Medical students' perceptions and attitudes about family practice: a qualitative research synthesis.
BACKGROUND
During the last decade medical students from most Western countries have shown little interest in family practice. Understanding the factors that influence medical students to choose family medicine is crucial.


OBJECTIVE
To systematically review and synthesize published evidence about medical students' attitudes and perceptions towards family practice.


METHODS
A qualitative systematic review. The literature search was undertaken in July 2010 in PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Social Science Citation Index (SSCI), and ProQuest Dissertations & Theses. Two authors independently selected the studies for their inclusion and assessed their quality. The selected studies were thoroughly read. Key themes and categories were identified. A matrix was created for allowing the comparison of each theme across studies.


RESULTS
Ten studies were finally included. Seven broad themes were identified across them: 1) Scope and context of practice was a broad theme comprising linked sub-themes: perception of a varied specialty, broad practice, holistic perspective and flexibility that allows having a family; 2) Lower interest or intellectually less challenging: treating common disease, repetitive, quasi administrative job; 3) Influence of role models, either positive and negative, and society: negative comments from other professionals, peers and family; 4) Lower prestige; 5) Poor remuneration; 6) Medical school influences, being important both the length and quality of the exposure; 7) Post graduate training, where the shorter duration and the lower intensity were perceived as positive aspects. After identifying these seven key themes, were also looked into patterns in the distribution of these themes among studies.


CONCLUSIONS
Our qualitative review provides a comprehensive picture of medical students' attitudes towards family practice in the available literature. In general, although some students find family medicine appealing, it is regarded as a career of low interest and prestige. More research is needed on the influence of role models, medical school and post graduate training.
Servicio Catalán de la Salud, División de Planificación y Evaluación Operativa, Barcelona, Spain.
Anna
A
Selva Olid
Amando Martín
AM
Zurro
Josep Jiménez
JJ
Villa
Antonio Monreal
AM
Hijar
Xavier Mundet
XM
Tuduri
Angel Otero
AO
Puime
Gemma Mas
GM
Dalmau
Pablo Alonso-
PA
Coello
D002755:Choice Behavior; D005194:Family Practice; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*