Keywords: Medical Students; Medical teaching; practice management; setting up an own practice; cross-sectional questionnaire study

Background:

Outpatient care in Germany, particularly general practice (GP), is increasingly threatened by demographic change and workforce shortages. Universities play a central role in early recruitment by addressing barriers to medical students’ (MS) intention to establish their own practice (OP) through targeted teaching, such as practice management (PM). However, PM remains underrepresented in German medical curricula.

Research questions:

What attitudes do MS have toward establish their OP? What are MS’ attitudes toward a potentially mandatory university course on PM?

Method:

All MS in the second (N = 200) and tenth (N = 220) term at Martin-Luther-University (MLU), Germany, were invited to participate between April and July 2025. A cross-sectional questionnaire study was conducted using a self-designed, pretested instrument, administered online and in paper form. The survey assessed attitudes toward establishing an OP and toward a mandatory PM course. Data were collected anonymously. Ethical approval was obtained (MLU Ethics Committee 2025-067); funding was provided by Stiftung Perspektive Hausärztinnen und Hausärzte. Complete-case analyses were performed using R (version 4.5.2).

Results:

The response rate was 78.3% (329/420). Participants were 67.2% female with a mean age of 23.8 years. Overall, 69.2% intended to establish their OP, preferably as a group practice. A mandatory PM course was supported by 43.8%, rejected by 24.6%, and viewed indifferently by 31.6%. MS intending to specialise in GP were significantly more likely to plan establishing their OP (IRR = 6.96) and to support mandatory PM teaching (OR = 2.03). Openness toward establishing an OP increased from the 2nd to the 10th term (IRR = 2.83). No significant associations were found for sociodemographic variables.

Conclusions:

Approximately two thirds of MS intended to establish their OP. While most preferred PM as an elective rather than mandatory course, GP orientation was strongly associated with both outcomes. These findings may inform curriculum development at universities.

Points for discussion:

Is practice management included in the curriculum at university?

If yes, how are your classes on practice management designed?

What are your lessons learned from these classes and do you know any comparable studies on MS' views on practice management?