Generalist training and the professional practice option according to the student’s perception

Abstract: Introduction: Since the National Curricular Guidelines for the Medicine course were implemented, with emphasis on the training of professionals with a generalist profile, the factors that may contribute to the interest in professional practice are unknown. Objective: This study aimed to analyze the perception of medical students regarding their generalist training and the factors that influence the desire for professional practice. Methodology: Descriptive and analytical cross-sectional study of qualitative and explanatory character with 523 students from different medical courses in the city of Salvador-Bahia, who answered an online survey after signing the informed consent form. The sample was categorized into interest in Immediate Specialization (IS) and among those who intend to Act as a Generalist (AG). The age and period of the course were also categorized into groups. Results: The age of the sample was 18 to 25 years in 83.7% (n = 438), with 72.5% (n = 380) being female, attending 69% of the 4º to 9º semesters (n = 363). The Immediate Specialization group represented 27.2% (95% CI: 35% -73%) and the group that intends to Act as a Generalist, 72.8% (95% CI: 68% -76%). General training did not influence the option for professional practice with RR = 0.81 (95% CI: 0.55-1.20) p = 0.308. The factors associated with AG were believing in the generalist’s resolution capacity and SUS guidelines (p摘要：研究背景：自国家医学课程教学大纲实施以来，其核心导向为培养通才型专业人才，但目前尚不明确哪些因素会影响医学生对专业执业的兴趣。研究目的：本研究旨在分析医学生对其通才培养的认知情况，以及影响其专业执业意愿的相关因素。研究方法：本研究为兼具质性与解释性特征的描述性分析横断面研究，研究对象为巴伊亚州萨尔瓦多市各医学专业的523名医学生，所有受试者在签署知情同意书（informed consent form）后完成线上调查问卷。样本被划分为即刻专科化（Immediate Specialization, IS）意向组与拟从事通科执业（Act as a Generalist, AG）意向组，同时对受试者的年龄及在读学年进行分组处理。研究结果：样本中83.7%（n=438）的受试者年龄为18至25岁，女性占比72.5%（n=380），69%（n=363）的受试者处于第4至9学年。即刻专科化意向组占比27.2%（95%置信区间（Confidence Interval, CI）：35%~73%），拟从事通科执业意向组占比72.8%（95%CI：68%~76%）。通才培养并未对专业执业选择产生显著影响（相对危险度（Relative Risk, RR）=0.81，95%CI：0.55~1.20，p=0.308）。与通科执业意向相关的因素包括认可通科医师的诊疗能力及遵循巴西统一健康系统（Sistema Único de Saúde, SUS）相关指南（p