How are French PMR physicians viewed by their colleagues?

By Emmanuelle Prelot, Franck Rolland, Evan Gouy, Linh-Nam Truong, Ariel Frajerman, Florent Vinchon, Nawale Hadouiri (nawale.hadouiri@chu-dijon.fr)

On behalf of the French National Association of Residents (Intersyndicale Nationale des Internes (ISNI)), we conducted a nationwide, web-based survey of stereotypes and social representations (SRs) of specialist physicians from all fields of medicine. The survey’s objectives were to assess differences in attractiveness between the various specialties and to better understand how medical students choose their specialty for residency. The survey was conducted between March 15th and April 18th, 2021, using the Limesurvey platform. A link to an anonymous questionnaire was posted on social networks by medical students’ and residents’ associations and was also disseminated by e-mail by certain medical associations (e.g. in the French Medical Council’s (Conseil Nationale de l’Ordre des Médecins (CNOM)) newsletter). The 4701 respondents did not have to comment on every specialty; in fact, we had divided the 44 specialties into 4 “attractiveness groups” of 11 specialties each, depending on the national median rankings (from 2017 to 2021) in the medical students’ choice of residency. Each respondent was asked to provide feedback on four specialties (one from each of the four groups, chosen at random by the Limesurvey system) and then had the option of commenting on a fifth specialty of his/her choice. In this context, we analyzed the stereotypes and SRs of French PMR physicians.

The self-questionnaire was based on the hierarchical evocation method and a qualitative question: “In order of importance, give four words or expressions that come to mind when you think about a PMR physician“). Below, we present some preliminary results. We excluded replies with fewer than three words/expressions. Each respondent’s SR of a PMR physician was graded from 1 to 5 by two investigators (EP and NH) with a double-blind grading method with 1: a very positive SR, 2: a positive SR, 3: a neutral SR, 4: a negative SR, 5: a very negative SR). We then determined the SRs’ principal themes in a correspondence factor analysis (CFA) and assessed the corpus’s central core using R interface for Multidimensional Analysis of Texts and Questionnaires (IRaMuteQ; http://www.iramuteq.org) software.

FIGURE 1

In all, 4701 medical students, medical residents and other physicians from all areas of France and all medical fields answered the survey, and 341 people commented on PMR physicians in particular (4 answers were excluded). The 341 respondents comprised 97 medical students, 168 residents, and 76 other physicians. Thirty-one respondents had deliberated chosen to comment on SRs of PMR physicians. The verbatim’s total wordcount was 1362, and the verbatim contained 292 different words. The six most frequently mentioned words were physiotherapist (n=82 occurrences; median rank among the four words: 2.4), rehabilitation (n=66; 1.6), sport (n=62; 2.1), multidisciplinary (n=54; 2.5), disability (n=60; 2.0) and little-known (n=35; 2.4). The median [interquartile range] SR score was 3 [2-3] for all respondents and 2 [2-3] for respondents who had chosen to comment on PMR physicians. The SR central core was “physiotherapist, rehabilitation, sport, disability, unknown, sluggish, complete, geriatrics, kind, quality of life, multiskilled, care coordinator”. In the CFA, four themes corresponded to SRs of PMR physicians: his/her personal and professional qualities (30.6% of the corpus), skills (29.5%), negative traits (22.8%), and daily practice (17.1%) (Figure 1). Further studies of this corpus and the determinants of stereotypes and SRs of French PMR physicians are now required, with a view to (i) increasing the attractiveness of our specialty as a residency choice, (ii) providing medical students with more accurate information about our role in the French healthcare system, and (iii) improving dialogue between medical specialties.

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