[Determinants of the choice of the first level of care in medicine as a field of training and work: A qualitative study].

Objective: To explore the determinants of eligibility and the choice of the first level of care as a workplace and training environment for health professionals.

Design: Qualitative study.

Setting: Four universities in the Metropolitan Area of Buenos Aires, Argentina.

Participants: Recently graduated doctors and medical students.

Method: Based on the grounded constructivist theory, semi-structured interviews and focus groups were conducted for data collection and subsequent analysis.

Results: 31 interviews and three focus groups were conducted during 2019-2020. Emerging concepts were organized in main axes for analysis. Positive and negative experiences were identified in relation to primary health care (PHC) in curricular spaces and practical rotations, and a significant lack of knowledge of its scope. For the choice of medical specialties, personal interests, future projections, social prestige, economic income and knowledge of a specific area of medicine are important. There is a devaluation in terms of the role and resolution capacity of PHC, and it is also associated with the assistance of populations with low socioeconomic resources.

Conclusions: Little knowledge of PHC, its lack of prestige, and insufficient remuneration for first-level care professionals were identified as the main barriers to choosing PHC as a place of work and training. In contrast, social commitment, the possibility of having a better lifestyle, and the type of doctor-patient relationship appear as the main facilitators.