A. Osiyemi1, O. Fasola1, I. Anjorin1, O. Adeyemo1, and T. Ilori1,2
- Department of Family Medicine, University College Hospital, Ibadan, Nigeria.
- Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria.
Background: One of the strategies adopted to improve interest in family medicine (FM) by many regions was the introduction of undergraduate family medicine training into the Medical School Curriculum. However, medical students’ interest in FM has been reportedly low ranging from 3 – 29%.
Objectives: This study described the pattern of medical students’ specialty choices and assessed factors associated with interest in FM specialization among them.
Methods: Using a cross-sectional study design, total sampling of fourth to sixth-year medical students undergoing family medicine rotation as of November 2017 (N= 412) was done. The response rate was 75% (N=309). A pre-validated semi-structured, self-administered questionnaire was utilized to assess factors associated with respondents’ interest in 12 medical specialties including FM.
Results: The respondents were predominantly male (67.3%), with a mean age of 23 (± 7.9) years. Most (83.4%) of them had at least one parent with tertiary school
education. Fifteen (4.9%) of the respondents indicated a current interest in
specializing in FM while 112 (36.2%) would consider FM in the future. A higher
proportion of those with family members with FM specialization (28.6%) expressed current interest in FM while the female gender was associated with future consideration of FM.
Conclusion: There is a low interest in FM specialization among medical students and this may be attributable to the fact that FM undergraduate training is relatively new in Nigeria. Further research on the role of mentorship and preceptorship on specialty choices of medical students needs to be carried out.
Keywords: Family medicine, Medical students, Medical specialties, Nigeria.
Dr. O. Fasola
Paelon Memorial Hospital,
Family Medicine (FM) as a specialty was born out of the need for holistic contextual patient care. The training in FM confers unique attributes that position the physician to offer health care at an affordable cost while maintaining high standards of care to all patients irrespective of age, sex, and gender.1 Increasing the workforce size providing primary medical care has become important especially in developing countries with limited resources.2,3 Undergraduate medical training is an effective strategy to meet this need and ensure equitable distribution of quality healthcare through primary care physicians.2,4,5 One of the strategies adopted to improve interest in family medicine by many regions was the introduction of undergraduate FM training into the medical school curriculum.6 A component of this training is the clinical clerkship in which the students have hands-on training and experience in patient care under the tutelage and supervision of family physicians.7 Family Medicine was introduced into Nigeria’s undergraduate medical education in 2008,3 to address the unmet need for primary care physicians.5 Study findings on the effect of clinical clerkship in stimulating interest in FM specialization have been equivocal.8–11 This study hypothesized that interest in the specialty would improve with increased exposure through clerkship. Numerous undergraduate medical programmes have reported low medical student interest in FM specialization (3 – 29%).6,11,12 With undergraduate FM still at its infancy in Nigeria, there are limited studies exploring the factors that influence medical students’ interest in the specialty. If strategies are to be implemented to improve career options in FM, more research has to be conducted targeted at young medical graduates, to understand their choices.
As such this study aims to describe the pattern of specialty choices and identify factors associated with current interest and future consideration of FM specialization among medical students in a Nigerian medical school.
This was a cross-sectional study carried out at the University of Ibadan (UI), Nigeria. At UI, 4th-year medical undergraduates receive didactic FM lectures while students in the 5th and 6th years undertake two blocks of FM clinical rotation/clerkship each lasting four weeks along with didactic sessions. Consenting 4th -6th-year students enrolled in the 2017 academic year were recruited for the study. Total sampling was carried out with a 75% response rate (309 of 412 students participated). Data was collected using a structured self-administered questionnaire that detailed respondent’s socio-demographic and family information, medical educational history, and questions exploring the student’s specialty interests. These questions were derived from pre-validated questionnaires from two similar studies6,13 and the current undergraduate FM curriculum at the university. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) Version 20.0 and statistical significance was set at < 0.05. Data were represented in tables and charts using frequencies and proportions. Bivariate analysis using Chi-square, and Fischer’s exact tests, were used to determine the association between the independent variables (sociodemographic data and clerkship year) and the dependent variables (current and future interest in FM). Approval of the Ethical Review Committee of the University of Ibadan/University College Hospital Ibadan Institutional Review Board (UI/UCH IRB) was obtained. Participation in the study was voluntary and informed consent was obtained before administration of the data collection tool. Privacy and confidentiality of the respondents was guaranteed by anonymizing the questionnaire. The respondents were not harmed in the course of the study and though there were no direct benefits to them at the time, the study findings will add to the body of knowledge on undergraduate family medicine education.