Factors affecting recruitment into General Practice: a double binary choice approach.

Recruitment to General Practice (GP) is currently low in many countries. Here we focus on two binary choices for junior doctors: first, whether to apply to GP; second, whether to accept a GP training place if offered. Previous attitudinal studies have indicated factors claimed to affect recruitment. The current study goes further by quantifying the relative impact of different factors on the propensity of candidates to apply to GP and accept a training place. An online questionnaire was sent to candidates applying to United Kingdom (UK) specialty training in 2015. Descriptive statistics and a path analysis evaluated the importance of various factors on GP applications. Our results were synthesised with an analysis of data from the online applications portal. With 3838 candidates responding to the survey, the path analysis showed that personality and previous GP experiences were strongly associated with the decision to apply. There was some evidence that it was easier to enter GP than other specialties; in terms of deciding whether to accept, the evidence suggests GP was a backup plan for around 9% of candidates who accepted a GP post. Our results indicate that recruitment initiatives should focus on candidates who apply to GP but not as first choice or consider GP but do not apply, particularly by providing substantial experience of GP and accentuating the positives of the specialty such as work-life balance and the intellectual challenge of working with patients in primary care. Acceptance of a GP place may also depend on competition for places in other specialties.