Does a brief clerkship change Hong Kong medical students' ideas about general practice?

Abstract

Objectives: This study examines the impact on students of a brief general practice clerkship, during a curriculum that is otherwise almost entirely hospital-based and in a practice environment that often does not encourage good primary care. Design: 15 focus group discussions were held with a total of 110 students, as part of an action research project. Student responses were audiotaped, transcribed and then analysed for recurrent themes. Setting: General Practice Unit, University of Hong Kong. Subjects: Medical students. Results: There was evidence of pre-existing negative stereotypes of general practice, but in many cases these were dispelled by the relationships students developed during their attachment to general practitioners in the community. In an overcrowded curriculum, students ration their time and energy, focusing their learning pragmatically on subjects that have a high profile during examinations. Conclusions: Even in healthcare and medical school systems that are specialist-dominated, and in which the circumstances of practice do not always encourage high standards of care, the general practice clerkship can allow students to gain an understanding of the importance of primary care, and of the significance of the general practitioner's role in the healthcare system.