Attitude of Maltese medical students towards family medicine.

Abstract

Description: The attitude of Maltese medical students towards family medicine has been examined through a cross-sectional study at two important stages in the history of the medical school in Malta. In 1991/92 Dr Denis Soler created, validated and published a questionnaire to explore this subject. He came to the conclusion then, that family medicine was seen as comparatively important to medical students, but was not necessarily their first choice of career. It should be noted that most other medical schools around the world have also identified the same problem and are trying to find solutions to it.

The issue is obvious. If the qualification system does not produce replacements for the general practitioners who exit (through retirement etc) and too many young doctors choose to specialize in other areas, the pressures increase unnecessarily on the secondary and tertiary health care sectors. Methods: Almost twenty years after his original questionnaire, we repeated Dr Soler's survey to find out if there had been any changes in the trend in Malta, not least because the Department of Family Medicine has been founded in the interim. The questionnaire was repeated in 2008 with all the students in the clinical years at the medical school at the University of Malta (n=200). Young doctors in Malta now have the opportunity to follow a course in post-graduate training over five years.

Problem finding: Malta's traditional problem has always been the loss of young doctors to the United Kingdom. Young doctors have seen their best chance for the future in migrating to the UK to complete their post-graduate training there before returning to Malta as a specialist - not necessarily in family medicine. The current problems in the primary health sector can be traced back to that source. The issue that Dr Soler and his colleagues from other countries identified almost twenty years ago are still, if not more, relevant today.

Aims: The issue we have to resolve is straightforward: are we training enough family doctors for the future? Considering the results of the current study is worrying. Today's students are simply not seeing family medicine as the first option in their career. All current efforts to get more students interested do not seem to be working. They compare the situation in Malta with the UK or Germany where family doctors are given much more importance, especially in management matters such as registration systems and IT health records. Malta therefore has to take positive action not only from the educational point of view, but also to meet the need to finance management issues, such as those identified in the previous paragraph. There is also a clear question to resolve - how the public health system interacts with the private health system, such as health insurance, at the general practitioner level. What Malta must address is the fact that family medicine still has a negative image compared to specific sectors such as surgery, gynaecology, dermatology and so on. Students see the financial issue of such specialities as offering a great advantage compared to, for example, the family doctor. The importance of the general practitioner, who has to work and, indeed, survive within the community, has to be accorded appropriate recognition and support.