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Professional pathways of General Practitioners in XXX: typology, temporality and influence on medical practice

Marina FERNANDES and Coralie BUREAU-YNIESTA

The professional pathway of general practitioners (GPs) develops through internships and employment during medical studies, followed by ambulatory practice. Trajectories – occurring before, during, after medical training – show considerable diversity. No study has fully described these pathways or analyzed links between trajectories and modes of practice in general medicine.This study analyzes the professional pathways and medical practice of GPs in XXX according to temporality (before, during, after studies) and typology (typical, atypical), and explores their influence on clinical practice. It is an ancillary study to a broader analysis of educational pathways and their impact on medical practice.We conducted a regional, cross-sectional, descriptive, observational study, using a mixed-methods design (quantitative: Excel®, BiostatTGV®; qualitative: data standardization, typological classification – « typical »: any employment accessible to medical students or in paramedical fields without specific degrees –, thematic analysis of free-text responses). A self-administered questionnaire, distributed over three months to GPs, explored professional pathways by temporality, current medical practice and perceived influence on practice. Five dimensions were assessed: practice mode, setting, organizational structure, schedule and patient panel.Participation ranged from 31.01% (1,346 GPs) to 21.87% (949). The primary outcome was statistically significant (p < 0.05). Professional pathways, atypical initially, gradually shifted toward medical specialization: 15.53% typical before studies, 56.79% during, 78.09% after. Atypical orientations remained the most frequent model across population characteristics and all five dimensions. Regardless of timing, the health and social, cultural, and sports sector – typically classified – dominated (32.72%), followed by services to individuals and communities (22.77%, mainly atypical), education and training (9.99%, more typical). Most experiences occurred during studies (54.08%). Certain sectors influenced practice mode and patient panel: health, services to individuals, politics/religion had positive effects, while education positively affected practice mode. Politics/religion negatively impacted schedule.No previous study has explored GPs’ professional pathways, giving this work originality and relevance. Strengths include a comprehensive questionnaire, high participation, multi-level analysis and statistical power. Limitations include recall bias, a novel typological classification, geographic scope.This study highlights an enriched model of general practice. Future perspectives include national expansion and creating a directory of French GPs’ professional pathways.