Skinner B D, Newton W P
Department of Family Medicine, University of North Carolina, Chapel Hill, USA.
Fam Med. 1999 Sep;31(8):559-65.
Knowing which factors predict National Resident Matching Program (Match) success is critical for medical students, student advisors, and residency faculty, but published reports have focused on a limited number of program characteristics or a small number of years.
We obtained information about region, affiliation, hospital size, population served, intern salary, and intern call schedule from the Directory of Family Practice Residency Programs for all US family practice programs from 1984-1998 and correlated them with initial Match results, using both univariate and multivariate techniques.
Over 15 years, there have been substantial increases in programs and positions offered, salaries, proportion of larger programs, and reduced intern call frequency. Western region, larger program size, and community hospital affiliation were associated with a higher initial Match rate, but only 7%-19% of the variance was explained. In the late 1980s, salary had an effect, as did call in the worst Match years; in recent years, suburban programs have filled better and rural programs less well. Hospital size had no relationship to fill rates.
Program characteristics have a real but modest impact on initial Match rates; the significance may increase in times of decreased interest in family medicine, such as the late 1980s and early 1990s.
了解哪些因素能够预测美国国家住院医师匹配计划(NRMP)的成功对于医学生、学生导师以及住院医师培训教员而言至关重要,但已发表的报告仅聚焦于有限的项目特征或少数年份。
我们从1984年至1998年的美国家庭医学住院医师培训项目目录中获取了有关地区、隶属关系、医院规模、服务人口、实习医生薪资以及实习医生值班安排等信息,并运用单变量和多变量技术将这些信息与初始匹配结果进行关联分析。
在15年的时间里,提供的项目和职位数量、薪资、大型项目的比例均大幅增加,实习医生的值班频率降低。西部地区、较大的项目规模以及社区医院隶属关系与较高的初始匹配率相关,但仅能解释7%-19%的差异。在20世纪80年代后期,薪资有影响,在匹配情况最差的年份值班安排也有影响;近年来,郊区项目的匹配情况较好,而农村项目的匹配情况较差。医院规模与匹配率无关。
项目特征对初始匹配率有实际但适度的影响;在对家庭医学兴趣降低的时期,如20世纪80年代末和90年代初,这种影响可能会增强。