Saudi university students
awareness and attitude towards family medicine
specialty
Dalia El-Sayed
Desouky (1,2)
Maryam Hassan Turkistani (3)
Wedad Saeed Althobaiti (3)
Mai Muaiwedh Algethami (3)
(1) Department
of Family and Community Medicine, College of
Medicine, Taif University, Saudi Arabia
(2) Department of Public Health and Community
Medicine, Faculty of Medicine, Menoufia University,
Egypt
(3) Faculty of Medicine, Taif University, Saudi
Arabia
Corresponding author
Dr. Dalia El-Sayed Desouky
Assistant Professor of Public Health & Community
Medicine, Department of Public Health and Community
Medicine, Faculty of Medicine, Menoufia University,
Egypt.
Assistant Professor of Public Health & Community
Medicine, Department of Family and Community
Medicine, College of Medicine and Applied Medical
Sciences, Taif University, Saudi Arabia
Saudi Arabia, Taif city, Alsalama street
Email: daliadesouky1234@gmail.com
Received: April 19, 2018; Accepted: May 10,
2018; Published: June 1, 2018
Citation: Dalia El-Sayed Desouky, Maryam Hassan
Turkistani, Wedad Saeed Althobaiti, Mai Muaiwedh
Algethami. Saudi university students awareness
and attitude towards family medicine specialty.
World Family Medicine. 2018; 16(6): 4-16. DOI:
10.5742/MEWFM.2018.93390
Abstract
Background: Worldwide, there is
shortage of family medicine (FM) specialists
and disinterest of medical students in
choosing FM as a career. Saudi Arabia
is facing the same problem.
Objectives:
The aim of this study was to know
the magnitude of knowledge and attitude
of Saudi medical and non-medical students
towards FM specialty.
Methods:
A cross-sectional study was done on 708
students of Taif University using a self-administered
questionnaire about socio-demographic
factors, knowledge and attitude towards
FM specialty.
Results: Medical
students showed a significant higher percentage
of students who saw that FM specialty
has an essential social function, has
a pleasant working environment, has a
high social status, is an attractive option
for a medical students, is an interesting
specialty from a research perspective,
and is an important specialty in: disease
prevention/Health promotion, family-focused
health care, bio-psychosocial focus of
health care, collaboration with other
sectors, team work, bioethics, and urgent
care. Only 6% of medical students chose
FM as a future career, and the mostcommon
factor influencing the specialty preferences
was the good working condition and the
quality of life. Female students and older
grades showed a significant higher percentage
of students choosing FM as a future career.
For all participants, the study reflects
the bad reputation about FM specialty
regarding its status within the medical
profession, scientific prestige and salary.
Conclusion:
Medical students had better knowledge
and perception of family medicine compared
to non-medical students, but they had
low interest in choosing it as a future
career.
Key words: students,
Saudi, awareness, attitude, family, medicine
Abbreviations
FM Family medicine
FP Family Physician
KSA Kingdom of Saudi Arabia
SPSS Statistical Package of Social Science
2 Chi-square test
|
Family medicine (FM) is a cornerstone for developing
a community based health care system (1), and
family physicians (FPs) are the most appropriate
physicians to be located in primary health care
(2). They are qualified to provide continuing
and comprehensive medical care, health maintenance
and preventive services to each member of the
family (3).
Worldwide, many people suffer from lack of
access to proper preventive and curative health
services due to shortage of FM specialists (4,5),
or their mal-distribution (6), a matter that
has forced many countries to adopt national
strategies to overcome this problem.
There is a decrease in the number of medical
students interested in choosing FM as a career
(4,7,8,9,10), a matter that makes the low number
of FM specialists a worldwide problem (2,4,
5, 7,8,9,10).
Studies have found that medical students know
the importance of FM specialty, but did not
consider it attractive according to the scientific
and technical interest, workplace conditions,
and research prospective (11,12,13). Their knowledge
about FM specialty was found to increase by
studying it as a mandatory course in medical
collages, but that doesnt increase their
interest in choosing it as a profession (6,
14).
A systematic review of ten studies done on
medical students in western countries found
that over the last decade, medical students
showed a decreased interest in FM as a career
choice. This result was revealed although students
found FM an interesting specialty, but they
considered it a career of low prestige (4, 5,
8, 15).
According to studies done in Arab countries,
a nationwide web-based survey carried out on
600 students of seven Egyptian medical colleges
showed that, although 90.7% of them believed
in the importance of FM in the Egyptian healthcare
system, only 4.7% showed an interest in its
choice as a future career (16).
In the Kingdom of Saudi Arabia (KSA), FM practice
became a recognized specialty because of increasing
cases of morbidity and mortality due to preventable
diseases (17). That is why there is an urgent
need to train as many family medicine practitioners
as possible to deal with these cases (17). Studies
from KSA have shown that more attention is required
at all levels of FM in order to produce an adequate
number of family physicians to improve the academic
aspects and the services provided by FM in the
country (18,19,20).
According to a study titled Family medicine
practice in Saudi Arabia: the current situation
and proposed strategic directions plan 2020,
there is a shortage of qualified family physicians
in all Saudi health care sectors (21). Despite
the scarcity of Saudi FM practitioners and the
governmental need for this specialty, only one
study was done on medical students of King Saud
University to assess students knowledge
about the family medicine specialty and their
attitude towards choosing FM as a career. The
study found that students knew the importance
of FM specialty only after the FM course was
taken in the college. The study notified the
high probability that the general Saudi population
will have little knowledge and appreciation
of the importance of the family medicine practice
(22).
Knowledge and attitudes of Saudi university
students towards FM is presently not well known
as only one known study was done to address
this issue. That is why this study was carried
out to know the magnitude of knowledge and attitude
of both medical and non-medical students of
Taif University towards FM specialty.
Study Design and time frame: The present
study was a cross-sectional study done on students
of Taif University in the time frame from January
to May 2018.
Sampling methodology: Multistage sampling
methodology was carried out, and the university
community of Taif University was the sampling
frame. The university includes two (female and
male) sections. The medical college was chosen
by its male and female sections and simple random
sampling methodology was carried out to choose
the non- medical college, where its male and
female sections were included.
The total number of students from the medical
and non-medical colleges (male and female sections)
registered in the academic year 2017-2018 was
obtained from the office of the students
affairs. After exclusion of the non-respondents,
the total number of participants was 753 students,
with a response rate of 69.46%. Incomplete questionnaires
(45) were excluded leaving 708 questionnaires
for final analysis.
Inclusion/exclusion criteria: All students
who agreed to share in the study from the two
colleges were included. Non-Saudi students and
those who refused sharing were excluded.
Ethical Considerations: The study was
reviewed and approved by the Research Ethics
Committee of Taif University, and from the deanships
of the colleges included in the study. Verbal
consent was obtained from students before participating
in the study.
Study instrument: A self-report format
of a pre-designed questionnaire where the first
few question were to collect data about age,
sex, marital status, and educational grade,
was used. A filter question about previous knowledge
about FM specialty was added, where students
who replied yes (502 students) were
qualified to reply to the subsequent questions
on knowledge and attitude towards FM specialty.
For each item a 5-point Likert scale from strongly
disagree to strongly agree was used and scored
from 1- 5 respectively, where a score greater
than 3 was considered a positive response (16).
For medical students, an additional section
was added to address their specialty preference,
factors influencing their preferences, and reason
for not choosing FM specialty for students who
replied they were not choosing FM as a future
career. The items of the questionnaire were
taken from questionnaires used in previous research
(9, 16, 23, 24). Afterwards, pilot testing of
the questionnaire was carried out on 40 university
students to check the clarity, comprehension
and the interpretation of each item.
Statistical analysis: Data was coded, tabulated
and analyzed using (SPSS) version 20 (Armonk,
NY: IBM Corp.). Qualitative data was expressed
as numbers and percentages, and Chi- squared
test (2) was applied to test the relationship
between variables, and quantitative data was
expressed as mean and standard deviation (Mean
± SD). A p-value of <0.05 was considered
as statistically significant.
In the present study, among the 708 participants,
53.4% were females, 61% were from the medical
college, and their mean age was (20.48 ±
1.75) years. The percentage of the participants
from each grade ordered from the 1st to the
6th is as follows: 15.1%, 18.5%, 19.9%, 19.5%,
13.6% and 13.4% respectively. About 70% of all
participants had heard about FM specialty before,
and only 48% thought that they had a good knowledge
about FM specialty. Of the participants, only
7.5% had a FP among relatives, 64.4% visited
a PHC Unit as consumers before, and 79.4% of
them were satisfied with the service given (Table
1).
Click here for Table
1: Comparison between medical and non-medical
students according to their response to statements
related to FM specialty
Table 1 shows that a highly significant difference
was found between medical and non-medical students
(in the favor of medical students) according
to previous hearing about FM, and having adequate
knowledge about it (p =<0.001).
Click here for Table
2: Comparison between medical and non-medical
students according to their response to statements
about the FM role in Saudi Arabia
Table 2 shows a highly significant difference
between medical and non-medical students (in
the favor of medical students) according to
their opinion that FM specialty: (1) Has an
essential social function, (2) Has a pleasant
working environment, (3) Has a high social status,
(4) Is an attractive option for a medical students,
and (5) Is an interesting specialty from a research
perspective (p =<0.001). A non-significant
difference was found between medical and non-medical
students according to their opinion that FM
specialty: (1) Has a high status within the
medical profession, (2) Provides a high salary
in comparison with other specialties, and (3)
Has a level of scientific prestige equivalent
to other specialties.
Click here for Table
3: Comparison between medical and non-medical
students according to their response to the
importance of FMs contributions to other
areas of preparation
In Table 3 a significant difference was found
between medical and non-medical students (in
the favor of medical students) according to
their response to the importance of FM in:
(1) Disease prevention/Health promotion,
(2) Family-focused health care,
(3) Bio-psychosocial focus of health care,
(4) Collaboration with other sectors (education,
social services or other),
(5) Team work
(6) Bioethics, and (
7) Urgent care (p =<0.005). A non-significant
difference was found between medical and non-medical
students according to their response to the
importance of FM in:
(1) Research,
(2) Clinical epidemiology,
(3) Community-focused health care,
(4) Health care across the lifespan,
(5) Clinical attention for the most common problems,
and
(6) Communication/Doctor-patient relationship
(p =>0.005).
Figure 1 (next page) shows that according to
the students specialty preferences, FM
ranked the tenth among eleven specialty options
given to students (only 6% of students chose
it a future career). The most common factor
that influenced the specialty preferences of
medical students was the good working condition
and the quality of life, and the least factor
was the popularity of the specialty (Figure
1).
Click here for
Figure 1: Medical students specialty preferences
and factors influencing their choice
The reasons for not choosing FM as a future
career for medical students was the students
disinterest in the specialty for (44.2%) of
students, lack of information about FM for (29.5%)
of them, being a difficult field (15.5%), and
(10.5%) of students had multiple reasons of
the above.
Table 4 shows that a significant gender difference
was found according to choosing FM as a future
career, as 8% of female students chose it compared
to 3% of male students (p=0.034). A significant
difference was found between students
grades as regards choosing FM as a future career,
where the 6th grade students had the highest
percentage of students who chose FM, followed
by the 5th grade, the 4th , the 3rd and the
2nd grade students (11.6%, 8.3%, 7.4%, 2.7%,
and 1.7% respectively) (p=0.022). None of the
students in the 1st grade chose FM as a future
career.
Click here for Table
4: Association between some studied variables
and the choice of FM as a future career by medical
students
A significant difference was found between
students according to their choice of FM as
a future career and having a FP among relatives,
where 18.5% of those who have a FP among relatives
chose FM, compared to 5.2% of those who dont
have a FP relative and chose FM (p=0.005). A
non-significant difference was found between
students who chose and who didnt choose
FM according to: having a good knowledge about
FM specialty, previous visit of a PHC Unit or
their satisfaction as consumers with the service
given (p =>0.005).
Determining the public knowledge and attitudes
towards FM specialty and identifying deficiencies
in knowledge can help those responsible for
health education to raise awareness of the community
about the importance of FM and correct any related
misconceptions (25).
In the present study medical college had a
significant higher percentage of students who
had heard previously about FM or had adequate
knowledge about it when compared to non-medical
students (Table 1). This result goes along with
that revealed from another Saudi study which
stated that the general Saudi population does
not know the importance of FM specialty to the
country (22). The study reported that this lack
of information was present even among medical
students, where their knowledge and attitude
towards FM did not improve until they had completed
the FM training course in the college.
Compared to the non-medical college, medical
college also had a significant higher percentage
of students who had a positive response towards
FM as having an essential social function, a
pleasant working environment, a high social
status, and their response that FM is an attractive
option for medical students, and is an interesting
specialty from a research perspective (Table
2). This result was observed in previous studies
done with medical students where the vast majority
of students surveyed reported the essential
social function of FM (11,12,15).
The same positive response regarding the work
environment was displayed also in previous studies
where students saw the work environment of the
family practice is friendly due to lack of competition
compared to a hospital work environment (26),
and the ability of working in a multidisciplinary
team (27).
This work shows that, despite 84.1% of medical
students who thought that FM has an essential
social function, only 37.8% thought that it
is an attractive option for a medical student,
17.5% thought that FM has a high status within
the medical profession, 14.3% thought that it
has a level of scientific prestige equivalent
to other specialties, and only 9.5% thought
that FM specialty provides a high salary in
comparison with other specialties (Table 2).
This disappointing trend was observed in a study
done in Spain which found that despite 89.8%
of medical students who reported the important
social role of FM; only 20% believed that FM
has a high status within the medical profession
(9).
This result is in agreement with previous studies
which reported that FM is at the bottom
of the medical hierarchy and it is considered
as an inferior choice according to medical students
point of view (4,11).
In the present study, only 37.8% of medical
students thought that FM is an attractive option
for a medical student. This result was seen
in other studies which found that despite medical
students who agreed on the essential social
role of FM they did not consider it to be an
attractive option for a medical student. The
cause of their opinion was the lower scientific
prestige, lower salary and less research opportunities
of FM compared to other specialties (11,12,15).
This study showed that, only 9.5% of medical
students thought that FM specialty provides
a high salary in comparison with other specialties,
a result that was revealed from another study
done on medical students in
Toronto University where about 89% of them saw
that FPs are paid too little (28). In another
study medical students see that the FP is unable
to gain additional income from the private sector
(11).
In the present work only 14.3 % of medical
students surveyed thought that FM has a level
of scientific prestige equivalent to other specialties.
This negative opinion was also revealed from
a systematic review which found that despite
medical students finding FM appealing, it was
considered as a specialty of low interest and
prestige (15).
The non-significant difference found between
medical and non-medical students according to
the previous four items (FM as an attractive
option for a medical student, has a high status
within the medical profession, has a level of
scientific prestige equivalent to other specialties,
provides a high salary in comparison with other
specialties), reflects the ignorance of the
general Saudi population of the basic role of
FM and the aspects it presents as an important
medical specialty for the Saudi society. It
also reflects the bad reputation and misconceptions
about FM specialty among the general population.
This study showed that compared to students
of the non-medical college, medical students
reported a significant higher positive response
to the importance of FM in disease prevention/health
promotion, family-focused health care, bio-psychosocial
focus of health care, and collaboration with
other sectors, team work, bioethics, and urgent
care (Table 3). This result goes along with
that revealed from a study done in Spain where
students found that the most important contributions
of FM was in doctor-patient relationship and
the clinical attention for the most common problems
(9), a matter that can solve the Saudi health
sector problem of the shortage of qualified
FPs (21).
This study showed a non-significant difference
between medical and non-medical students according
to their response to the importance of FM in
clinical attention for the most common problems,
and communication/doctor-patient relationship,
where more than 70% of all students had a positive
response to the importance of FM in these two
fields (Table 3). The same result was revealed
from previous studies where medical students
pointed out the FPs/patients relationship, as
they saw the general physicians, were more patient
centered (29,30).
Similarly, less than 40% of all students (without
a significant difference between medical and
non-medical students) had a positive response
to the importance of FM in research, clinical
epidemiology, community-focused health care
and health care across the lifespan, with no
significant difference between medical and non-medical
students (Table 3). This reflects absence of
basic information about the role of FM and nature
of the work of the FP among the studied sample.
The same opinion was observed in a previous
study where medical students complained of the
lack of research in the FM training (11,12).
According to medical students specialty
preferences, internal medicine specialty was
the most chosen specialty in the present study,
a result that was seen in a Turkish study (31).
The most common specialties chosen by students
in the present study were internal medicine,
surgery, dermatology and pediatrics. The same
result was observed in another two Saudi studies
(32,33). This result was also reported by medical
students in other international studies where
surgery, general medicine and pediatrics were
the most chosen specialties by surveyed medical
students (34).
According to FM specialty, the present work
showed that only 6% of students chose it as
a future career, where it ranked the tenth among
eleven specialty options given (Figure 1). This
result goes along with that observed in a recent
Saudi study done on 220 medical students of
Taibah University, where only 6.8% of students
chose FM (33).
In a previous Saudi study done on medical students
of King Saud University, medical students become
more willing to practice FM only after completing
their clinical training course and getting a
wide knowledge on FM, when about 58% of them
chose FM as a future career (22). This finding
reflects the negative attitude of medical students
towards FM specialty, which boosts results observed
in other studies where FM is devalued as a professional
activity and a future career by medical students.
(4,7,8,9,10).
The proportion of students who chose FM as
a future career in the present study is lower
than that observed in other international studies
(4,5,7,8,9,10). The low percentage of medical
students who chose FM as a future career is
observed in the present study despite 84.1%
of them reporting that FM has an essential social
function and 69.8% stating that it has a pleasant
working environment. These contradictory responses
were reported in an Egyptian study, where 90.7%
of students believed in the vital role of FM,
but only 4.7% of them reported to choose it
as a future career (16). And it goes along with
other international studies where medical students
know the importance of FM specialty, but do
not consider it an attractive career choice.
(11,12,13).
The percentage of students who chose FM as
a future career in the present study is however
higher than that observed in a study done in
nine universities in five sub-Saharan African
countries, where only 4.5% of medical students
chose FM as a future career (35). It is also
higher than results revealed from a study done
in Spain where only 1.4% of medical students
chose FM (36).
The good working conditions and the quality
of life were the most common factors that influence
the specialty preferences among surveyed medical
students in the present study; a result that
was also reported by medical students in a previous
Saudi study where lifestyle and personal interest
were the most common factors influencing specialty
preferences (32).
The high level of income was ranked 6th among
thirteen options of factors influencing career
preferences chosen by medical students in the
present study, a result that was observed in
another Spanish study where the high salary
ranked 8th among the given options (9).
The least important factor that influenced
career choice in the present study was the popularity
of the specialty, a result that is in keeping
with an Egyptian study, where the nature of
the specialty and its importance were the most
observed factors influencing the career choice
(16).
A previous systematic review demonstrated the
importance of assessing factors influencing
choosing FM as a future career among medical
students to prevent the future shortage of FPs
(37). The present study showed that 44.2% of
students who didnt choose FM as a future
career reported their disinterest as a reason
for not choosing FM.
Studies have demonstrated and explained the
disinterest of medical students towards choosing
FM as a future career in the light of being
a boring practice with an administrative role
that compromised its medical aspects according
to students opinion (11). Other studies
showed that medical students see FM as a superficial
specialty that is not intellectually challenging
as it deals with common diseases while severe
problems are referred to specialists (4,11).
Some students think that advances in medical
knowledge can be found only in organ or disease-based
specialties (11). Medical students in another
study thought that the duty of the FP is just
to triage patients, and practicing FM has a
lack of evidence base as it teaches them communication
and counseling skills but not knowledge (30).
The negative attitudes and comments from residents,
peers, or other specialists on FM were found
to have a negative effect on the students
interest in FM too (4,11). Other studies showed
that families may force the medical student
to choose another specialty (4,11), a matter
that reflects the ignorance of the public of
the importance of the specialty of FM. Others
explained this in the light of the negative
perception of medical students of FM clinical
rotation as being a study overload as it focuses
on theoretical aspects of FM rather than the
practical ones (16). FM is a medical field that
has a high expectation level, as the FP should
have adequate knowledge about every facet of
health care, and this may make medical students
less motivated to choose FM as a future career
(38).
In Saudi Arabia, FM specialty is facing a lot
of challenges; these challenges include the
inefficient and incomplete health records in
hospitals and medical training centers, the
lack of skilled trainers in the FM field for
effective teaching of medical students, [8],
in addition to the shortage of FPs which increase
the workload and the burnout of the available
physicians, and in turn decreases the time they
have to teach medical residents (19,39). This
situation was illustrated in a previous Saudi
study which showed that all Saudi medical colleges
have a FM department with a total staff of only
170 teachers (21).
Previous studies proposed changing the curriculum
design of medical schools to start teaching
the basic elements of FM early in the third
or fourth year (4,40). Others proposed improving
the practical and theoretical content of the
curriculum of FM to improve medical students
knowledge and attitude towards it, and to increase
their willingness to choose it as a future career
(9). These proposals have proved effective in
a previous Saudi study where medical students
become more willing to choose FM as a future
career after completing their clinical training
course (22).
The significant gender difference in choosing
FM as a future career in the favor of females
was found in other studies (7,9,16,41). This
gender difference was explained in another study
by the female belief of their presence in a
double income family which enables them to consider
choosing FM without consideration of the income
(4,42). In addition, female medical students
think that FM enables working part-time allowing
having a family. A different result was observed
in a Japanese study where a non-significant
difference was found between male and female
medical students according to their choice of
FM as a future career (43).
The undergraduate medical programme of Taif
University includes 6 years divided into 12
semesters. Medical students are exposed to FM
in the FM module taught in the 5th year which
has a five weeks length, where clinical FM is
covered during these weeks. In the present work,
a significant difference was found between students
grades according to choosing FM as a future
career, where the highest percentage of students
who chose FM were in the 6th grade followed
by students in the 5th grade, the 4th, the 3rd
and the 2nd grade respectively. This result
was observed in a previous study done in South
Africa where students in the first three years
of medical colleges showed the least interest
in FM (44). It is also in line with studies
that reported the increased interest in FM over
years of medical training, and the improvement
of their attitude towards FM as they progress
in medical school (7,9), a finding that was
somewhat explained by the more contact with
general physicians during students training
(45).
The observed gradual increase of students
interest in FM as they progress in the study
years could be hypothesized by the low interest
of students in the early years due to lack of
exposure to FM (8).
The significant higher percentage of students
who choose FM in the 5th and 6th year could
be explained by their completion of the FM module
in the 5th year, besides their exposure to FPs
during their rotations. This was proved by the
result of the previous Saudi study done in King
Saud University, where medical students
desire to select FM specialty increased after
completion of their clinical training course
(22). This result is in agreement with studies
which showed that medical students become more
interested in choosing FM after experiencing
FM clinical training and gaining knowledge about
the specialty during the clinical rotation [29].
This enables them to understand different aspects
of the specialty which can change their attitude
towards it (29,46).
In the present study, FM was not chosen as
a future career by any student in the 1st grade,
a matter that was found in a previous study
and explained by the students poor knowledge
regarding FM (41).
Studies have shown that having a FP among relatives
may be a motive for a medical student to choose
FM as a future career. The present study observed
this relation, where 18.5% of medical students
who have a FP among relatives chose FM, compared
to 5.2% of those who dont have a FP relative
chose FM.
In the present study, having a good knowledge
about FM specialty, previous visit of a PHC
Unit or their satisfaction as consumers with
the service given didnt affect medical
students choice of FM as a future career. This
result is in contrast with the previously mentioned
Egyptian study where students intention
to choose FM as a future career was found to
be associated with a previous consumer experience
with FM (16). This could be explained by the
good status of PHC units in Saudi Arabia as
an oil producing country with better health
care services available in PHC settings. This
was proved in a previous study done to assess
the Patients Satisfaction with Primary
Health Care Centers Services in the capital
which showed that 82% of clients were satisfied
with the services, where cleanliness of the
PHCs and technical abilities of the staff were
the most common reasons behind satisfaction
(47). This high level of satisfaction was reported
in other national studies (47,48).
This study demonstrated that medical
students had better knowledge and perception
of family medicine compared to non-medical
students, but they had low interest
in choosing it as a future career. Interest
in FM as a specialty increases among
female students and those in older grades.
All studied students had a bad opinion
about FM regarding its status within
the medical profession, scientific prestige
and salary. The study calls for awareness
campaigns to increase the awareness
of the Saudi population on FM specialty
and the role of the family physician.
Strategies should be planned and implemented
by medical schools to increase the knowledge
of FM specialty among medical students,
to define its parameters, and to change
the medical curriculum to enable the
exposure of medical students to the
content of FM in their early years in
the medical school.
Limitations
Limitations of this study are: (1) Using
a self-reported questionnaire which
was prone to recall bias. (2) Study
design was a cross-sectional one which
showed the relation between variables
without concluding the cause-effect
relationship. (3) Findings of the study
cant be generalized on Saudi university
students as it was limited to only one
Saudi university (4). The intention
of medical students to choose FM as
a career is not known whether it will
be implemented in the future or not.
Acknowledgments
The authors gratefully acknowledge the
support provided by the officials of
the chosen colleges, and the cooperation
of the participant students. Special
thanks to Drs: Mohammed Ali Algarni
and Alwaleed Saeed Ali Aljabir who helped
in data collection from male students.
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