Motivations de Choix de Spécialités chez les Internes au Congo

RESUME Introduction. Le Congo accuse une penurie de medecins plus marquee pour certaines specialites, pour contribuer a reduire cette disparite, nous avons etudie les motivations de choix de specialite. Materiels et methodes. Une enquete transversale descriptive, prospective. Tous les internes d’une annee civile ont ete interroges entre juillet et aout 2019. Le sexe et l’âge, le choix de specialisation et la motivation ont ete etudies. Les specialites etaient : chirurgicales, medicales, pediatrie, gynecologie-obstetrique, ORL, ophtalmologie, imagerie, psychiatrie, sante publique, medecine de travail et legale, biologie medicale et medecine generale. Resultats. Sur 137 internes 62,77% etaient hommes, d’âge moyen 25 ans, tous souhaitent se specialiser. Le choix de specialites etait : medicales (38,6%), chirurgicales (20,5%), gynecologie-obstetrique (9,4%) et pediatrie (7,9%). La psychiatrie (1,46%) et la biologie medicale (aucun choix) etaient les dernieres. Les femmes ont en majorite choisi le bloc gynecologie-pediatrie (OR=9,37, IC 95%= [3,767-23,326], p<0,0001), la chirurgie a attire plus d’hommes sans difference significative (OR=1.6384, IC 95% = [0.5479 - 4.8994], p= 0.3771). Les principales motivations etaient : passion pour l’organe ou le theme de specialite (53,52%), vocation suscitee par les maitres (37,32%), prestige sociale (28,1%), opportunite de carriere (21,83%). Conclusion. Les specialites pour lesquelles il y’a plus de maitres etaient les plus prisees. Les principales motivations de choix pouvaient etre liees a l’enseignement et a l’enseignant. Les preferences des etudiants n’ont pas ete en adequation avec les priorites sanitaires nationales. Des mesures incitatives sont necessaires pour combler des deserts medicaux dans certains domaines. ABSTRACT Background.Congo is experiencing a greater shortage of doctors for certain specialties, in order to help reduce this disparity, we have studied the motivations for choosing specialties. Materials and methods. A descriptive, prospective crosscutting survey. All residents in a calendar year were interviewed between July and August 2019.Gender and age, specialization choice and motivation were studied. Specialties were: surgical, medical, pediatrics, gynecologyobstetrics, ORL, ophthalmology, imaging, psychiatry, public health, occupational and legal medicine, medical biology and general medicine. Results. Out of 137 interns 62.77% were men, middleaged 25 years, all want to specialize. The choice of specialties was: Medical (38.6%), surgical (20.5%), gynecologyobstetrics  (9.4%)  and pediatrics (7.9%). Psychiatry (1.46%) and medical biology (no choice) were the last. The majority of women chose the gynecology-pediatric block (OR=9.37, IC 95%= [3.767-23.326], p<0.0001), surgery attracted more men without significant difference (OR=1.6384, IC 95% = [0.54 79 - 4.8994], p= 0.3771). The main motivations   were: passion for the organ or specialty theme (53.52%), vocation inspired by the masters (37.32%), social prestige (28.1%), career opportunity (21.83%). Conclusion. Specialties for which there are more masters were the most popular. The main motivations for choice could be related to teaching and teaching. Student preferences were not in line with national health priorities. Incentives are needed to fill medical deserts in some areas.