Self-perceived competence and its determinants among pre-intern (PRINT) doctors in Uganda

Abstract

AbstractIntroductionUganda still survives way below the recommended doctor-patient ratio. This problem could be solved by increasing the number of doctors produced in the country annually. Attempts at this are ongoing, however, this is challenged by the absence of quality assurance programs amidst lack of a universal medical curriculum. With inadequate supervision and limited resources in health facilities, transitioning from students’ life to clinical practice is perhaps the most challenging time for an intern doctor. We used the domains of competencies provided by the General Medical Council to assess levels of self-perceived competence and its determinants among pre-intern doctors (PRINTs) in Uganda.MethodsAn online cross-sectional study was conducted using a quantitative questionnaire distributed to confirmed pre-interns in Uganda. Self-perceived competence was determined by 4 Likert scale questions and participants were dichotomized into competent and incompetent using a standardized Bloom’s cutoff criterion. Determinants of self-perceived competence were determined by the ANOVA test.ResultsWe obtained 142 entries. Of these, 68.3% were males; median age was 26 years (range: 22-49). Majority of the participants (78.9%) had no prior medical-related training and only a third (34.5%) had previous work experience. Overall scores were poor and very few participants were confident they attained a satisfactory level of competence through their medical training. Participants reported more competence in basic procedural skills (Mean score: 19.8±3.2/21), followed by Knowledge (Mean score:12.4±3.1/15), with surgical (Mean score:11.5±3.5/18) and Emergency skills (Mean score: 12.5±4.4/21) scoring least. Participants with previous work experience were more likely to report higher competence scores than their counterparts (91.7 vs 84.9, p=0.039).ConclusionThe study shows that majority of PRINTs feel deficient in knowledge and skills to start clinical practice, with less competence in surgical skills and emergency care.There is need to review the training curricula to ensure adequate clinical exposure experiences for a smooth transition to clinical practice.