A qualitative perspective on what factors influence ScotGEM students’ career intentions

Abstract

Introduction: ScotGEM is a novel graduate medicine programme in Scotland with a rural generalist focus. This survey-based study aimed to assess the career intentions of ScotGEM students and the various factors influencing them.Methods: An online questionnaire was devised from existing literature that explored students’ interest regarding generalist or specialty career, geographical location, and influencing factors. Free-text responses regarding their primary care career interest and their reasoning behind geographical preferences allowed for qualitative content analysis. Responses were coded inductively and categorised into themes by two independent researchers who then compared and finalised the themes.Results: 126/163 (77%) completed the questionnaire. Content analysis of free-text responses in relation to a negative attitude towards a prospective GP career yielded themes: personal aptitude, emotional toll of GP and uncertainty. Themes in relation to desired geographical preference included: family factors, lifestyle issues and perceptions regarding professional and personal development opportunities.Discussion: The qualitative analysis of factors influencing the career intentions of students on the graduate programme is key to understanding what is important to them. Students who have decided against primary care have realised an early aptitude for specialism due to their experiences, while also witnessing the potential emotional toll of primary care. Family needs may already be dictating where they will choose to work in the future. Lifestyle reasons were in favour of both urban and rural careers, with a sizeable number of responses still uncertain. These findings and their implications are discussed in context of existing international literature on rural medical workforce.