Motivational factors for general practice training and career establishment: A cross-sectional study in Flanders, Belgium

In Flanders, Belgium, the 3-year specialised training in General Practice includes a specialty training rotation, for which trainees may choose their training site. After graduation, General Practitioners (GPs) decide where to establish their practice. This study explored the factors influencing GP trainees’ choice of training location, reasons for settling in a specific region after graduation, and motivations for remaining in or leaving a practice. In May 2024, the Interuniversity Centre for Education of General Practitioners distributed an anonymous online survey with closed- and open-ended questions to all GP alumni graduating between 2014 and 2023. Quantitative data were analysed using linear regression; qualitative data underwent content analysis. Of 772 alumni respondents (26.7% response rate), 93.4% were still practising as a GP. Most were female (70.9%), and 37.2% engaged in additional professional roles. Key influences on training location choice and practice settlement included colleague connections, proximity to home, and opportunities to work in group practices. Decisions to stay in or leave a practice were shaped by interpersonal relationships, practice organisation, and work–life balance. Working as a substitute GP was a frequent reason for changing practices, especially among recent graduates, to explore varied working environments. Both interpersonal and logistical factors strongly influence training practice choice and later GP practice settlement. High-quality training practices and supportive work environments are essential to promote sustainable GP careers and achieve a more balanced geographical distribution of GPs. GP trainees prioritise proximity to their family and interpersonal relations when selecting training location. Workplace relationships, practice organisation, and work-life balance are key determinants for joining and remaining in a GP practice GP career strategies should extend beyond financial incentives, emphasising quality training practices, good GP practice organisation and positive team dynamics.