ArticleInternational journal of environmental research and public health2020
A Realist Evaluation of Theory about Triggers for Doctors Choosing a Generalist or Specialist Medical Career.
Article in International journal of environmental research and public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Establishing a Pre-Vocational Surgical Society: Early Experience, Outputs and Educational Value.ANZ journal of surgery · 2026Article
- Theories and theoretical frameworks used in general practice career choice research: a scoping review.BMC primary care · 2026Article
- Strengthening integration of pathways into general practice in Australia: a virtual workshop study with stakeholders.BJGP open · 2026Article
- General practice specialty decision making: a system-level Australian qualitative study.BJGP open · 2025Article
- Securing tomorrow's workforce: insights from a Danish survey on factors influencing junior doctors' specialization in geriatric medicine.European geriatric medicine · 2025Article
- Employment Models to Attract and Sustain Rural Generalist Doctors: Barriers and Enablers.The Australian journal of rural health · 2025Article
- Subjective learning gain from a simulation-based health management course: a mixed methods study.Frontiers in public health · 2024Article
- Contemporary Australian socio-cultural factors and their influence on medical student rural career intent.The Australian journal of rural health · 2022Article
- Enabling uptake and sustainability of supervision roles by women GPs in Australia: a narrative analysis of interviews.BMC medical education · 2022Article
- Understanding concepts of generalism and specialism amongst medical students at a research-intensive London medical school.BMC medical education · 2022Article
- Exploring Doctors' Emerging Commitment to Rural and General Practice Roles over Their Early Career.International journal of environmental research and public health · 2021Article
- Increasing doctors working in specific rural regions through selection from and training in the same region: national evidence from Australia.Human resources for health · 2021Article
- The Future Health Workforce: Integrated Solutions and Models of Care.International journal of environmental research and public health · 2021Article
- Barriers to getting into postgraduate specialty training for junior Australian doctors: An interview-based study.PloS one · 2021Article
- Implementing an Integrated Generalist-Led Inpatient Care Model: Results of a Mixed-Method Evaluation.International journal of integrated careArticle
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There is a lack of theory about what drives choice to be a generalist or specialist doctor, an important issue in many countries for increasing primary/preventative care. We did a realist evaluation to develop a theory to inform what works for whom, when and in what contexts, to yield doctors' choice to be a generalist or specialist. We interviewed 32 Australian doctors (graduates of a large university medical school) who had decided on a generalist (GP/public health) or specialist (all other specialties) career. They reflected on their personal responses to experiences at different times to stimulate their choice. Theory was refined and confirmed by testing it with 17 additional doctors of various specialties/career stages and by referring to wider literature. Our final theory showed the decision involved multi-level contextual factors intersecting with eight triggers to produce either a specialist or generalist choice. Both clinical and place-based exposures, as well as attributes, skills, norms and status of different fields affected choice. This occurred relative to the interests and expectations of different doctors, including their values for professional, socio-economic and lifestyle rewards, often intersecting with issues like gender and life stage. Applying this theory, it is possible to tailor selection and ongoing exposures to yield more generalists.
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