[How can we support medical residents and lateral entrants into general practice during the transition from the inpatient to the outpatient setting? A qualitative interview study].

Abstract

Background: In the context of specialist training and lateral entry into general practice (GP), the transition from inpatient to outpatient work can be associated with challenges and uncertainty. In view of the GP shortages, it is particularly important to promote both the entry into primary care and the quality of postgraduate training.

Methods: In a qualitative interview study, 15 lateral entrants into GP and resident doctors ("residents") were asked about challenges and needs, and the results were analyzed using content analysis.

Results: Lateral entrants and residents are characterized by their hospital-oriented approach. In addition, lateral entrants have to (re-)familiarize themselves with being a doctor in training. The heavy workload is a key challenge for residents. Different structures and requirements of the inpatient and outpatient setting are challenging for both groups. Both groups see a need for support in areas such as adapted specialist knowledge, GP vocabulary and outpatient work processes, and they benefit from educational programs in heterogeneous groups including both lateral entrants and doctors in training in the outpatient setting, e.g., through networking.

Discussion: The common needs identified provide information for educational program planning. Irrespective of heterogeneous life circumstances, joint support programs can be both useful and resource-sparing, as existing programs are often suitable for covering the identified needs. The qualitative findings of this study provide insight into the (professional) biographical context of the interviewees and should be quantitatively verified in further research.

Conclusion: In order to facilitate the transition from inpatient to outpatient care for both lateral entrants and residents, existing seminar and mentoring programs of the Competence Centers for Postgraduate Education can meet, with a few minor adjustments, the needs of both groups. However, it is important to find unique ways to address these groups and to identify and remove barriers to participation at an organizational level.