The career pathways of new family physicians in South Africa from 2008 to 2022

Background: Family medicine has trained specialist family physicians in South Africa since 2008, but not investigated their career pathways. The study aimed to determine the career pathways of newly qualified family physicians between 2008 and 2022. Methods: A cross-sectional descriptive survey of all 186 family physicians via an electronic questionnaire. Results: Response rate was 44.6% % (83/186). Overall, 9.6% % emigrated, 10.8% % were no longer practising, and 79.5% % were still practising in South Africa. Of the latter, 14.5% % were in the private sector, 55.4% % in the public sector and 9.6% % in both. Of those in the public sector, 33.7% % were in specialist family physician posts, 12% % in medical officer posts, 4.8% % in managerial positions and 4.8% % in academic positions. Issues relating to safety and security were important to those working in both sectors and relationships with colleagues in the clinical team, to those in the public sector. Overall, participants practised near or within their province of training and were not equitably distributed. Conclusion: Only a third of graduates were in specialist family physician posts in the public sector. Attention needs to be given to retaining more graduates in such posts to achieve the goals of the national position paper. The proportion in the private sector was lower than expected. The reasons for no longer practising medicine should be further explored. Contribution: This is the first study on the career pathways of family physicians in South Africa since the new speciality was created. Understanding these pathways will assist with human resources for health planning.