Self-perceived competencies from physicians enrolled in the Peruvian Rural Service

Objective To assess self-perceived competencies among physicians enrolled in the Peruvian Rural and Urban Marginal Health Service (SERUMS) from 2020 to 2022, and to identify factors associated with self-perceived competency across key professional roles defined by the Ministry of Health's essential competency profile. Methods A cross-sectional analytical study was conducted among physicians enrolled in SERUMS between 2020 and 2022. Self-perceived competencies were assessed using the Comprehensive Preparedness for Service in Neglected Communities Questionnaire (C-PISCO), a previously validated 15-item instrument (McDonald's omega = 0.94; Cronbach's alpha = 0.93) evaluating three dimensions: clinician (5 items), health promoter (4 items), and holistic doctor (6 items). Responses were rated on a 5-point Likert scale and dichotomized as competent (≥4) or not competent (≤3). The survey was distributed via email and SERUMS-related social media groups; the response rate could not be determined due to the open distribution method. Poisson regression with robust variance was used to estimate adjusted prevalence ratios (aPR) with 95% confidence intervals (CI). Results Among 190 physicians surveyed, only 37 (19.47%) perceived themselves as competent across all roles. Self-perceived competency was highest for the clinician role (40.53%), followed by the health promoter role (36.32%), and lowest for the holistic doctor role (12.11%). No significant associations were found between demographic or training factors and self-perceived competencies, except for male sex, which was associated with higher self-perceived competency in the health promoter role (aPR: 1.69; 95% CI: 1.05 - 2.72). Conclusions Only two out of ten physicians perceived themselves as competent across all core roles. These findings suggest the need for comprehensive reforms in Peruvian medical education, including greater emphasis on non-clinical competencies such as leadership, collaboration, and interculturality, alongside the development of a national core curriculum and programmatic assessment during rural service.