de mayor ingreso (USD 36 000); atención primaria fue percibida como la de menor ingreso (USD 24 000). El ingreso (23,6%), el trabajo a futuro (19,7%) y “hacer una diferencia en las personas” (8,9%) fueron los principales factores involucrados en la elección. “Trabajar con personas con escaso acceso” se asoció de manera significativa con la preferencia por la atención primaria. La preferencia por otras especialidades fue influenciada por el “prestigio percibido” y “disfrutar la vida” (P < 0,05). La mayoría de los participantes que eligieron la atención primaria provenían de una universidad pública (P < 0,05), lo que pone de relieve el papel de las instituciones estatales de educación superior. Conclusiones. Existe una combinación de factores facilitadores y de barreras que inciden en el desinterés hacia las carreras de atención primaria. Se requiere de estrategias desde la academia y el sector gubernamental, así como la definición de políticas públicas, que favorezcan la elección de la atención primaria.
[ABSTRACT]. Objectives. To identify the preferred specialties, salary perception and other factors that influence the choice of a career in primary care among last-year medical students or social service students in Central America. Methods. A cross-sectional, multicenter study using a survey that investigated demographic information, preferred specialty, salary perception, and other factors that influence the choice of a specialty. Results. A total of 1 722 students from 31 universities participated and identified as future specialties: surgery (11.7%), gynecology/obstetrics (10.3%), pediatrics (9.9%) and internal medicine (6.6%). General medicine was preferred by 3.8% and family medicine by 1.1%. On grouping them, the greatest interest was observed for medical specialties (49.7%), followed by surgical specialties (31.7%). Primary care registered an interest of 17.1%. Surgical specialties were perceived as having the highest income (USD 36 000); primary care was perceived as having the lowest income (USD 24 000). Income (23.6%), future work (19.7%) and “making a difference in people” (8.9%) were the main factors involved in the choice. “Working with people with low access” was significantly associated with preference for primary care. Preference for other specialties was influenced by “perceived prestige” and “enjoying life” (P < 0.05). Most participants who chose primary care were studying at a public university (P < 0.05), highlighting the role of public institutions of higher education. Conclusions. There is a combination of facilitating factors and barriers that affect the low interest in primary care careers. There is a need for strategies from academia and the government sector, as well as the definition of public policies, that support the choice of primary care.