Abstract / Summary
Abstract Background Medical internship is a critical transition from undergraduate education to independent clinical practice. In Uganda, intern doctors provide much of the frontline obstetric care despite shortages of specialist obstetricians. However, little is known about how interns perceive their competence and readiness to practice in obstetrics and gynaecology or the undergraduate training experiences that shape this readiness. This study explored medical interns' perceived competence and readiness to practice in obstetrics and gynaecology and the curricular factors influencing their preparedness. Methods An exploratory qualitative study, underpinned by an interpretivist paradigm, was conducted among medical interns at Kawempe National Referral Hospital and Naguru Regional Referral Hospital, Uganda. Data were collected through ten in-depth interviews and two focus group discussions with interns who had completed their obstetrics and gynaecology rotation. Interviews were audio-recorded, transcribed verbatim and analyzed thematically using an inductive approach. Trustworthiness was enhanced through member checking, independent coding and triangulation of data sources. Results Four interrelated themes emerged: undergraduate training experiences shaping competence; perceived competence in obstetrics and gynaecology; transition to internship and evolving readiness; and contextual barriers and recommendations for strengthening readiness. Interns consistently perceived themselves as well prepared in theoretical knowledge, clinical reasoning and communication, but less prepared in practical and procedural skills, particularly operative obstetrics. Readiness for practice evolved through supervised clinical exposure, repeated procedural practice and mentorship during internship. Limited theatre exposure, high student-to-patient ratios and inconsistent supervision constrained competence development, whereas simulation, structured supervision and increased opportunities for hands-on practice were perceived to enhance readiness for independent practice. Conclusions Medical interns perceived readiness for obstetrics and gynaecology practice as extending beyond theoretical competence to the ability to apply knowledge confidently in clinical practice. Readiness was shaped by both undergraduate training and the clinical learning environment, with supervised procedural experience emerging as a key determinant of confidence and competence. Strengthening competency-based undergraduate training through structured procedural teaching, consistent supervision and workplace-based assessment may improve graduates' readiness for internship and enhance the quality and safety of frontline obstetric care in Uganda.