Buckley L M, Sanders K, Shih M, Hampton C L
Medical College of Virginia Campus, Virginia Commonwealth University School of Medicine, 1200 E Broad St, PO Box 980102, Richmond, VA 23298-0102, USA.
Arch Intern Med. 2000 Sep 25;160(17):2625-9. doi: 10.1001/archinte.160.17.2625.
To assess attitudes about career progress, resources for career development, and commitment to academic medicine in physician faculty at an academic medical center who spend more than 50% of their time in clinical care.
Faculty survey.
Academic medical center and associated Veterans Affairs medical center.
A total of 310 physician faculty responded to the survey. Half of the faculty reported spending 50% or less of their time in clinical care (mean, 31% of time) (group 1) and half reported spending more than 50% of their time in clinical care (mean, 72% of time) (group 2). Group 2 faculty had one third of the time for scholarly activities, reported slower career progress, and were less likely to be at the rank of professor (40% and 16% for groups 1 and 2, respectively; P<.001) or to be tenured (52% and 26%, respectively; P<.001) despite similar age and years on faculty. Group 2 faculty were 50% more likely to report that tenure and promotion criteria were not reviewed at their annual progress report (P =.003) and that they did not understand the criteria (P<.001). Group 2 faculty valued excellence in patient care over scholarship and national visibility. Group 2 faculty reported greater dissatisfaction with academic medicine and less commitment to a career in academic medicine.
Physician faculty who spend more than 50% of their time in clinical care have less time, mentoring, and resources needed for development of an academic career. These obstacles plus differences in their attitudes about career success and recognition contribute to significant differences in promotion. These factors are associated with greater dissatisfaction with academic medicine and lower commitment to academic careers.
评估在一所学术医疗中心中，将超过50%的时间用于临床护理工作的医师教员对职业发展、职业发展资源以及对学术医学的投入程度的态度。
教员调查。
学术医疗中心及相关退伍军人事务医疗中心。
共有310名医师教员参与了此次调查。一半教员报告称他们将50%或更少的时间用于临床护理工作（平均为31%的时间）（第1组），另一半教员报告称他们将超过50%的时间用于临床护理工作（平均为72%的时间）（第2组）。第2组教员用于学术活动的时间仅为第1组的三分之一，职业发展较慢，教授职级的比例较低（第1组和第2组分别为40%和16%；P<0.001），终身教职的比例也较低（分别为52%和26%；P<0.001），尽管两组教员年龄和任教年限相似。第2组教员报告称在其年度进展报告中未审查终身教职和晋升标准（P = 0.003）以及他们不理解这些标准（P<0.001）的可能性高出50%。第2组教员更看重患者护理方面的卓越表现而非学术成就和全国知名度。第2组教员对学术医学的不满程度更高，对从事学术医学职业的投入程度更低。
将超过50%的时间用于临床护理工作的医师教员用于学术职业发展所需的时间、指导和资源较少。这些障碍以及他们对职业成功和认可态度上的差异导致晋升方面存在显著差异。这些因素与对学术医学更大的不满以及对学术职业更低的投入相关。
