Factors Influencing Whether Doctors Intend to Stay Working In Primary Health Care After Completing Residency in Family and Community Medicine in Paraíba, Brazil

Background In the last decade, there has been a 250% increase in the number of doctors trained in Family and Community Medicine (FCM) residency programs in Brazil; however, it is estimated that there is a need to train around 50,000 specialists to work in Primary Health Care (PHC) teams, especially in more remote regions with vulnerable populations. This study investigates the factors associated with the intention of doctors linked to the ten FCM residency programs in the state of Paraíba to continue working in PHC. Methods This is a cross-sectional, analytical study with a quantitative approach and a census-type sample of 211 doctors, residents and preceptors. Data was obtained using an electronic questionnaire administered in the second half of 2023. Descriptive, bivariate (Chi-square and Fisher's exact) and logistic regression analyses were carried out. The grouping variable “intention to continue working in PHC” was found to be associated with sociodemographic and academic variables and intrinsic and extrinsic factors that could influence doctors' decisions. Results Most participants were female (61.6%), without a partner (57.3%), and without children (82%). 42 (19.9%) worked as preceptors and 169 (80.1%) as residents. 90.5% of the preceptors intended to continue in primary care, compared to 54.4% of the residents. There was an association between being married or in a stable union (p = 0.031), having children (p = 0.002), having graduated from a public institution (p = 0.017) and experience in PHC (p = 0.049) with the grouping variable. The majority of doctors make this decision during their undergraduate studies (p < 0.001), the period of experience in PHC contributes to the decision (p = 0.002), as do more stable employment relationships, such as permanent (p = 0.015), statutory (p < 0.001), the offer of a master's degree (p < 0.001). Conclusion The intention of doctors linked to the ten FCM residency programs in the state of Paraíba to continue working in PHC is associated with their identification with the area. The decision is made during graduation and strengthens with experience. More stable employment relationships, the offer of a master's degree in the area and the opportunity to act as a preceptor in the FCM residency program all contribute to the desire to remain in PHC throughout their professional career.