Qualitative study of motivators and outcomes of Sri Lankan doctors achieving MRCGPInternational.

BACKGROUND: The UK's Royal College of General Practitioners accredits overseas examinations in family medicine through MRCGP[INT] rather than exporting MRCGP UK. There is limited research on the motivating factors and outcomes of this practice on candidates. AIM: To explore factors motivating Sri Lankan doctors to pursue the South Asian MRCGP[INT] and their perceived benefits and barriers to sitting the examination. METHODS: Qualitative semi-structured 1:1 interviews with 14 successful past MRCGP[INT]SA candidates were undertaken in Sri Lanka. Findings were analysed with N-Vivo software. A phenomenological approach was used. Interpretive dimensions were applied drawing on information from interviews, informal conversations and observations. RESULTS: Motivators to sit the examination included a desire to improve patient care and seeking recognition as a family doctor. Younger doctors had hopes of increased future income and there was some expectation that the examination may improve overseas employment prospects. The examination conferred greater confidence, new patient-centred communication skills, introduced the use of evidence-based guidelines and increased awareness of the UK health system to most participants. There were examples of diffusion of knowledge through different teaching channels. Relative to Sri Lankan examinations, formal training opportunities were limited and value for money of annual membership fees were questioned. Financial and geographical barriers to the examination were noted. CONCLUSION: Currently MRCGP[INT]SA offers additional value for successful candidates in Sri Lanka who perceive accreditation by a UK college favourably. Improvement of pre- and post-exam support linked to MRCGP[INT]SA in Sri Lanka is needed. Further research into the long-term impact is necessary, in particular regarding equity of access, migration and local training development.