Medical student attitudes towards family medicine in Spain: a statewide analysis (BMC Family Practice)

Background: Family and community medicine (FM) became a recognized specialty in Spain in 1978; however, most medical schools in Spain still lack mandatory core courses in FM. As part of a larger study that evaluates medical student attitudes and perceptions about primary care (PC) in university education and in the National Health System, we present the first cross-sectional results. Methods: The study population was all first-, third-, and fifth-year students (2009-2010) in 22 participating medical schools in Spain (of 27 total). The 83-item survey had three sections: personal data, FM training, and professional practice expectations/preferences). Chi-squared test or analysis of variance were used, as appropriate. Results: We had a 41.8% response rate (n=5299/12667); 89.8% considered the social role of FM to be essential, while 20% believed the specialty was well respected within the medical profession. The appeal of FM increased with years of study, independent of student characteristics or medical school attended. Among third and fifth-year students, 54.6% said their specialty preferences had changed during medical school; 73.6% felt that FM specialists should teach FM courses, and 83.3% thought that FM rotations in primary care centers were useful. Conclusions: Students valued the social role of FM more highly than its scientific standing. The vast majority believe that FM training should be mandatory. Only 25% of first-year students have clear preferences for a specialization. Interest in FM increases moderately over their years of study. Working conditions in FM have decisive influence in choosing a specialty.