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Background: The attractiveness of general practice (GP) is increasing, as is evident in its growing popularity among students and the sharp rise in specialist certifications. However, in view of the future challenges at the GP level of care, there is a shortage of young doctors. It would thus be desirable if postgraduate training could be completed quickly, particularly in this area. Objective: The aim of this article is to improve the state of knowledge of the actual length of postgraduate training in general practice and to identify the motives for choosing this specialty and possible factors influencing postgraduate training length. Project description: The cross-sectional study conducted of general practitioners (GPs) after completion of the medical specialist examination (survey period January 2020 to September 2023, population 530 persons, response rate 50%, n=265) examines the decision-making processes and the individual course of postgraduate training as pursued by newly certified general practitioners (Fachärzt*innen für Allgemeinmedizin - FÄ AM) in Hesse, Germany. Results: Excluding lateral entrants (Quereinsteiger*innen), the respondents' length of postgraduate training was 8.88 years on average (SD=3.97, median 7.75 years, Q1=6.0, Q3=10.0). The main reasons stated for choosing the specialty were personal role models and experiences made while studying. The descriptive analysis of the data collected indicates that an early choice of specialization could be associated with a shorter length of postgraduate training. Conclusion: Positive experiences during medical studies can contribute to a doctor's decision in favor of a specialty and may possibly be a factor in shortening the subsequent length of postgraduate training. From a healthcare perspective, medical education and postgraduate training should therefore be more closely linked so that those starting postgraduate training in general practice have a firm specialty preference in mind more frequently in future. [ABSTRACT FROM AUTHOR]

Objective: In Germany, the rotation into the general practitioner's practice (GPP) as part of postgraduate medical training in general practice traditionally takes place at the end of the training period. The aim of this study was to explore possible subsequent effects of beginning training in the GPP from the perspective of general practitioners (GPs) and GP trainees. Methods: Nationwide, GPs and GP trainees were recruited who started specialization in GP in the GPP. Semi-structured telephone interviews were conducted between June and October 2022 using a self-developed interview-guide. The results were transcribed verbatim and analyzed using content analysis. Results: N=15 interviews were conducted, averaging 54 minutes (32-75 minutes) each (9 federal states, 4 GPs, 11 GP trainees). From the participants' perspective, advantages included close supervision, flat hierarchies, more time for preparation and follow-up, self-directed learning as well as higher basic salary and regular working hours. Positive effects mentioned were reinforcement in career choice, early understanding of workflow in GPP, early development of a GP attitude and strengthening of professional self-confidence. Disadvantages included initial uncertainty at the beginning of the profession and limited opportunities for peer exchange. In conclusion, all participants would recommend beginning specialization with a rotation in the GPP. Discussion: Starting in GGP allows GP trainees to learn about GP in a self-directed, research-oriented manner and based on consultations which enables early professional identity formation. GP trainees should avoid lack of collegial support by participating in a postgraduate training program. In a second step, GP trainers perspectives need to be assessed. Conclusion: Beginning GP postgraduate training with a rotation in GP is advantageous and should be structurally promoted. [ABSTRACT FROM AUTHOR]

Objective: To aid the shortage of general practitioners (GPs) in Germany, since 2011 medical specialists from other fields may switch specialisation by undergoing a slim-lined training programme (lateral entry) into general practice (GP). Available published qualitative and quantitative data on lateral entrants (LEs) is scarce. Aim of the study was an explorative analysis of LEs in the competence centre for postgraduate medical education Baden-Wuerttemberg (KWBW). Methods: In 2016, a multicentric cohort study was initiated including all GP trainees entering the KWBW. Data from 2016 to 2022 was included (T0). A follow-up with graduates from the KWBW was performed once in 2023 (T1). Surveys at T0 and T1 were self-developed, piloted, and included questions on social demography, education, qualification, current training, working environment and professional plans. Dataset was analysed exploratively. Results: At T0, 884 GP trainees participated (response 95.2%). 23.8% of participants were LEs (N=210). Most LEs were specialists from anaesthesiology (34.8%), internal medicine (28.5%) and surgery (20.6%). LEs had been working in their previous specialty for a median of 3 years before starting GP-training. At T0, LEs were seven years older than their colleagues (p<0,001). The proportion of men among LEs was higher (34.3% vs 25.1%, p=0,009). LEs were more decisive to open their own GP practice (p=0,009). At T1, 48 LEs participated of which 92% were practising GPs (N=36). 64,5% considered themselves rural GPs and work in communities <20.000 people (N=36). LEs mainly choose GP because of its specific way of working, job dissatisfaction and personal motives such as opportunity to start a practice. Most LEs strongly agreed that they would switch to GP again. Discussion: LEs are a relevant party among GP trainees. Many LEs become self-employed and contribute essentially to providing primary care. Lateral entry attracts specialists, also from rural areas, seeking for professional satisfaction. This is why LEs should follow their new path within a regional competence centre providing GP specific courses, mentoring and a professional network. Conclusions: LEs graduating from KWBW have become an important pillar of primary care in Baden-Wuerttemberg. [ABSTRACT FROM AUTHOR]

Background: With the new licensing regulations for doctors coming into force, medical faculties are faced with the task of recruiting and qualifying more GP colleagues to train students in their practices. Objective: The aim of the study was to determine the motivation of GPs to train students in their own medical practices. Method: A cross-sectional survey of Thuringian GPs was conducted from April to May 2020. 21 items on motivation, incentives and barriers were recorded and examined using univariate and multivariate analyses. Results: The response rate was 35.8% (538/1,513). The GPs surveyed considered themselves motivated to train students in their medical practices. The motives can be described as predominantly intrinsic: the mutual exchange of knowledge, desire to share knowledge and to promote future doctors. Incentives included the opportunity to keep up to date with the latest knowledge, further training and contacts with colleagues. Barriers to teaching in the own medical practice were concerns about not being able to treat the same number of patients, a possible disruption of practice operations and lack of space. An analysis of the subgroups of GPs who were not yet teaching physicians indicated similar motives and barriers regarding training students in their practices, with a slightly lower overall motivation. Conclusion: The results describe the facets of the motivation of Thuringian GPs to train students and can be helpful for the expansion of a sustainable network of training GP practices. It is essential to address motives, to counter difficulties with individual solutions and to create targeted incentives. [ABSTRACT FROM AUTHOR]

Background and teaching situation: The SARS-CoV-2 pandemic had a substantial didactic impact on medical teaching. In Erlangen, the lecture "General Practice" was offered asynchronously and digitally in an inverted-classroom concept. Contents were available via a learning platform. The lecture was presented using annotated videos, consolidation materials and control questions. A forum encouraged for discussions and feedback and collected in-depth aspects for a case-based video consultation. The aim of this work is to evaluate and critically examine the digital teaching concept during the SARS-CoV-2 pandemic. Methodology: Two semester cohorts evaluated the lecture. Overall impression of the lecture, didactic elements, suitability and the desired future lecture format were surveyed quantitatively. Free text answers were evaluated by means of qualitative content synthesis. Results: In terms of overall impression, the students (N=199) rated the lecture on average as "very good" (M=1.41, SD=.57). Digital methods were perceived as suitable for supporting self-study, and digital usage was rated as unproblematically (M=1.18, SD=.50). Desired future teaching formats were blended learning concepts (79.4%). Organisation, structure and content presentation were highly appreciated. The time for completing the course was perceived critically. The students urged for more practical and consolidating lecture work. Discussion and implications: The results illustrate high acceptance of digital teaching and underline the demand for future blended learning concepts. It is particularly important to better consider the students' time investment and practical relevance of digital self-learning mechanisms. [ABSTRACT FROM AUTHOR]

Introduction: Starting in 2013, a five-year, competence-based postgraduate programme, the "Seminartage Weiterbildung Allgemeinmedizin" (SemiWAM®) for continuing education in general practice, was developed and offered in Bavaria. This evaluation reports on the experiences of SemiWAM® after a first cycle. Material and methods: Process reflection based on the cycle of Kern: In addition to qualitative findings, results of the evaluation forms (mean values with standard deviation) are presented. The evaluation form contained questions on organisational issues, content of presentation, didactic preparation of the supervisor, transfer to real life practice as well as demographic variables. All questions were voted on a six-point Likert scale from "1=very satisfied" to "6=very dissatisfied". Results: The reflection showed three crucial entry points: Choosing "reason for encounter" as a content precondition to ensure target audience needs, the close didactic supervision of supervisor, and the continuous growth of supervisor team with newly qualified GP. The evaluation results for the overall assessment (MW 1.11-1.60), the didactic concept (MW 1.30-1.87), as well as the transfer into daily life practice (MW 1.48-2.35) reflect the high quality of the SemiWAM®. Discussion: The SemiWAM® curriculum presented can be easily transferred to comparable structures in Germany that accompany specialty training, such as the competence centres for residency training in general practice. The process evaluation based on the core cycle also provides important support for the agile implementation of these or similar programmes. [ABSTRACT FROM AUTHOR]

Objectives: The extent of university teaching in general practice is increasing and is in part realised with attachments in resident general practices. The selection and quality management of these teaching practices pose challenges for general practice institutes; appropriate instruments are required. The question of the present study is whether the student evaluation of an attachment in previously poorly evaluated practices improves after teaching physicians have received feedback from a colleague. Methods: Students in study years 1, 2, 3 and 5 evaluated their experiences in general practice attachments with two 4-point items (professional competence and recommendation for other students). Particularly poorly evaluated teaching practices were identified. A practising physician with experience in teaching and research conducted a personal feedback of the evaluation results with these (peer feedback), mainly in the form of individual discussions in the practice (peer visit). After this intervention, further attachments took place in these practices. The influence of the intervention (pre/post) on student evaluations was calculated in generalised estimating equations (cluster variable practice). Results: Of 264 teaching practices, 83 had a suboptimal rating. Of these, 27 practices with particularly negative ratings were selected for the intervention, of which 24 got the intervention so far. There were no post-evaluations for 5 of these practices, so that data from 19 practices (n=9 male teaching physicians, n=10 female teaching physicians) were included in the present evaluation. The evaluations of these practices were significantly more positive after the intervention (by n=78 students) than before (by n=82 students): odds ratio 1.20 (95% confidence interval 1.10-1.31; p<.001). Conclusion: The results suggest that university institutes of general practice can improve student evaluation of their teaching practices via individual collegial feedback. [ABSTRACT FROM AUTHOR]

Background: One of the aims of the German student selection network (Studierendenauswahl-Verbund, stav) is to review existing procedures for selecting medical students and to relate their effectiveness to students' career aspirations as well as to their further careers. Against the background of changes in the selection procedures and the introduction of the rural doctor quota (Landarztquote), the study conducted here aims at contributing to the current discussion on the future of GP (general practitioners) care, especially in rural areas. Methods: In 2019 and 2020, the stav conducted a German nationwide online survey among medical students towards the end of their "Practical Year" (Praktisches Jahr, final-year medical students in practical training). The associations between selection parameters and students' interest in later working as a GP as well as students' preference to later work in a place with a low population density were investigated. Furthermore, socio-demographic variables and variables related to medical studies were taken into account. Statistical comparisons were carried out using Chi2- and Mann-Whitney U tests. Results: A total of 1,055 students in their Practical Year (65.4% female, 27 years) completed the survey. As their final professional position, 12.1% aspired to own a GP practice or work as employed GP after completing medical specialist training in general medicine (interested students: 9.9%) or general internal medicine (interested students: 9.5%). Compared to their fellow students, those interested in working as a GP had been more often admitted to medical school via the waiting time quota and had more often already completed vocational training in a medical-related field. 39.1% of those interested in working as a GP wanted to work in a place with a low population density. Coming from a place with a low population density as well as completing the medical internship (Famulatur) for GP care in such a place turned out to be positive influencing factors. Discussion: The observed associations between waiting time quota and interest in working as a GP as well as between origin from a place with a low population density and preferring to later work in such a place go hand in hand with changes in the access regulations for medical studies, which concern both the waiting time quota (abolition of the latter) and a regulation of the number of rural doctors (rural doctor quota). In order to evaluate the current changes in the access regulations for medical studies, longitudinal studies are desirable that cover the time from the application to study up to the medical specialist examination and further career. [ABSTRACT FROM AUTHOR]

Objective: A competency-based training of medical students that is adapted to the realities of care is required internationally and is being intended in Germany with the Master Plan for Medical Studies 2020. In order to test these competencies, the German National Institute for state examinations in Medicine, Pharmacy and Psychotherapy (IMPP) has developed a concept for the redesign of the final part of the medical licensing examination in Germany. It focuses on general and interprofessional healthcare in the examination with outpatients. The aim of this work is to assess the feasibility of the new final examination on the basis of pilot examinations in family practices and to derive further steps for the national implementation. Methods: Fourteen medical students in their internship year completed a full examination with patients aged 42 to 84 years. Examiners evaluated the examination performance using standardised evaluation forms. Feasibility was qualitatively assessed in terms of compliance with content and time limits, examination results, patient reflections, and implementation in the practice. Results: Students were able to complete all tasks within the given time frame. Based on the evaluation forms, the examiners assessed the performance of the students. Patients appreciated the structured course of the examination in the familiar location of their family practice. For the nationwide implementation of the examination, 2,500 examination practices are required for about 10,000 examinees per year. Four students can then be examined on two days per year in each practice. Conclusions: Oral-practical examinations with outpatients in general medical practices can be carried out successfully throughout the nation. An implementation of the examinations throughout Germany requires that medical studies are restructured and that this new curriculum is implemented as intended by the Master Plan for Medical Studies 2020. Furthermore, training and remuneration of examiners together with a legal framework for the new examination must be established. [ABSTRACT FROM AUTHOR]

Aim: The Masterplan Medizinstudium 2020 (Masterplan for Medical Studies 2020) focuses on practice-oriented undergraduate training with increased involvement of rural teaching practices. The demand for teaching practices for the final year will increase at all medical faculties in Germany. The project medPJplus at the University Medical Center Göttingen (UMG) presents an approach for successfully acquiring general medical teaching practices in local rural areas. Project outline: The project medPJplus implemented eight measures in cooperation with medical students, interested general practitioners, and regional players in the surrounding districts to attract new teaching practices: we established public relations, accredited practices, organized the didactic training of participating general practitioners, created a digital platform for students that is linked to the nationwide PJ-Portal, and organized information events, workshops, and feedback reports to regional actors. Results: Within one year, a total of 40 new teaching practices with 57 new teachers in the local rural area joined the project in southern Lower Saxony. A three-stage didactic training concept for general practitioners was established at the UMG. A digital platform enhances the visibility of general practitioners and their activities for students. The teaching practices can now be found on the nationwide PJ-Portal. Fourteen students have currently completed their period of the final year in family medicine there. Conclusions: It is possible to acquire rural general medical teaching practices for the final year. This depends on four core elements: addressing and didactic training of interested general practitioners, networking of medical students with teaching physicians and regional actors, digitally presenting teaching practices, and developing solutions for mobility and living space during the final year. [ABSTRACT FROM AUTHOR]

Aim: The seminar program of the KWBW Verbundweiterbildungplus® is offered by the Competence Center for Postgraduate Medical Education in Baden-Württemberg (KWBW) for physicians specializing in general practice (GP trainees). Attendance is a voluntary one comprised of 48 curricular units of 45 minutes each per GP trainee. This seminar program is meant to be attended in parallel to the postgraduate medical education in clinic or practice. The intention behind this project was to develop objectives, topics and a feasible structure for a seminar curriculum while taking time and financial constraints into account. Method: The Kern cycle was applied in an open, modified nominal group consensus technique in the form of an iterative process. Participating were 17 experts from the departments of general practice at the universities in Freiburg, Heidelberg, Tuebingen and Ulm, plus a pediatrician. Results: The main objective was defined as empowering GP trainees to independently provide high-quality primary care, including in rural areas. A basic curriculum was defined based on relevant frameworks, such as the 2018 Model Regulation for Postgraduate Medical Training (Musterweiterbildungsordnung/MWBO) and the Competency-based Curriculum General Practice (KCA). Overall, the seminar curriculum has 62 basic modules with 2 curricular units each (e.g. Basic Principles of General Practice, Chest Pain, Billing) and another 58 two-unit modules on variable topics (e.g. digitalization, travel medicine) adding up to 240 (124+116) curricular units. A blueprint with a rotation schedule for all of the teaching sites in Baden-Württemberg allows regular attendance by n=400 GP trainees over a period of five years, with individual variability in terms of program length. Conclusion: The model entails a five-year, flexible program to accompany the postgraduate medical education in general practice which can also be implemented in multicenter programs and those with high enrollments. The model's focus is on acquisition of core competencies for general practice. Despite the current shift to eLearning seminars due to SARS-CoV, the program's implementation is being continued, constantly evaluated, and used to further develop the KWBW Verbundweiterbildungplus® program. [ABSTRACT FROM AUTHOR]

Background: The corona pandemic is changing the framework conditions for medical studies and continuing education as well as the work with patients and within teams. Systematic reflection and communication about experiences and ways of dealing with them forms the basis for successful learning in and out of the crisis. Therefore, we designed a 90-minute workshop "Corona-Debriefing" for students and physicians in specialist-training in family medicine (ÄiW) using three successive moderated interaction phases: Questionnaire survey via tele-dialogue voting (TED) with immediate presentation of results and discussion, moderated experience reports on the categories risk/assessment/support/coping and finally moderated group discussions in small groups to collect "best practice" examples of crisis management. Objective: We tested "Corona-Debriefing" as a pilot test with 48 participants (TN) in July 2020 (30 present, 14 online) in order to assess mental stress and risk perception of participants plus formative/brief summative evaluation of the workshop. Methods: The PHQ-4 with its subscales GAD-2 (anxiety) and PHQ-2 (depression) was used to assess mental stress; risk assessments were made by means of self-constructed 5-point Likert-scales for the dimensions person/society/health/economy. A formative evaluation was carried out by means of a questionnaire at the end of the event; the brief summative assessment was asked for by means of a school grading scale. Results: 37 complete TED questionnaires and 22 evaluations were obtained. TN showed a low personal risk assessment, but considerable fears about social and economic developments. Needs are seen mainly in improvements regarding organization, protective equipment and technical communication (e.g. official recommendations for action). The workshop was rated "good" or "very good" in 95% of the evaluations. Criticism was directed at the limited time available, the narrowing of topics by moderators and the desire for (even) more room for the exchange of personal experiences. Conclusion: The workshop "Corona-Debriefing" is a relatively easy way to use crisis experiences for learning processes. "Corona-Debriefing" can be used by changing the focus of moderation in various courses, years or fields of study, whereby the participants' own personal and clinical crisis experiences remain a prerequisite for a meaningful "debriefing". [ABSTRACT FROM AUTHOR]

Background: The SARS-CoV-2 pandemic had a strong impact on academic teaching and could change it sustainably. Ad hoc digitization of teaching had to be carried out. General practice teaching situation: Education in general practice at the Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) offers, in addition to the main lecture, various elective courses, clinical traineeships, internship as well as the elective part in the final practical year. The main lecture and one clinical elective course were offered digitally in the summer term 2020. Digital methods: In the main lecture, an adapted inverted-classroom concept was used. Podcasts and audio annotated videos were provided. Teaching materials were reflected via a weekly, 1hr video consultation and in a forum. An asynchronous learning module was developed for the elective course "Smart Decision-making in Clinical Practice". Each module consisted of course preparation, podcasts and follow-ups as well as a supervised forum. Results: The main lecture (response rate n=115/170; 67.6%) was rated "very good" on average. The same applies to the commented videos. The forum, reflective video consultation and teaching materials were rated "good" on average. The predominantly desired forms of presence were "Focus on virtual with in-depth presence phases" (n=54) and "Focus on presence phases, virtual support only" (n=37). Discussion and implications: The digital restructuring enables students to work on the course contents independently. This requires self-regulation strategies, which in future shall be taught through portfolio work. The teaching focus shifts from a passive teaching format to an interactive one. First evaluation results showed a very good acceptance by the students. [ABSTRACT FROM AUTHOR]

Background: The task of the Competence Centers for vocational training (KW) is to increase the attractiveness and quality of vocational (=post-graduate) training in general practice. For this purpose, they offer, among other things, a structured seminar program for post-graduate trainees in general practice (GP-trainees). During the Covid-19 pandemic the seminar program of the KWBW-Verbundweiterbildungplus® in Baden-Württemberg was converted to digital formats. The goal of the paper is to evaluate the acceptance by the GP-trainees and lecturers, to describe experiences with the conversion to e-learning and to derive recommendations with regard to the future orientation of seminar programs in post-graduate as well as continuing medical education. The implementation was based on a modified Kern-cycle and aimed at offering eight teaching units of 45 minutes each to a large number of GP-trainees. It tried to maintain the high quality of content and education as well as the interactive character of the previous seminars. For this purpose, the events were designed as synchronous webinars (six units) with asynchronous preparation and post-processing (two units) according to the flipped classroom method. The evaluation by the participating GP-trainees and lecturers was performed online using a multi-center developed and pre-piloted questionnaire. Results and discussion: N=101 GP-trainees participated in the evaluation of five individual seminar days in the second quarter of 2020 (response rate 97%). 58% (N=59) of the trainees were satisfied or very satisfied with the implementation. 82% (n=83) rated pre-tasks as helpful. 99% (n=100) would participate in an online seminar again. For 52% (n=53) of the trainees, the attitude towards e-learning had changed positively. The main advantages mentioned were no travel, save in time and costs as well as increased flexibility. The main disadvantages mentioned were less personal interaction and technical obstacles. The high acceptance of the new digital format showed the fundamental potential of e-learning in continuing medical education. The experiences can be a source of inspiration for other departments and KW. However, it also shows that important goals of KW, such as the personal interaction of the peer group, could not be achieved. In the future, it is important to develop a suitable mix of presence and digital formats with the aim to improve the attractiveness as well as sustainability of continuing medical education. [ABSTRACT FROM AUTHOR]

The CanMEDS roles has conveyed through a digital videoconference supported teaching format in which the students develop their own case-based, interactive e-learning units. The learning forms used are problem-based learning and peer-teaching. After a quality check by the lecturer the e-learning units are made available to further general medicine lessons. [ABSTRACT FROM AUTHOR]

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Objective: This article reports on the conceptual development and subsequent implementation of a targeted and attractive general practice teaching program in a rural area for students of human medicine at the medical faculty of Goethe University, Frankfurt am Main. Project description: Since the 2016/2017 winter semester, usually up to 15 interested students a year have had the opportunity to participate in the longitudinal priority program "Landpartie 2.0". The program runs for six semesters during the clinical stage of medical studies and consists of regular internships during which the students receive one-to-one support in a family practice, and participate in a series of seminars and an annual one-day excursion. The aim is to enable students, early on in their studies and without any obligations, to gain uninterrupted experience of providing patient care, and to find out what it means to pursue a career in family medicine. Results: Since the beginning of the annual program, 62 students have been included in it. The initial results show that the different elements of the program fulfil the expectations and requirements of participants and that their overall level of satisfaction is high. Almost 95% of students reported that they felt their knowledge had increased as a result of the internships, and they rated them as a useful part of their medical education. Despite the rural focus of the program, around half of the participants were of urban origin. Conclusion: The "Landpartie 2.0" provides students with the opportunity to familiarize themselves with family health care in a rural area. Further studies should investigate to what extent the program encourages students to continue their training with a view to pursuing a career in family medicine. [ABSTRACT FROM AUTHOR]

Background: The 2002 Medical Licensure Act gave German universities certain freedoms for reforming their medical degree courses. The Medical Faculty of the University of Cologne took advantage of this opportunity and introduced a model study course in the winter semester 2003/04 through §41 of the Medical Licensure Act. One of the main reasons for this was that back then there was an increasing shortage of doctors in clinical curative medicine and GP primary care. This study investigates whether the introduction of the Cologne Model Study Course (MSG) can show stronger interest in curative medical work (especially General Practice) compared to students of the standard degree course (RSG). Methodology: The proof of added value was examined through graduate surveys conducted at the University of Cologne and through the proportion of students who completed the PY elective rotation "General Practice". The students of the standard degree course (start of studies prior to winter semester 2003/2004) were compared with students of the model study course (start of studies from winter semester 2003/04 onwards). Measurements were carried out using descriptive frequency tables and correlation analyzes according to Spearman. Results: The students' interest in curative medicine was already high (91%) even before the model study course was introduced and increased only slightly (to 91.9%). There is also only a slight increase in specialization in General Practice (RSG=5.9% vs. MSG=9.2%). However, selection of rotations in General Practice was significantly increased (RSG=1.9% vs. MSG=3.4%, r=0.046 **, p<0.005). Conclusion: The Cologne Model Study Course in Human Medicine has increased awareness of the subject of General Practice among students through a large number of curricular changes. The fact that only marginal effects can be demonstrated shows once more the strong dependence of choosing General Medicine as a career path on other factors (such as gender or the presence of positive role models) and emphasizes the necessity of promoting General Practice student education not only through increased curricular mapping but by additional innovative concepts to maximize the status of General Practice from the perspective of students. [ABSTRACT FROM AUTHOR]

The Brandenburg Medical School "Theodor Fontane" (MHB) was founded in 2014 by municipal and non-profit institutions in Bernau, Brandenburg an der Havel and Neuruppin to train more physicians for the non-metropolitan region of Brandenburg. Since the 2015 summer term, 48 medical students have been enrolled each year, accepted through the university's own selection process in which the score on the German school-leaving exam (Abitur) and time spent on the waiting list play subordinate roles. Tuition fees can be partially financed through scholarship agreements with regional hospitals if the applicants commit themselves to medical specialist training (Facharztweiterbildung) at a particular hospital. The main places of study are Neuruppin and Brandenburg an der Havel; there is a decentralized study phase from the eighth to tenth semester of study. The Brandenburg Reformed Medical Curriculum (BMM) complies with the model clause contained in the German regulations governing the licensing of medical doctors (ÄAppO). The curriculum is based on problem-based learning (PBL) and focused on competencies and consists of integrated interdisciplinary modules that combine, from the very beginning, basic sciences with clinical and theoretical medical subjects. The focus on general practice is visible in the regularly held "Practical Days" (Praxistag) during which second-year students and above have the opportunity to observe at participating medical practices and familiarize themselves with primary care in Brandenburg. A special focus of BMM is on the acquisition and development of communication and interpersonal skills. These are imparted through a longitudinal curriculum referred to as "Teamwork, Reflection, Interaction, Communication" (TRIK). High value is placed on critical thinking and scientific scholarship and this is reflected in an eight-week academic placement in which the students independently write a research paper. Several different teaching formats ensure that, along with learning specific subjects, sustained personal development can also take place. BMM's decentralized study phase starting in the eighth semester represents a special part of the curriculum in which students complete their clinical training in small groups at selected cooperating hospitals in Brandenburg. This phase encompasses not only hospital placements and other local patient-centered courses, but also centralized instruction via video conferencing to assure that basic sciences and clinical theory continue to be covered. Knowledge- and performance-based semester assessments, in particular OSCEs, reinforce the practical aspects of the training. These replace the M1 state medical examination in the first study phase. The first medical students are now in their ninth semester as of April 2019, making it still too early for final evaluations. The curriculum, successfully implemented to date, already satisfies core requirements of the Master Plan 2020 for undergraduate medical education (Masterplan Medizinstudium 2020) with the curriculum's organization and structure, curricular content, assessment formats and student admission process. With its decentralized structure, BMM specifically addresses the social and health policy challenges facing rural regions of Brandenburg. This is the first curriculum that has taken on the improvement of healthcare in rural regions as its central aim. [ABSTRACT FROM AUTHOR]

Aim: Following changes in licensing regulations for doctors ("Approbationsordnung") in 2012, a 4-week clinical attachment ("Famulatur") in primary care is now mandatory for all medical students in Germany. To date, it has not been studied how the Famulatur in primary care is perceived by the learner or the teacher. The aim of this study was to explore the experiences of both medical students and primary care physicians (PCPs) with regard to the teaching and learning situation in the Famulatur in primary care. Methods: A qualitative analysis of semi-structured interviews with 12 students from the medical faculty in Tübingen, Germany, and 17 PCPs from this region, was performed. Interview material was analyzed following content analysis according to Mayring. Results: In addition to considering the variety of tasks expected of the students and the optimal time for the Famulatur during the medical curriculum, the main themes of the interviews were the strengths, weaknesses and suggestions for improvement of the Famulatur. The Famulatur was predominantly perceived positively, although it being obligatory was criticized. In particular, the 1:1 supervision and the extended duration (compared to the first curricular primary care placement ("Blockpraktikum")) were positively evaluated. PCPs and students were critical of the lack of a learning and educational Famulatur framework, which would have enabled earlier orientation and alignment of each party. Conclusion: The Famulatur offers good learning opportunities for medical students and provides an insight into primary care, which is typically seen positively; it appears to heighten enthusiasm for primary care within budding doctors. Even if the obligation should cease in "The Master Plan for Medical Studies 2020" (Masterplan Medizinstudium 2020), it would be beneficial to optimize the primary care Famulatur; the development of a student logbook and learning objectives could be helpful, for example in the form of portfolios. [ABSTRACT FROM AUTHOR]

Aim: Against the background of an impending shortage of family practitioners, it is important to investigate the factors influencing the choice to become one. The aim of this study was to identify factors that encourage medical students to choose to practice family medicine. Method: Using a questionnaire, students in the fourth and fifth years of their studies in the Federal State of Hesse were asked about the factors that had influenced their choice of medical specialty and their experience of courses in family medicine. Predictors of an interest in practicing family medicine were calculated using multiple logistic regression. Results: 361 questionnaires were returned, representing a response rate of 70.9%. Confirmation of personal strengths, an interest in the field, and practical experience of the subject generally turned out to be important factors influencing the choice of medical specialty. 49.3% of students expressed an interest in practicing family medicine. A link ex- isted between an interest in working as a family doctor and the oppor- tunity to take over an existing practice, experience of medicine in rural areas, and an appreciation of the conditions of work. With regard to education at medical school, positive experiences during a clinical traineeship in family medicine and positive role models among teachers of general practice were identified as predictors. Conclusion: Almost half the medical students were open to the idea of practicing family medicine. Experience of medicine in rural areas and positive experiences of courses in general practice were linked to an increased interest in working as a family doctor. To promote this interest, it may be a promising approach to increase opportunities to collect experience of medicine in rural areas, and to encourage highly motivated teaching practices. [ABSTRACT FROM AUTHOR]

Objective: At the end of the Practical Year (PY), medical students decide on a specialization. Individual motivational factors and barriers play a central role in the choice of the subsequent subject area and the place of establishment (city/country). The aim of this study was to document the barriers of PY students within the General Practice (GP) tertiary elective over time. Methodology: Two guided interviews were conducted with each participant (N=19) as part of qualitative process monitoring - a pre-interview at the start and a post-interview after completion of the PY. Evaluation Erlangenof the interviews was based on Grounded Theory. Results: 13 barriers could be deduced fromthe 38 interviews. Themost frequently cited barriers were "expected workload", "recreational opportunities", "work-life balance" and "compatibility with family". 13 of the participants were firmly committed to continuing GP training, 12 of whom aspired to opening a practice in a rural area. Another three were considering GP training, three had decided against it after the PY. After the PY, some of the previously anticipated individual barriers were now perceived in a more differentiated manner as a result of practical experience. The barriers "work-life-balance", "compatibility with family", "recreational opportunities" and "infrastructure" had been largely eliminated. Conclusion: The PY General Practice Tertiary itself appears to have a positive impact on the individual barriers expressed before the PY. Targeted experience with a PY in General Practice at the end of study seems to be a solution to increase the attractiveness of the subject. [ABSTRACT FROM AUTHOR]

Aim: Participation of medical students in the conceptual development of targeted and attractive teaching content for rural areas. Method: A questionnaire was developed to gather information on students'views of their current medical studies, career interests, and what requirements should be met by an optional rural health program in general practice. By means of an online survey in summer 2015, all medical students from the fourth preclinical semester onwards (n=2,150) at Goethe University Frankfurt were surveyed on one occasion. Statistical analysis was mainly descriptive. Personal attitudes towards a career as a family practitioner were examined for statistical significance. Further information was gathered on whether a measurable correlation exists between personal background and desired work location. Results: Of the 2,150 students that were contacted, 617 participated in the survey (response rate=28.7%). The results covered a wide range of ideas and recommendations and were representative both of medical students with a positive attitude toward general practice, as well as those that were rather critical of teaching in general practice. The students expected the planned health program to be of strong practical relevance and to acquaint them with the administrative and economic aspects of running a practice. Conclusions: By includingthe target group in the development process, it was possible to tailor the health program to meet the needs of future participants more precisely. Student participation can also be expected to result in greater acceptance of the program. The results on teaching content may also provide other medical faculties with orientation when developing comparable programs. [ABSTRACT FROM AUTHOR]

Zielsetzung: Ärztinnen und Ärzte in Weiterbildung (ÄiW) Allgemeinmedizin haben überwiegend wenig Austausch mit ihrer Peer Group, weil sie meist die einzigen ÄiW sind, die zu einer gegebenen Zeit in dem entspre chenden Fachbereich bzw. der Praxis arbeiten. Die hier vorgestellte Online-Plattform „KOLEGEA“ hat daher das Ziel, die Weiterbildung Allgemeinmedizin in Deutschland durch den virtuellen Austausch zu unterstützen. Methodik: In einem interdisziplinären Forschungsprojekt wurde 2012 eine Online-Plattform etabliert, die Ärztinnen und Ärzten in Weiterbildung ÄiW) mittels ihrer Einheitlichen Fortbildungsnummer (EFN) frei nutzen können. Neben problemorientierten Lernen können anonymisiert ein- gestellte Patientenfälle mit der Gemeinschaft diskutiert und mit erfahrenen Mentoren (Fachärztinnen/Fachärzten für Allgemeinmedizin) in virtuellen Kleingruppen eingeordnet und diskutiert werden. Ergebnisse: Eine anonyme Online-Umfrage im Rahmen der Evaluation in 2014 wies darauf hin, dass die Plattform positiv aufgenommen wurde, wenn auch Zeitmangel als begrenzender Faktor für die Nutzung beschrieben wurde. Die Datenanalyse zeigte, dass die KOLEGEA-Plattform in allen Bundesländern von ÄiW genutzt wurde. Passive Nutzungsmuster überwiegen (90%). Ergänzend wird die Weiterentwicklung der Plattform in 2015/2016 beschrieben, die einen Aktivitätsmonitor als spielerische Lernelemente integriert. Schlussfolgerungen: Die niedrige Response der Online-Umfrage 2014 und die vorläufigen Auswertungen zu Nutzungsmustern lassen nur erste Trends erkennen, ob KOLEGEA den Weiterbildungsprozess unterstützt. Die Plattform wird als hilfreiche Ergänzung zu einer besseren Strukturierung der Weiterbildung Allgemeinmedizin eingeschätzt. [ABSTRACT FROM AUTHOR]

Hintergrund: Aufgrund des drohenden "Hausarztmangels" rückt die Versorgung mit Hausärzten und im Zuge dessen die Aus-und Weiterbil-dung zum Facharzt für Allgemeinmedizin zunehmend auf die politische Agenda in Deutschland. Mit dem Ziel die hausärztliche Versorgung durch eine Steigerung der Attraktivität der Allgemeinmedizin zukünftig sicher-zustellen, wurde 2009 das Programm Verbundweiterbildungplus Baden-Württemberg (VWBplus BW) im bestehenden KompetenzZentrum Allge- meinmedizin Baden-Württemberg entwickelt. Diese Arbeit beschreibt Wilhelm Nieblingdie Erfahrungen bei der Entwicklung einer curricularen bildung für Ärzte in Weiterbildung (ÄiW) zum Facharzt für Allgemeinmedizin. Projektbeschreibung: Das KompetenzZentrum Allgemeinmedizin Baden-Württemberg unterstützt den Aufbau und die Ausgestaltung regionaler Weiterbildungsverbünde. Erstes Hauptelement der VWBplus BW ist das begleitende Seminarprogramm für ÄiW. Es ist an den Inhalten des Heidelberg, Abteilung Kompetenzbasierten Curriculums Allgemeinmedizin ausgerichtet und Allgemeinmedizin und soll medizinische Expertise und weitere ärztliche Kompetenzen wie Kenntnisse in Betriebswirtschaft, Praxisführung und Kommunikation fördern. Zweites Hauptelement stellen individuelles Mentoring und Beratung der ÄiW bei der Berufs-und Lebensplanung dar. Hauptelement sind Train-the-Trainer-Seminare, bei denen die Kompe-tenzen derWeiterbilder geschult werden. UmInhalte eng an den Bedürf-nissen der Zielgruppen auszurichten, werden wissenschaftliche Evalua-tionen und Begleitforschung durchgeführt. Ergebnisse: Seit Beginn im Jahr 2009 sind 685 ÄiW in das Programm eingetreten, von denen 141 ihre Facharztprüfung bestanden haben Lübeck, Institut für (Stand Dezember 2016), insgesamt nehmen 31 Verbünde, 60 Kranken-Allgemeinmedizin, Lübeck, häuser und 211 Hausarztpraxen teil. Die Seminartage werden von ÄiW Deutschland durchschnittlich mit 1,43 auf einer sechsstufigen Likert-Skala (1=sehr zufrieden bis 6=sehr unzufrieden) beurteilt. Die ÄiW erachteten neben der fachlichen Weiterbildung den kollegialen Austausch als sehr und wichtig. Bisher wurden im begleitenden Seminarprogramm in 185 Seminaren à 90 Minuten 250 von 320 Inhalten des Kompetenzbasierten Curriculums Allgemeinmedizin berücksichtigt. In 13 Train-the-Trainer-Kursen konnten 281 Weiterbilder geschult werden. Sie beurteilten diesen Kurs im Mittel mit 1,36 auf der sechsstufigen Likert-Skala. Die Weiterbilder hoben vor allem den kollegialen Austausch als sehr positiv hervor. 2013 wurde das DEGAM-Konzept Verbundweiterbildungplus in Anlehnung an die VWBplus BW entwickelt. Seit 2008 wurden über 40 Publikationen zum Thema ärztliche Weiterbildung publiziert. Schlussfolgerung: Die seit Jahren wachsenden Teilnehmerzahlen sprechen dafür, dass die VWBplus BW für den ärztlichen Nachwuchs relevant ist und zur Attraktivität des Fachs Allgemeinmedizin beiträgt. Dabei belegen die durchgehend sehr guten Evaluationsergebnisse des Schulungsprogramms und des Train-the-Trainer-Kurses die Ausrichtung der Inhalte an die Bedürfnisnisse der Zielgruppen. Durch das curriculare Weiterbildungsprogramm VWBplus BW werden eine strukturierte, kompetenzorientierte und an Qualität ausgerichtete Weiterbildung sowie der kollegiale Austausch gefördert, was auch für andere Fachrichtungen relevant sein könnte. Die steigende Zahl von ÄiW und Fachärzten für Allgemeinmedizin in Baden-Württemberg lässt darauf schließen, dass die VWBplus BW die Anzahl der Hausärzte positiv beeinflusst. [ABSTRACT FROM AUTHOR]

Einleitung: An einigen Standorten in Deutschland werden Seminarprogramme für Ärzte in Weiterbildung zum Facharzt für Allgemeinmedizin (ÄiW) durchgeführt. Die Lerninhalte wurden bisher regional unterschied lich ausgewählt. Ein deutschlandweit einheitlicher Themenkatalog fehlt. Ziel war es eine Themensammlung für ein 5-Jahre dauerndes Seminarprogramm zu entwickeln. Methode: Die Arbeitsgruppe Seminarprogramme der DEGAM (Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin) hat auf Grundlage einer Telefonkonferenz (n=7 Ärzte mit Referentenexpertise) eine Online-Umfrage aller universitären allgemeinmedizinischen Abteilungen Deutschlands durchgeführt. Weitere zwei Anbieter wurden durch Internetrecherche detektiert. Aus 14 zurückgemeldeten Seminarprogrammen wurden 884 Themen zusammen getragen. Diese wurden in einer Datenbank eingepflegt, Doppelnennungen gestrichen und kategorisiert: Praxismanagement/Praxisablauf/Formularwesen/Qualitätsmanagement (n=33 Themen), häufige akute und chronische Erkrankung inclusive Disease Management Programme (n=29 Themen), Kommunikation, neurologische, psychische und psychiatrische Beratungsanlässe (n=24 Themen), häufige Beratungsanlässe/ inkl. aus „kleinen“ Fachgebieten: Auge/Haut/HNO/Pädiatrie (n=99 Themen), hausärztliche Ar- beitsweisen (n=42 Themen). Anschließend wurden diese nachWichtig- keit und Anzahl der Unterrichtseinheiten im Rahmen eines Expertenworkshops bewertet. Ergebnisse: Es entstand ein Vorschlag für eine 160 Unterrichtsstunden (mit 111 Einzelthemen) umfassende Themensammlung mit einem Zusatzkatalog („Add-on“). Schlussfolgerung: Es liegt für Deutschland eine vorläufige Version für einen bundesweit erarbeiteten Themenvorschlag für ein 5-Jahres-Semi- narprogramm vor. Dadurch können die Weiterbildung begleitende Seminarprogramme standortübergreifend inhaltlich abgestimmt werden. Hierdurch ergibt sich potentiell die Möglichkeit Wissens- und Kompe- tenzlücken, die in der praktischen Tätigkeit der ambulanten und statio-nären Weiterbildungsabschnitte häufig verbleiben, zu reduzieren. [ABSTRACT FROM AUTHOR]

Hintergrund: Die medizinische Grundversorgung in ländlichen Regionen befindet sich weltweit in einer Nachwuchskrise. Internationale und nationale Empfehlungen raten zur Stärkung praktischer Fertigkeiten und Kompetenzen im Medizinstudium. Dazu gehört, auch im Interesse der Nachwuchsbindung, den Kontakt zu allgemeinmedizinischen Lehrpraxen frühzeitig, mentoriert und longitudinal zu integrieren. Dazu wird die Klasse Allgemeinmedizin (KAM) in Halle seit 2011 als Wahlpflichtfach mit 20 individuell mentorierten Studierenden pro Jahr beginnend mit dem ersten Fachsemester durchgeführt. Wir berichten über die Evaluation-sergebnisse der ersten zwei Jahre. Methodik: Eine standardisierte Online-Befragung wurde mit allen Teilnehmern der KAM in zwei Jahrgängen 2011 bis 2012 (N=38) durchgeführt. Die Befragung erfolgte jeweils zum Ende des ersten Sommersemesters und nutzte eine adaptierte Version des Heidelberger Inventars zur Lehrevaluation (HILVE-II) und das Berliner Evaluationsinstrument für selbsteingeschätzte, studentische Kompetenzen (BEvaKomp). Ferner wurde jährlich die Präferenz zu Fachgebietswahl und Ort der Niederlassung erfragt. Mittels binär-logistischer Regression wurden Prädiktoren für die Präferenz zur Fachgebietswahl Allgemeinmedizin und Ort der Niederlassung geschätzt. Durch univariate Auswertungen wurden die Anteile der Studierenden ausgezählt, die in verschiedenen Kompetenzbereichen einen Wissenszuwachs durch die KAM berichteten. Zusammenhänge zwischen den beabsichtigten Verbleib in der KAM und der Lehrqualität wurden anhand bivariater Korrelationen ausgewertet. Ergebnisse: 48% der Studierenden stimmten der Aussage eher oder völlig zu, dass die Seminare der KAM bei ihnen zu einer Steigerung der Fachkompetenz geführt haben. Dieser individuelle Kompetenzerwerb im Modellprojekt stellte einen signifikanten Prädiktor für die Präferenz zur Fachgebietswahl Allgemeinmedizin dar (OR 7,98; 95%-KI [1,27-50,27], p= 0,027). Studierende, die das Engagement (r=0,504), die Betreuung (r=0.526) und das Interaktionsmanagement (r=0,529) der Mentoren positiv einschätzten, waren eher gewillt, ihre Teilnahme an der KAM fortzusetzen. Schlussfolgerung: Die erfolgreiche Vermittlung versorgungs-relevanter Kompetenzen an Studierende erwies sich in unserem Projekt als wichtigster Prädiktor einer Präferenz einer Fachgebietswahl Allgemeinmedizin. Hierfür müssen die ärztlichen Mentoren entsprechend geschult und Studierende gezielt auf die Praxiserfahrungen vorbereitet werden. [ABSTRACT FROM AUTHOR]

Introduction: With the amendment of the medical licensure act (Approbationsordnung) in 2012, a four-week clerkship in primary care (FHV) became mandatory. We investigated the expectations with which students begin the FHV, which criteria are relevant in selecting the location for the FHV, and the experiences the students had during the FHV. Method: In a cross-sectional study, all third-year students at both medical schools in Saxony-Anhalt were surveyed in 2013 about their expectations and experiences regarding the FHV. This is the last cohort for which the FHV is optional. Questions were asked about 29 items addressing six topics (personal information, selection of FHV location, selection of FHV medical practice, expectations, experiences, and specialty selection). Results: Out of a student body of 446, responses were received from N=424 (response rate 95.1%; of which 61.8% female). Of these students, 71 (16.7%) had completed the FHV and 70 (16.5%) were planning to; another 267 students (63%) had not (yet) planned to participate in an FHV. Where a student's parents lived, personal recommendations of a particular medical practice and the attractiveness of the region were the most important criteria for selecting the clerkship site. After completing the FHV, the learning objectives reflected themselves in the experiences of the students in a similar order and significance as in the expectations of students who planned or had not (as of yet) planned to complete the FHV. A relevant influence of the FHV confirming the choice to specialize in general practice or outpatient care was not indicated by those who had completed the FHV. Conclusion: After location and practice, the FHV is selected according to personal criteria and in connection with prioritized learning objectives. From the students' perspective, the most frequently named learning objectives are also identified as acquired experience after completing the FHV. However, the FHV does not have a reinforcing effect on the selection of general practice as a specialty. [ABSTRACT FROM AUTHOR]

Objective: In many departments of General Practice (GP) in Germany, young doctors who are trainees also work as researchers. Often these trainees work part time at the university and part time as a trainee in clinical practice. However, little is known about the situation of the actors involved. The aim of the study was to investigate the perspectives of GP trainees, heads of departments and GP trainers regarding the combination of research and GP training. Methods: We conducted a web-based survey with the heads of all German departments of General Practice, GP trainees who also conduct research and their GP trainers. The questionnaires consisted of open and closed questions. The results were analyzed using descriptive statistics and qualitative methods. Results: 28 heads of GP departments and 20 GP trainees responded. The trainees were mostly very satisfied with their situation as a trainee. However, the trainees considered the combination of research and GP training as difficult. The respondents name as problems the coordination of multiple jobs and the lack of credibility given to research in General Practice. They name as solutions research-enabling training programs and uniform requirements in training regarding research. Conclusion: The combination of GP training and scientific research activity is perceived as difficult. However, well-organized and designed programs can improve the quality of the combination. [ABSTRACT FROM AUTHOR]

Introduction: Traditional university teaching formats are of limited use when it comes to conveying the inner workings and specific remit of general medicine in a practical way. Small supervised groups present themselves as a plausible and effective alternative for learning to interact with patients in low prevalence areas. Description of the project: A frontal lecture was transformed into an interactive seminar-like lecture for 280 students. Short kick-off presentations served as an introduction to rotating circuit stations. Knowledge, skills and professional attitude specific to general and family medicine were intensively trained by 28 small groups in and around the auditorium by means of activating didactic methods. The small groups were supervised by experienced GP's trained as tutors. During six days, consisting of 3.5 hour sessions per day, working methods, a large variety of common medical conditions, preventive primary care and care for the elderly were amongst the topics addressed. Results: This new format was successfully implemented and developed with regards to content as well as organisation. Well over 90% of the 274 participating students evaluated tutors' commitment, coherent delivery of content, learner-oriented atmosphere and practical focus positively. Given the advantages of a small-group learning situation, the somewhat cramped conditions were accepted by 92%. Discussion: The innovative concept was able to work successfully within the specific framework of patient care in a general and family medicine setting. A creative approach to the lack of space managed to mobilise resources for practical small-group work. Being able to work on specific general practice problems in a small-group setting and immediately reflect upon them was rated positively overall. Conclusions: Responsibilities and specific working methods in general practice / family medicine can be trained successfully even with large groups of students when limited space is used creatively. In a supervised circuit-training setting, students are able to apply their existing knowledge and skills in a practical way. Further research is needed to assess individual learning success and gains in competence under this novel learning situation. [ABSTRACT FROM AUTHOR]

Background: Whilst the structure of primary care vocational training in Germany is being increasingly formalized there remains an abundance of disparate locally defined criteria for the training practices. Advanced medical training in the ambulatory setting has also been identified as an area of need by other specialties. Goal: In contrast to the current practice of a unregulated authorization by regional medical associations this catalogue provide transparent, clearly defined criteria for the assignment of training practice status. Methods: The first draft of the criteria catalogue integrates feedback from 30 academic general practitioners. The feasibility of the catalogue was tested by a further 30 surgeries. Analysis included an assessment of the sociodemographic characteristics of the trainers and their prac-tices as well as satisfaction of the participants with the approved authorization period. Results: The criteria catalogue comprises 19 items within the domains of trainer qualification, practice infrastructure and patient specific factors as well as mandatory criteria. The points scored through this system confer a variable period of authorization. Of the 30 participants 17 were satisfied with the period of authorization they received, 10 were dissatisfied, and one was indifferent. Satisfaction showed no correlation with sex, experience as a trainer, or with the score achieved through the criteria catalogue. It correlated little with the length of time practicing as a doctor Conclusion: The criteria catalogue reflects both the breadth of general practice as well as the skills of the trainers. Satisfaction of participants in the test group was good, and infers a basis for applying the catalogue through regional medical associations to assign teaching practice status. It may also be used as a blue-print for other medical specialties. [ABSTRACT FROM AUTHOR]

Background: The influence of a final-year elective internship in general practice (IGP) on motives affecting graduates' choice of specialty is the object of great public interest, yet still insufficiently evaluated. Longitudinal studies show the influence of numerous motives (e.g. work-life balance), but not following the IGP experience itself. Thus, we performed a cross-sectional questionnaire study of all graduates who completed the IGP in Saxony-Anhalt during 2007-2012 regarding their motives for choosing a speciality. Method: A standardized questionnaire was sent to 109 former interns in general practice. The questionnaire contained 29 items addressing three topics (personal attitudes, concept of personal and professional life, motives for speciality choice) and used single-choice and multiple-choice answers, as well as Likert scales. Correlation analysis was carried out by means of Kendall's tau. Results: The questionnaire reached 97 former interns, of which (46%) responded. In the overall ranking of motives for speciality choice, family (71%), leisure time (66%) and job opportunities (48%) rated as more important than income (36%), mentoring (20%), status or scientific work (20%). Only 29% of the respondents stated that their speciality choice was changed by the IGP. If the speciality choice was already established before the IGP, the influence of the IGP on speciality choice was significantly low (r=-.5; p<.01). However, if the IGP had an influence on speciality choice, it was correlated with a new perception of general practice (r=.36; p<.01). This new perception was associated with a positive influence of the medical teacher during the IGP. Conclusion: The final-year IGP is an opportunity to change the perception of general practice in students who are still undecided. This can lead to different speciality choices in a subgroup. Personal attitudes and concepts of personal life and career were also important factors affecting speciality choice. The aspects of the positive influence exerted by medical teachers on those students who are still undecided during the IGP should be carefully evaluated. [ABSTRACT FROM AUTHOR]

Objective: Germany is witnessing an increasing shortage of general practitioners (GPs). The aim was to determine predictors of the job-related motivation of medical students of three medical faculties with different institutionalisation of general practice as an academic discipline. Methods: Medical students were surveyed with a standardised questionnaire about their attitudes towards general practice and their motivation to work as a GP in different working conditions. Predictors for positive attitudes and motivation were calculated using logistic regression models. Results: 940 (15.2%) out of 6182 medical students from three Bavarian medical faculties participated in an online survey. 585 (62.7%) were female, and the average age was 25.0 (standard deviation 3.7). The average grade of a university-entrance diploma was 1.6 (standard deviation 0.5). 718 (76.4%) could imagine working as a GP. However, they favoured being employed within another organisation and not having their own private practice (65.5% vs. 35.1%). "Presence of a professorship of general practice" was associated with a positive attitude towards general practice (OR 1.57; 95%CI 1.13-2.417). Motivation for working as a GP was associated with "being female" (OR 2.56; 95%CI 1.80- 3.56) and "presence of a professorship of general practice" (OR 1.68; 95%CI 1.14-2.46). Having a lower grade for one's university-entrance diploma was associated with a higher preference to work in one's own practice (OR 1.39; 95%CI 1.02-1.90). Conclusion: A high amount of medical students were open-minded towards general practice. However, they favoured employment within an organization over working in their own practice. Institutionalisation of general practice as an academic discipline might be of importance to gain positive attitudes towards general practice and motivate medical students to work as a GP. [ABSTRACT FROM AUTHOR]

Objective: Psychosocial symptoms are common in patients with heart failure. Little research, however, has been done to determine which psychosocial factors influence primary care patients' consultation frequency in the case of heart failure. Methods: We recruited 310 primary care patients with heart failure by analysing electronic patient records. At baseline, psychological distress (anxiety and depression; HADS), disease coping (FKV), negative affectivity and social inhibition (DS-14), disease-specific quality of life (MLHFQ) and social support (F-SozU) were measured by validated questionnaires. Severity of heart failure (according to NYHA-classification and Goldman's Specific Activity Scale) and sociodemographic characteristics were documented by self-report instruments. Nine month later, patients were contacted by telephone in order to assess GP consultation frequency. Logistic regression was done to determine whether these psychological, medical and sociodemographic factors were associated with primary care utilisation. Results: On average, patients consulted their general practitioner (GP) 8.2 times during nine months. Female subjects and patients with higher levels of perceived heart failure severity, physical problems and anxiety or depression as well as those living alone visited their GP significantly more often. In multivariate analysis, frequent attendance in general practices was predicted by physical problems and living alone. These factors explained 11.6% of the variance of frequent attendance in general practices. Conclusion: Psychosocial factors of help-seeking behaviour in heart failure patients focus on mental and physical discomfort and a lonely home situation. These factors might need to be compensated by GP consultation. GPs should address the rearrangement of physical, mental, and social resources to strengthen self-reliance of patients with heart failure. [ABSTRACT FROM AUTHOR]