The influence of internship training experience on Kenyan and Ugandan doctors' career intentions and decisions: a qualitative study.

IF 2.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Global Health Action Pub Date : 2023-12-31 Epub Date: 2023-11-09 DOI:10.1080/16549716.2023.2272390
Yingxi Zhao, Daniel Mbuthia, Dos Santos Ankomisyani, Claire Blacklock, David Gathara, Sassy Molyneux, Catia Nicodemo, Tom Richard Okello, Elizeus Rutebemberwa, Raymond Tweheyo, Mike English
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Abstract

Background: Medical internship is a key period for doctors' individual career planning and also a transition period for the broader labour market.

Objectives: We aimed to understand the complex set of factors influencing the career intentions and decisions of junior doctors, post-internship in Kenya and Uganda.

Methods: We conducted semi-structured interviews with 54 junior medical officers and 14 consultants to understand doctors' internship experiences and subsequent employment experiences. We analysed the data using a mix of a direct content approach, informed by an internship experience and career intentions framework developed primarily from high-income country literature, alongside a more inductive thematic analysis.

Results: Echoing the internship experience and career intentions framework, we found that clinical exposure during internship, work-life balance, aspects of workplace culture such as relationships with consultants and other team members, and concerns over future job security and professional development all influenced Kenyan and Ugandan doctors' career preferences. Additionally, we added a new category to the framework to reflect our finding that interns might want to 'fill a health system gap' when they choose their future careers, based on what they witness as interns. However, often career intentions did not match career and employment decisions due to specific contextual factors, most importantly a shortage of job opportunities.

Conclusion: We have shown how internship experiences shape medical doctors' career intentions in Kenya and Uganda and highlighted the importance of job availability and context in influencing doctors' career choices.

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实习培训经验对肯尼亚和乌干达医生职业意向和决策的影响:一项定性研究。
背景:医学实习是医生个人职业规划的关键时期,也是更广泛的劳动力市场的过渡期。目的:我们旨在了解影响肯尼亚和乌干达初级医生实习后职业意向和决策的一系列复杂因素。方法:我们对54名初级医生和14名顾问进行了半结构化访谈,以了解医生的实习经历和随后的就业经历。我们采用直接内容法对数据进行了分析,主要根据高收入国家文献开发的实习经历和职业意向框架,以及更具归纳性的主题分析。结果:与实习经历和职业意向框架相呼应,我们发现实习期间的临床暴露、工作与生活的平衡、工作场所文化的各个方面,如与顾问和其他团队成员的关系,以及对未来工作保障和专业发展的担忧,都会影响肯尼亚和乌干达医生的职业偏好。此外,我们在框架中添加了一个新的类别,以反映我们的发现,即实习生在选择未来职业时,可能希望根据他们作为实习生的经历来“填补卫生系统的空白”。然而,由于特定的背景因素,最重要的是缺乏工作机会,职业意向往往与职业和就业决定不匹配。结论:我们展示了肯尼亚和乌干达的实习经历如何影响医生的职业意向,并强调了工作机会和背景在影响医生职业选择方面的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Global Health Action
Global Health Action PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
5.10
自引率
3.80%
发文量
108
审稿时长
16 weeks
期刊介绍: Global Health Action is an international peer-reviewed Open Access journal affiliated with the Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine at Umeå University, Sweden. The Unit hosts the Umeå International School of Public Health and the Umeå Centre for Global Health Research. Vision: Our vision is to be a leading journal in the global health field, narrowing health information gaps and contributing to the implementation of policies and actions that lead to improved global health. Aim: The widening gap between the winners and losers of globalisation presents major public health challenges. To meet these challenges, it is crucial to generate new knowledge and evidence in the field and in settings where the evidence is lacking, as well as to bridge the gaps between existing knowledge and implementation of relevant findings. Thus, the aim of Global Health Action is to contribute to fuelling a more concrete, hands-on approach to addressing global health challenges. Manuscripts suggesting strategies for practical interventions and research implementations where none already exist are specifically welcomed. Further, the journal encourages articles from low- and middle-income countries, while also welcoming articles originated from South-South and South-North collaborations. All articles are expected to address a global agenda and include a strong implementation or policy component.
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