In Ukraine, health financing reform of 2018 highlighted the importance of family medicine and general practice. Primary health care providers have received more managerial autonomy, new approach to providers’ payments as well as mix of public and private providers has been allowed. Still, family medicine has been left behind for many years: medical education curricula has not include adequate share of general practice courses, and additionally GPs were mostly ignored by specialists – physicians, patients, policy makers and medical university graduates who had to make the choice of their future specialty. Hence, the issue of perception of family medicine in medical schools, universities still demands more attention and actions.

A family medicine perception study was conducted by the Ukrainian-Swiss Project “Medical Education Development” in spring 2019 in five medical universities in Ukraine among students of the third and sixth years of study, and teachers of different university departments. The survey showed very low interest of students in family medicine as their future specialty – only 20% of respondents expressed potential interest in this field in contrast to 49% in case of surgery and 48% gynecology.

The existing medical education curricula contains mostly one course on family medicine which is taught in the sixth (last) year of undergraduate study, when most students already have chosen a future specialty. Moreover, it lasts for six days, which is not enough to raise real interest in this field. Hence, the curricula do not contribute to the adequate perception of family medicine. In the study, the students have commented that the course is very theoretic, does not distinguish family medicine from other specialties, e.g., therapy, and quite often teachers do not deliver all the necessary classes. Thus, 42% of students say that the course did not help them to obtain a comprehensive understanding of family medicine as a professional field, and only 30% of students think that this knowledge is useless for their future medical career. In the end, only 22% state that such a course raised their interest in the specialty. 

According to the study results, medical students continue to pursue negative views of family medicine both before and after the course on family medicine. Thus, 58% of students support the statement that family doctors have limited career opportunities and 52% agree that family doctors are able to solve only minor health problems. Among other statements supported by the respondents are the following: the quality of health care provided by family doctors is not too good (50%), when treating patients, family doctors should at an early stage request additional support from a specialist (75%). Most students agree that it is not very attractive to work as a family doctor in Ukraine (59%). Students’ perception corresponds with teachers' perception: they tend to support more negative views on family medicine. 

The Ukrainian-Swiss Project “Medical Education Development” considers teaching at a medical university as an important contributing factor to the forming of an appropriate perception of family medicine and the further development of quality professionals in the field. That is why the project in cooperation with medical educators and primary health care physicians is working on the updated course on family medicine and advocates for shifting course to the third year of study at medical universities. 

The full version of the research is available in Ukrainian here: http://www.swisstph.ch/

For further information, please, contact Olga Korolenko.