Doctoral defence: Marta Velgan "Addressing the family physician shortage: career and migration intentions in Estonia and Europe"

On May 15th Marta Velgan will defend her thesis "Addressing the family physician shortage: career and migration intentions in Estonia and Europe".

Supervisors:
Professor Ruth Kalda, University of Tartu
dr Nele Michels, The Interuniversity Centre of General Practice Education (Belgium)

Opponent:
Senior lecturer Eeva Pyörälä, University of Helsinki (Finland)

Summary
The family physician shortage is a threatening problem for the healthcare systems of many countries, requiring specific solutions. It is known that well-organised primary care helps prevent chronic diseases and premature death and reduces unnecessary healthcare costs. The ageing population place a more significant burden on the healthcare system, making it particularly important to ensure a sufficient number of various healthcare specialists. While the number of physicians has increased over the past five years in most European countries, including Estonia, the number of family physicians has either decreased or remained the same. Several factors determine whether there will be enough family physicians in healthcare: medical students’ interest in family medicine, the career intentions of early-career family physicians, the migration of family physicians, and the dropout of family physicians at any stage during their career. The main aim of this research was to add to our understanding of the causes of the family physician shortage to provide evidence on factors influencing this phenomenon and possible solutions. To this end, various methods were used to conduct studies in Estonia and several European countries.

The findings highlight the importance of medical students’ exposure to family medicine during studies and having family physicians as role models. There is also a need for improvements in training programs, particularly in preparing family physicians for the management aspects of running a practice and working with a patient list. Moreover, policy changes and better funding are necessary to support family physicians and address issues like poor working conditions, inadequate remuneration, and lack of recognition. Emphasising work-life balance and career flexibility is vital for creating sustainable career paths, reducing burnout, and enhancing job satisfaction among future and current family physicians.