Factors associated to the career choice of family medicine among Japanese physicians: the dawn of a new era.

Q1 Medicine
Asia Pacific Family Medicine Pub Date : 2014-10-03 eCollection Date: 2014-01-01 DOI:10.1186/s12930-014-0011-2
Kenya Ie, Masao Tahara, Akiko Murata, Manabu Komiyama, Hirotaka Onishi
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Abstract

Background: Despite recent developments in post-graduate family medicine training in Japan, the numbers of junior doctors entering family medicine residencies are still limited. The objective of this qualitative study was to investigate the possible factors associated to the career choice of family medicine, especially in the context of the newly established family medicine programs in Japan.

Methods: From December 2010 to January 2011, we distributed a semi-structured questionnaire about career choice to 58 physician members of the Japan Primary Care Association, and 41 of them responded. Four researchers used the Modified Grounded Theory Approach (Kinoshita, 2003) for three-stage conceptualization.

Results: We extracted a conceptual model of the choice of newly established family medicine as a career in Japan, consisting of six categories and 77 subordinate concepts from 330 variations. The subcategories of personal background affecting the family-medicine career choice were characteristics ("self-reliance," "pioneering spirit"), career direction ("community/rural-orientedness," "multifaceted orientation") and experience (e.g., "discomfort with fragmented care"). We divided the influencing factors that were identified for career choice into supporters (e.g., "role model"), conflict of career choice (e.g., "anxiety about diverse/broad practice"), and the dawn of a new era in family medicine in Japan (e.g., "lack of social recognition," "concern about livelihood," and "too few role models").

Conclusions: Although the dawn of a new era seemed a rather negative influencer, it was unique to our study that the dawn itself could attract those with a "pioneering spirit" and an "attitude of self-training." Unlike previous studies, the positive factors such as lifestyle and the short residency program were not shown to be part of family medicine's attractiveness. In contrast, "concern about livelihood" was specific among our respondents and was related to career choice in the dawn period. "Community-orientedness" and "multifaceted orientation" (which have aspects in common with previous studies' findings) would appear to be universal regardless of cultural and medical system differences. In our study, these universal factors were also found to be part of the attractiveness of family medicine from the practitioners' viewpoints, and these factors may become great influencers for family medicine candidates.

Abstract Image

日本医生选择家庭医学职业的相关因素:新时代的来临。
背景:尽管日本最近在家庭医学研究生培训方面有所发展,但进入家庭医学住院医师培训的初级医生人数仍然有限。本定性研究旨在调查与家庭医学职业选择相关的可能因素,尤其是在日本新设立家庭医学项目的背景下:方法:2010 年 12 月至 2011 年 1 月,我们向日本初级保健协会的 58 名医生会员发放了有关职业选择的半结构化问卷,其中 41 人作了回答。四位研究人员采用修正基础理论方法(Kinoshita,2003 年)进行了三阶段概念化:结果:我们从 330 个变量中提取了日本新成立家庭医学作为职业的选择概念模型,包括 6 个类别和 77 个下级概念。影响家庭医学职业选择的个人背景子类别包括特征("自力更生"、"开拓精神")、职业方向("社区/农村导向"、"多方面导向")和经验(如 "对分散护理的不适应")。我们将影响职业选择的因素分为支持者(如 "榜样")、职业选择冲突(如 "对多样化/广泛实践的焦虑")和日本家庭医学新时代的到来(如 "缺乏社会认可"、"对生计的担忧 "和 "榜样太少"):尽管新时代的来临似乎是一个相当消极的影响因素,但在我们的研究中,新时代的来临本身就能吸引那些具有 "开拓精神 "和 "自我培训态度 "的人。与以往研究不同的是,生活方式和短期住院医师培训计划等积极因素并未成为家庭医学吸引力的一部分。相比之下,"对生计的关注 "在我们的受访者中比较特殊,与黎明期的职业选择有关。"以社区为导向 "和 "多方面导向"(与之前的研究结果有共同之处)似乎具有普遍性,与文化和医疗制度差异无关。在我们的研究中,从从业者的角度来看,这些普遍因素也是家庭医学吸引力的一部分,这些因素可能成为家庭医学候选人的重要影响因素。
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Asia Pacific Family Medicine
Asia Pacific Family Medicine Medicine-Family Practice
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