Developing the intention to pursue a general practice career: a longitudinal survey study from medical school graduation into postgraduate medical training.

Background: Due to a demographic shift, among others, more general practitioners will be needed in Denmark in the future. In this study, we examine Danish medical trainees' intention to pursue a career in general practice as they gain firsthand work experience during postgraduate education. The expanded conceptual framework of medical students' primary care career choice was used in the selection of variables related to the medical trainees' career intentions and work experience and in the interpretation of the results.

Methods: The study was a prospectively conducted longitudinal cohort study using cross-sectional time-series data. A questionnaire specific to the Danish context was used for data collection among a national cohort of medical trainees before they entered their first postgraduate training year and again after 15-17 months. Data was analyzed descriptively, and the effect of time on the intention to pursue a career in general practice was assessed using mixed models.

Results: Results showed significantly more medical trainees intended to pursue a general practice career at follow-up compared to baseline. Also, the group of medical trainees with that intention included the highest proportion of participants who were parents at follow-up. The intention to pursue a career in general practice was, among others, associated with an interest in regular work hours and the opportunity to work part-time and be self-employed at baseline and follow-up.

Conclusion: Applying the conceptual framework to the results suggests that medical trainees already at medical school graduation had gained an authentic and sufficient perception of general practice characteristics and that the shifts in specialty intentions during the follow-up period were driven by changes in personal characteristics.