Abstract

Introduction Uganda 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.

Methods An 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.

Results We 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).

Conclusion The 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.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The author(s) received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was conducted in accordance with the Declaration of Helsinki approved by the Mulago Hospital Research and Ethics Committee under reference number MHREC 2201. Verbal informed consent was obtained from all participants before a link to the online questionnaire was shared. Additionally, the consent form was provided on the cover page of the Google Form and participants were asked to affirm whether they were willing to continue using prompts “Yes” or “No”. Those who chose “Yes” were linked to the questionnaire while those who chose “No” were not granted access to the questionnaire.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All relevant data are within the manuscript and its Supporting Information files.

List of abbreviationsCPRCardiopulmonary resuscitationC-SectionCaesarean SectionGCSGlasgow Coma ScaleGMCGeneral Medical CouncilIUDIntrauterine deviceIVIntravenousMBChBBachelor of Medicine and Bachelor of SurgeryNGNasogastricOBGYObstetrics and GynecologyPOPPlaster of ParisPRINTsPreinterns