Knowledge and perception of Family Medicine among medical students at University of Ibadan, Nigeria Knowledge and perception of Family Medicine among medical students at University of Ibadan, Nigeria OE Fasolaa , AO Alaoa, BA Ibisolaa* , AM Obimakindea,b and IC Odekunlea aDepartment of Family Medicine, University College Hospital, Ibadan, Nigeria bFamily Medicine Unit, Department of Community Medicine, University of Ibadan, Ibadan, Nigeria *Corresponding author, Email: likitavabi2012@gmail.com Background: Postgraduate training in Family Medicine in Nigeria began over three decades ago, but it was not until recently that the National University Commission (NUC) made it a policy for all Nigerian universities to include undergraduate Family Medicine training in their curriculum. This study aimed to assess the awareness and perception of Family Medicine among medical students at the University College Hospital (UCH), Ibadan. Method: A descriptive cross-sectional study was conducted over a period of four weeks (June 11–July 6, 2018) among 131 fourth-year, 118 fifth-year and 163 sixth-year medical students at UCH, Ibadan. Data were obtained using a self-administered questionnaire. Results: Data were collected from 309 (75% of the target population). The mean age of the respondents was 22.3 ± 2.3 years. The majority (74.4%) did not have a family member who was a doctor and only 2.3% had a family member who was specialising in Family Medicine. Most of the participants (68.9%) had good knowledge of Family Medicine, while 57.3% had good perception of Family Medicine as a specialty. Importantly, an increase in year of clerkship was associated with an increase in the knowledge of Family Medicine among the respondents. Conclusion: It was observed that with increase in length of exposure to Family Medicine as a specialty, knowledge and perception of the specialty improved among the medical students. It is imperative that all the medical schools in Nigeria implement the NUC directive and start undergraduate Family Medicine training. Keywords: knowledge, perception, Family Medicine, medical student, Ibadan Introduction The realisation of the essential role played by the family phys- ician in the provision of quality first contact care and in the judi- cious use of limited resources has led to an increasing need for family physicians globally.1 Family physicians are specialist phys- icians trained to provide continued, comprehensive care for people of all ages irrespective of gender and illness;2 as such, it is important that more medical graduates choose to specialise in Family Medicine to facilitate efficient first contact care in all strata of healthcare delivery.1 Unfortunately, Family Medicine as a specialty still struggles for recognition in some parts of the world, especially in Africa, where a great need still exists in the teaching of Family Medicine at undergraduate level.3 The undergraduate teaching of Family Medicine may facilitate adequate and appropriate perceptions of the speciality by medical students and prevent incorrect bias against the speciality. In Nigeria, family physicians are some- times perceived as being synonymous with medical officers, who are generalists with the basic medical degree and skills that are acquired from years of clinical practice without any structured postgraduate training or recertification.4 The core competencies that distinguishes a family physician from a medical officer include patient/person centred clinical methods (PCCM), using the biopsychosocial model of care, primary care management, specific problem-solving skills, a comprehensive approach and holistic modelling2 These compe- tencies are best introduced early from the foundation years of medical school and should be ingrained in every doctor’s basic medical training. This is currently lacking in the medical education obtained by most medical officers. Though postgraduate family medicine training has been ongoing for up to 30 years in Nigeria,5 it is not reflective of inclusion of Family Medicine in undergraduate medical edu- cation. Unlike other specialties, which are introduced to medical students from the first year in medical school, under- graduate Family Medicine is yet to be fully incorporated into the curriculum of many medical schools in Africa. In Nigeria, despite the introduction of Family Medicine into undergraduate school at the University of Calabar, College of Medicine in 1976,5,6 it is difficult to explain the slow adoption in other medical schools in Nigeria. Currently, only 15 universities,7,8 which equates to barely 1% of Nigerian medical schools, teach Family Medicine despite the 2015 recommendation by the National Universities Commission that Family Medicine should be incorporated into the undergraduate curriculum in Nigeria.9 In Europe, a study found that up to 19% of medical schools had no or a very brief Family Medicine curriculum.10 However, in South Africa, Family Medicine training is well established in most medical schools.3 According to the Nigeria Undergraduate Medical and Dental Curriculum template of 2012,11 the tenets of Family Medicine should be introduced as part of lectures in the second and third years of medical school, while clinical rotations (clerkship) in Family Medicine I (Junior clerkship) and II (Senior clerkship) should be undertaken in the first semesters of the fifth and sixth years respectively.11 This is the format currently being uti- lised in the College of Medicine, University of Ibadan since 2015 following the implementation of the new integrated curriculum across all faculties of the university.12 Family Medicine lectures have also been newly incorporated into the core lectures South African Family Practice 2019; 61(5):197–202 https://doi.org/10.1080/20786190.2019.1648110 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC 4.0] http://creativecommons.org/licenses/by-nc/4.0 S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 © 2019 The Author(s) ARTICLE South African Family Practice is co-published by NISC (Pty) Ltd, Medpharm Publications, and Informa UK Limited (trading as the Taylor & Francis Group) http://orcid.org/0000-0001-7384-1327 http://orcid.org/0000-0003-2763-2924 mailto:likitavabi2012@gmail.com http://crossmark.crossref.org/dialog/?doi=10.1080/20786190.2019.1648110&domain=pdf&date_stamp=2019-09-23 http://creativecommons.org/licenses/by-nc/4.0 series in the fourth year of medical education at the College of Medicine University of Ibadan. In South Africa, a study across first- to fourth-year medical stu- dents showed poor knowledge across all groups of students, especially among first-year medical students.4 An improvement in knowledge of Family Medicine was noted among third-year Pakistani medical students who had a two-week clerkship in Family Medicine.13 Similar trends were reported among Spanish students following a four-month primary care course, inclusive of a one-week clinical clerkship in primary care.14 A sys- tematic review by Turkeshi et al. in 2015 reported that learning experiences from clerkship tend to improve students’ attitude and interest in the specialty and may influence their career intentions.15 Another study conducted in Saudi Arabia revealed that clinical rotations in Family Medicine improved the students’ knowledge of and attitude to Family Medicine.16 As a specialty still in evolution globally, studies have shown a diverse variation in the length of clerkships and structure of undergraduate Family Medicine curriculum across different set- tings and in various countries.15 The teaching of Family Medicine is, however, yet to be incorporated into undergraduate medical education in most medical schools in Nigeria despite the National Universities Commission directive to create Family Medicine departments and allow for specific periods of Family Medicine didactic and clinical exposure.17 There is a paucity of information regarding Family Medicine teaching in medical schools in Nigeria. This study set out to determine the level of knowledge and perceptions of Family Medicine among medical students in Nigeria and the association with the length of clerkship. Methodology Design and setting The study used a descriptive cross-sectional design and was con- ducted over a one-month period (June 11–July 6, 2018) at the University College Hospital (UCH), Ibadan located in Ibadan North Local Government Area of Oyo state. University College Hospital is an 850-bed hospital established in 1957 for the train- ing of medical students at the College of Medicine, University of Ibadan (COMUI), resident doctors and other health professionals. The then Faculty of Medicine was one of the first faculties of the University of Ibadan at its establishment 68 years ago. Presently it is part of the COMUI, which is made of six faculties, namely the faculties of Basic Sciences, Clinical Sciences, Public Health, Dentistry, Nursing and Physiotherapy.18 The medical students are schooled within the Faculty of Basic Medical Sciences in the first three years of medical school and within the Faculty of Clinical Sciences in their last three years of the six-year pro- gramme of undergraduate medical training in Nigerian universities. The first year until the end of the first half of the third year of medical school are preclinical in nature, while the latter half of the third year to the sixth year are clinical. It is noteworthy to explain that the second half of the third year is a transition phase when the students have general introductory lectures to clinical sciences and acclimatise to the clinical settings. The clinical years entail core lectures that span all organ/body systems, patient-centred care, community health, and laboratory medicine, as well as clinical rotations through the different clini- cal departments of University College Hospital (UCH), Ibadan. The Family Medicine core lectures series consists of 22 didactic lectures spread over the first 18 months of the clinical years, which iterates Family Medicine tenets, perspectives and man- agement of conditions across all organ systems. Two blocks of four-week clerkship rotations, namely Family Medicine I (junior clerkship) and Family Medicine (senior clerkship) II, are under- taken by the fifth- and sixth-year medical students in the Depart- ment of Family Medicine, UCH. The General Out-Patient Clinic (GOPC) of the Department of Family Medicine, UCH, Ibadan pri- marily serves as an entry point to the hospital for patients under the age of 60 years, while the Geriatric Centre, an off-shoot of the Family Medicine Department, cares for patients aged above 60 years. Patients in both the general outpatient clinic and geriatrics centre are seen, triaged and treated by Family Medicine resident doctors and consultant family physicians who provide primary and secondary levels of care and refer to other specialties as required. Students on Family Medicine clini- cal posting rotate through these two clinics. Study population The study involved medical students of the COMUI who were in the clinical school. There were 131 fourth-year students, 118 fifth-year students and 163 sixth-year students at the time of the study. The fourth-year (first clinical year) students were chosen to represent the baseline informants as they were yet to have Family Medicine clinical exposure. All consenting medical students in the fourth to sixth years who were present in the classroom at the time of data collection were included in the study. Data collection Data were collected using a self-administered questionnaire (Appendix 1), which contained different sections as follows: Section A: Sociodemographic and family characteristics of the respondents. Section B: Questions exploring the student’s knowledge and understanding of Family Medicine as a specialty. The questions were derived from a pre-validated questionnaire from a similar study14 on the current undergraduate Family Medicine curricu- lum of the University of Ibadan. Each correct answer was scored 1 point, and an incorrect answer scored 0. Section C: Questions on perception of the respondents towards Family Medicine, which was answered on a Likert scale: strongly agree, agree, uncertain, disagree and strongly disagree. The questions were derived from pre-validated questionnaires from similar studies assessing perception of Family Medicine among medical students14, 19 and on anecdotal evidence on the perception of Family Medicine in this environment. Strong agreement and agreement with a positive statement on Family Medicine or strong disagreement and disagreement with a negative statement was scored 1 point. Any other response did not earn any points. The survey was conducted in the classroom setting, either before or after class lectures. The study was explained to the medical students by a research assistant who had no affiliation with the medical students. The research assistant provided clarifications regarding the survey, obtained consent from the students and collected completed questionnaires. All question- naires were anonymous and no personally identifiable infor- mation was collected. 198 South African Family Practice 2019; 61(5):197–202 Data analysis The primary outcome variables were knowledge and percep- tions of Family Medicine. The independent variables were the sociodemographic characteristics. Knowledge and perception scores above the overall mean score of respondents were categorised as positive while those below the mean score were categorised as negative. Other variables were also grouped as categorical variables for ease of analysis. Data collected were cleaned and statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS Version 20.0 IBM Corp, Armonk, NY, USA). The confidence inter- val was set to 95% and a p-value of less than 0.05 was considered significant. Descriptive statistics were displayed using frequency tables. Bivariate and multivariate analysis using a chi-square test and binary logistic regression respectively were carried out to test the association between sociodemographic characteristics and knowledge and perceptions of Family Medicine. Ethical considerations Approval of the Ethical Review Committee of the University of Ibadan/University College Hospital Ibadan Institutional Review Board (UI/UCH IRB) was obtained with study number UI/EC/18/ 0138. Results The results obtained from the data collected from 309 partici- pants are presented in this section. The sociodemographic characteristics of the respondents are given in Table 1. Their mean age was 22.3 ± 2.3 years. Most of the respondents (74.4%) did not have a family member who was a doctor, while only 2.3% had a family member who practices Family Medicine. The respondents’ knowledge score ranged from 6 to 13, with a mean score of 11.1±1.5. The score for perception ranged from 0 to 14 with a mean score of 7.7±2.6. As shown in Table 2, 68.9% and 57.3% of the respondents had positive knowledge and a positive perception of Family Medicine as a specialty. Tables 3 and 4 show that as the clerkship year and monthly allowance increased, knowledge and perception of Family Medicine among the medical students also improved. A binary logistic regression performed to ascertain the effect of these factors showed that the monthly allowance was not Table 1: Frequency table of respondent sociodemographics Sociodemographic characteristics Frequency Percentage Gender Male 208 67.3% Female 101 32.7% Age range < 25 years 272 88% > 25 years 37 12% Marital status Single 306 99% Married 3 1% Religion Christian 263 85.1% Islam 37 12% Others 9 2.9% Tribe Yoruba 202 65.6% Hausa 5 1.6% Igbo 61 19.8% Others 40 13% Year of clerkship Fourth year 105 34% Fifth year 85 27.5% Sixth year 119 38.5% Medical doctor as a family member Family physician 7 2.3% Specialist in other specialties 72 23.3% None 230 74.4% Monthly allowance < ₦20,000 (< $55) 124 40.3% ≥ ₦20,000 (≥ $55) 184 59.7% Table 2: Knowledge and perception of Family Medicine Variables n = 309 Percentage Knowledge of Family Medicine specialty: Positive 213 68.9% Negative 96 31.1% Perception of Family Medicine specialty: Positive 177 57.3% Negative 132 42.7% Table 3: Factors affecting knowledge of family medicine Year of clerkship Knowledge of Family Medicine χ2 p- value Negative knowledge Positive knowledge Fourth year 52 (49.5%) 53 (50.5%) 26.562 .001* Fifth year 22 (25.9%) 63(74.1%) Sixth year 22 (18.5%) 97 (81.5%) Monthly allowance < ₦20,000 (< $55) 47(37.9%) 77(62.1%) 4.85 0.028* ≥ ₦20,000 (≥ $55) 48(26.1%) 136(73.9%) *Statistically significant at 5% level of significance. Table 4: Factors affecting perception of Family Medicine Year of clerkship Perception of Family Medicine as a specialty χ2 p- value Negative perception, n (%) Positive perception, n (%) Fourth year 55 (52.4) 50 (47.6) 6.371 .041* Fifth year 34 (40.0) 51(60.0) Sixth year 43 (36.1) 76 (63.9) Gender: Male 89 (42.8) 119 (57.2) 0.001 0.972 Female 43 (42.6) 58 (57.4) Doctor family member Family Medicine 3 (42.9) 4 (57.1) 0.007 0.936 Other specialties 32 (44.4) 40 (55.6) Monthly allowance < ₦20,000 (< $55) 63 (50.8) 61 (49.2) 5.356 .021* ≥ ₦20,000 (≥ $55) 69 (37.5) 115 (62.5) *Statistically significant at 5% level of significance. Knowledge and perception of Family Medicine among medical students at University of Ibadan, Nigeria 199 significantly associated with knowledge (p = 0.648) and percep- tion (p = 0.12) levels respectively. Discussion This study showed that a significant number of medical students in the clinical years had a positive knowledge of Family Medicine as a specialty. The knowledge of Family Medicine is expected to be greater among those who have had higher levels of exposure to the practice as corroborated and reported by other studies.13 This was demonstrated by the increasing proportion of students with a positive knowledge of the specialty, which was elicited in 50% of the fourth-year students and in approximately 80% of the final-year students. The final-year (sixth year) medical stu- dents who had been exposed to a total of eight weeks of Family Medicine clerkship in addition to Family Medicine core lectures obviously demonstrated better knowledge of Family Medicine compared with the fifth-year medical students who had four weeks’ clerkship and the fourth-year medical students who were yet to undergo a clinical clerkship posting in Family Medicine. This finding is similar to that of another study in which significantly higher scores were recorded for questions assessing knowledge in Family Medicine following a four- month Family Medicine course.14 In addition, exposure to a Family Medicine course and clerkships have been reported to improve attitudes to and perceptions of Family Medicine, as depicted in this study.14,16,19 In a study among students in a Spanish medical school, following a primary care course, there was a significant increase in the proportion of students who con- sidered Family Medicine as a specialty of preference, increasing from 38.6% prevalence to 70.4%.14 A higher monthly allowance was also found to be associated with better knowledge and per- ception of Family Medicine. This was most likely due to the con- founding effect of their clerkship year as it is expected that the monthly allowance would increase with higher level classes in medical school based on their advanced needs. This study did not show a significant association between having a relation who is specialising in Family Medicine and medical students’ perception of the specialty. The drive to have family physicians in adequate numbers to cater for our population needs to be strategically entrenched through awareness creation at the undergraduate levels. The Nigerian Universities Commission has taken the first step by asking all universities in the country to commence Family Medi- cine training at the undergraduate level, a directive that is well embraced by the College of Medicine, University of Ibadan. Limitations This study was limited in that it was a cross-sectional study that could not establish a temporal relationship between clerkship exposure and changes in knowledge and perceptions of the stu- dents. This could have been achieved using a longitudinal study design; however, the mobility of clinical medical students especially for external elective posting would have made this challenging. In addition, this study could not include all students in clinical school as intended because of the exigencies of the medical school, which made some of the students unavailable at the time of data collection. Conclusion The result of this study shows that to improve the knowledge and perceptions of Family Medicine among medical students, clinical clerkship in Family Medicine should be promoted in medical schools. This is important because medical graduates with sound knowledge of Family Medicine, irrespective of future area of specialisation, will possess a good understanding of primary care, which will strengthen the healthcare systems of Nigeria as a nation. Recommendations The findings from this study support the National Universities Commission’s recommendation that Family Medicine teaching and clinical clerkship must be included in the curriculum of medical schools in Nigeria. Funding – The study received partial sponsorship from the Association of Resident Doctors (ARD), University College Hospi- tal Ibadan 2017/18 Executive Year. Disclosure statement No potential conflict of interest was reported by the authors. ORCID OE Fasola http://orcid.org/0000-0001-7384-1327 BA Ibisola http://orcid.org/0000-0003-2763-2924 References 1. De Maeseneer J. Family Medicine facing new challenges on a global scale. In: The world book of Family Medicine. European. Ljubljana: Stichting WONCA Europe; 2015. p. 143–145. 2. Allen J, Gay B, Crebolder H, et al. The European definition of general practice/ Family Medicine. 2011. 3. Besigye I, Mash R, Essuman A, et al. Conference report: undergradu- ate family medicine and primary care training in Sub-Saharan Africa: reflections of the PRIMAFAMED network. African J Prim Heal Care Fam Med ISSN Afr J Prm Heal Care Fam Med. 2017;9(1):2071–936. 4. Hagemeister D, Pal A, Naidoo N, et al. Undergraduate medical stu- dents’ interest in specialising in Family Medicine at the University of the free state, 2014. South African Fam Pract. 2017;1(1):1–6. 5. Udonwa N, Ariba A, Yohanna S, et al. Family Medicine in West Africa: progress, milestones, and challenges so far in Nigeria (1980–2010). Niger J Fam Pr. 2011;1(2):1–9. 6. Okokon I, Ogbonna U, Asibong U, et al. Teaching family medicine in medical schools – The perspective from a Nigerian medical [Internet]. University of Calabar. 2012 [cited 2017 Dec 27]. p. 1–11. Available from: https://www.researchgate.net/publication/266145778_Teaching_ family_medicine_in_medical_schools_-_The_perspective_from_a_ Nigerian_medical_school 7. Ladipo M. Undergraduate Family Medicine. In: 19th Annual General Meeting/Scientific Conference. Umuahia: Society of family physicians of Nigeria; 2016. 8. Society of family physicians of Nigeria. Update on status of under- graduate Family Medicine across Nigeria. In: 21st SOFPON Annual General Meeting. Akure: Society of family physicians of Nigeria; 2018. p. 6–7. 9. National Universities Commission. Implementing steps for new medical schools, accreditation issues and the new minimum bench- mark (2015) for the MBBS/ BDS programmes [Internet]. Vol. 11, Monday Bulletin. Abuja; 2016. p. 20–1. Available from: http://nuc. edu.ng/wp-content/uploads/2015/01/MB-16th-May-2016-update. pdf 10. Brekke M, Carelli F, Zarbailov N, et al. Undergraduate medical edu- cation in general practice/family medicine throughout Europe-a descriptive study. BMC Med Educ. 2013;13(157):1–9. 11. Federal Ministry of Health of Nigeria HS 20/20 P. Nigeria undergradu- ate medical and dental curriculum template, 2012 [Internet]. Bethesda, MD; 2012 [cited 2017 Jul 18]. p. 1–136. Available from: https://www.hfgproject.org/wp-content/uploads/2015/02/Nigeria- Undergraduate-Medical-and-Dental-Curriculum-Template.pdf 12. Obimakinde A, Ilori T, Ladipo M. 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Available from: https://www.medicalworld nigeria.com/2015/11/nuc-approves-seven-year-four-year-mbbs-bds- program-in-new-minimum-academic-standards#.WkPC-d-nHIU 18. University of Ibadan. History [Internet]. University of Ibadan. 2017 [cited 2017 Dec 28]. Available from: https://ui.edu.ng/History 19. Philips J, Charnley L. Third- and fourth- year medical students chan- ging views of Family Medicine. Fam Med. 2016;48(1):54–60. Received: 19-03-2019 Accepted: 23-07-2019 Appendix 1 Questionnaire Knowledge and perceptions of Family Medicine among medical students at the University of Ibadan Good day. This is a self-administered questionnaire for research purposes in Undergraduate Medical Education in Family Medicine con- ducted by a group of Family Medicine residents of the University College Hospital, Ibadan in collaboration with lecturers in the College of Medicine, University of Ibadan. Participation is voluntary and all information gathered will be treated as confidential. Thank you for agreeing to take part. Signature: Serial no: Section A: sociodemographic characteristics 1. Year/Level … … … … … … … … … … … … … … … … … … … … … 2. Group … … … … … … … … … … … … … … … … … … … … … … … … 3. Age as at last birthday (years) … … … … … … … … … … … . . 4. Gender 1. Male 2. Female 5. What position are you in the family 1. First 2. Last 3. Others 6. Relationship status 1. Single 2. Engaged 3. Married 7. Religion 1. Christianity 2. Islam 3. Others … … … … … … … … … … … 8. Tribe 1. Hausa 2. Ibo 3. Yoruba 4. Others … … … … … … 9. What is your monthly monetary allowance from your parents/ guardian? 1. Less than 20,000 2. 20,000 – 40,000 3. 40,000 – 60,000 4. 60,000 and above 10. What is your father’s occupation … … … … … … … … … … … … … … … … … … 11. What is your father’s highest level of education? 1. None 2. Primary 3. Secondary 4. Tertiary 12. What is your mother’s occupation … … … … … … … … … … … … … … … … … … 13. What is your mother’s highest level of education? 1. None 2. Primary 3. Secondary 4. Tertiary 14. Do you have any family member who is a medical doctor? 1. Yes 2. No 15. If Yes to 14 above, what specialty? … … … … … … … … . . 16. How would you describe where you grew up? 1. Rural 2. Urban 17. How many degree exams have you written? (Part 1, Part 2 etc.) … … … … … … … … … … … … 18. In how many of these exams did you have resits? … … … … … … … … … … … … … … … … … . Section B: knowledge of Family Medicine specialty 20. Family Medicine is a recognised specialty 1. No 2. Yes 21. Family physicians provide first-contact care and link patients to the healthcare system 1. No 2. Yes 22. Family physicians can manage people of all age groups 1. No 2. Yes 23. Family physicians can manage people irrespective of the disease 1. No 2. Yes Knowledge and perception of Family Medicine among medical students at University of Ibadan, Nigeria 201 https://www.medicalworldnigeria.com/2015/11/nuc-approves-seven-year-four-year-mbbs-bds-program-in-new-minimum-academic-standards#.WkPC-d-nHIU https://www.medicalworldnigeria.com/2015/11/nuc-approves-seven-year-four-year-mbbs-bds-program-in-new-minimum-academic-standards#.WkPC-d-nHIU https://www.medicalworldnigeria.com/2015/11/nuc-approves-seven-year-four-year-mbbs-bds-program-in-new-minimum-academic-standards#.WkPC-d-nHIU https://ui.edu.ng/History 24. Family physicians provide comprehensive and continued care 1. No 2. Yes 25. Family physicians manage problems that may not have a specific diagnosis 1. No 2. Yes 26. Illness and disease are the same in Family Medicine 1. No 2. Yes 27. Patient-centred care is emphasised in Family Medicine 1. No 2. Yes 28. The family physician serves as an advocate for the patient and community 1. No 2. Yes 29. The family physician is a researcher 1. No 2. Yes 30. Family physicians are the same as general practitioners 1. No 2. Yes 31. Family Medicine is the same as Internal Medicine 1. No 2. Yes 32. Family Medicine is an important part of the health system 1. No 2. Yes Section C: the following statements are on perceptions of family medicine. Please tick the box showing the response most appropriate to you Strongly agree Agree Uncertain Disagree Strongly disagree 33. Family Medicine clinical rotation is beneficial to medical students 34. I would rather have Family Medicine as an elective rather than compulsory rotation 35. The duration of the rotation is sufficient 36. Family Medicine is intellectually stimulating 37. The cases managed by family physicians are not serious cases 38. Family physicians are not as important as the other specialists 39. I do not think it is possible to be a specialist in Family Medicine as it covers a wide range of medical problems 40. Family Medicine is easy compared with other specialties 41. I think there are more jobs for family physicians than other specialists 42. I think the workload in Family Medicine is more than in other specialties 43. I think other specialists make more money than family physicians 44. Cost of healthcare is reduced with more family physicians 45. I think the prospects for Family Medicine abroad are appealing 46. I think the prospects for Family Medicine in Nigeria are poor 47. I think Family Medicine is a specialty for females 202 South African Family Practice 2019; 61(5):197–202 Abstract Introduction Methodology Design and setting Study population Data collection Data analysis Ethical considerations Results Discussion Limitations Conclusion Recommendations Disclosure statement ORCID References Appendix 1 Outline placeholder Questionnaire Knowledge and perceptions of Family Medicine among medical students at the University of Ibadan Section A: sociodemographic characteristics Section B: knowledge of Family Medicine specialty Section C: the following statements are on perceptions of family medicine. 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