Anderson K D, Jacobs D M, Blue A V
Department of Surgery, Michigan State University, East Lansing 48824-1315, USA.
Am J Surg. 1999 Mar;177(3):237-9. doi: 10.1016/s0002-9610(99)00019-7.
Graduate medical education has undergone economic and structural changes-changes that have placed increasing pressure on medical students and programs to match effectively. This study documents the experiences, perceptions, and ethical dilemmas of medical students with the 1998 match process.
Surveyed were 437 senior students from three medical schools. Students were questioned about: interviewing practices, communication with programs, commitments made, ethical dilemmas faced, and the match process itself. Data were analyzed using Student's t test, the chi-square test, and descriptive statistics.
In all, 314 (72%) students responded. Programs expect postinterview communication from students (57%). Students perceive that programs are making "informal" commitments (43%), lying to them (33%), and encouraging their unethical behavior in order to match (21%). Ethical dilemmas are related to requests for informal commitments.
The NRMP's ruling that denounces prematch commitments is being broken by students and programs alike, resulting in the promotion of unprofessional behavior and gamesmanship.
毕业后医学教育经历了经济和结构上的变革，这些变革给医学生和项目带来了越来越大的压力，要求它们有效匹配。本研究记录了医学生在1998年匹配过程中的经历、看法和伦理困境。
对三所医学院的437名高年级学生进行了调查。询问学生关于：面试做法、与项目的沟通、做出的承诺、面临的伦理困境以及匹配过程本身。使用学生t检验、卡方检验和描述性统计分析数据。
共有314名（72%）学生做出回应。项目期望学生在面试后进行沟通（57%）。学生认为项目做出“非正式”承诺（43%）、对他们说谎（33%）以及为了匹配而鼓励他们的不道德行为（21%）。伦理困境与对非正式承诺的要求有关。
全国住院医师匹配项目（NRMP）谴责预匹配承诺的规定被学生和项目双方违反，导致不专业行为和投机取巧行为的滋生。
