Career choice in primary care: pre- and post-comparison of Honduran physicians completing social service

OBJECTIVE. To describe and compare patterns of specialty choice among physicians in Honduras before and after completing mandatory social service; and to identify and compare salary perceptions and factors that may influence their career choice. METHODS. A quantitative methods approach was used on a cross-sectional questionnaire survey applied to 106 physicians completing social service in September 2015. Statistical analysis was performed using chi-square and factor analysis. RESULTS. Interest in family medicine was low and declined from 2.2% before social service to 0.9% after. Median annual expected income was 19.5% lower overall compared to the beginning of social service, and in particular, for primary care specialties (US$ 17 733), it was significantly lower than for other specialties (US$ 27 281). Participants reported that the most important factors influencing career choice were: income potential (23.3%), making a positive difference in people’s lives (19.4%), challenging work (10.7%), and perceived prestige (7.8%). Two factors were significantly associated with a preference for specialties other than primary care: the opportunity to teach (P= 0.008) and “makes positive difference in people’s lives“ (P = 0.005). When all categories were compared, “makes positive difference in people’s lives“ (P = 0.043), and opportunities to practice with independence (P = 0.036) were factors significantly associated to career decision. CONCLUSION. Since interest in primary care among physicians decreased during social service and salary perception increased in favor of non-primary care careers, offering greater incentives for this specialty should be explored. Additional research to identify factors that might support the choice of a career in primary care are recommended.