Keywords: primary care, cardiovascular health, family medicine training, professional autonomy, Bulgaria

Aim:

Тo explore how final-year medical students, family medicine residents, and early-career general practitioners perceive their preparedness to provide cardiovascular care, and to identify educational and systemic factors influencing professional confidence and clinical autonomy.

Method:

A brief anonymous cross-sectional survey was conducted among final-year medical students, family medicine residents, and early-career general practitioners in Plovdiv, Bulgaria. Early-career general practitioners were defined as those within the first five years of independent clinical practice. A structured questionnaire, including Likert-scale and open-ended items evaluated perceived competence in cardiovascular risk assessment, chronic disease management, patient communication, and system-related challenges in ambulatory practice.

Results:

A total of 62 participants completed the survey. Only 42% reported adequate confidence in managing chronic cardiovascular diseases in clinically complex patients. Confidence was higher in patient communication and lifestyle counselling (71%), whereas administrative and regulatory aspects of cardiovascular care remained a major source of insecurity, with only 34% feeling confident. Limited prescribing autonomy was identified as a key barrier by 61% of respondents.
More than half (57%) perceived a disconnect between academic training and real-life ambulatory cardiovascular practice, particularly in rural or under-resourced settings. Additional limiting factors included insufficient hands-on and simulation-based training, large practical group sizes, chronic underfunding (68%), short consultation times (54%), and administrative overload (62%). Despite these challenges, 83% expressed strong motivation to pursue a career in family medicine.

Conclusions:

Strengthening cardiovascular care in primary care requires better alignment between academic training and outpatient practice, expanded practical and simulation-based education, and greater professional autonomy. Empowering future family physicians is essential for sustainable cardiovascular health at the community level.