Brotherton Sarah E, Rockey Paul H, Etzel Sylvia I
Division of Graduate Medical Education, American Medical Association, Chicago, Ill 60610, USA.
JAMA. 2003 Sep 3;290(9):1197-202. doi: 10.1001/jama.290.9.1197.
By selecting a specialty to train in, physicians entering graduate medical education (GME) training provide advance information about the future physician workforce.
To determine trends in the residency choices of medical school graduates entering GME training.
DESIGN, SETTING, AND PARTICIPANTS: The American Medical Association and Association of American Medical Colleges jointly surveyed active programs as well as combined programs in academic year 2002-2003 about active, transferred, and graduated residents. In 2002 the survey was sent to 8064 program directors; 84.2% of them confirmed the status of all active residents and 82.6% completed the program survey.
In addition to overall trends, the specialty choices of graduates of osteopathic schools (DOs) and international medical graduates (IMGs). Also, where native US citizen resident physicians attended medical school if not in the United States, with a focus on Hispanic ethnicity and Spanish-language facility.
The census counted 98 258 resident physicians in GME programs in academic year 2002-2003, similar to 5 years ago and reversing a decline over the past few years. There were 23 443 residents in graduate year 1 (GY1) positions, for which prior GME training is not required, a slight increase from 2001-2002. The proportion of GY1 residents without prior GME increased slightly compared with 2001-2002 (92.3% to 93.3%). In 1996-1997, 624 DOs were GY1 residents without prior GME (2.9%); their numbers increased to 1312 (6.0%) in 2002-2003. The number of IMGs in GY1 positions without prior GME also increased over this period, from 5033 (23.5%) to 5623 (25.7%). Over the past 6 years the number of IMG and DO GY1 residents without prior GME in specialties such as general surgery, obstetrics and gynecology, and emergency medicine has increased disproportionately faster than the overall rate. Hispanic native US citizens are more likely to be IMGs than non-Hispanic native US citizens (9.6% vs 5.0%). One third of Hispanic native US citizen IMGs received their medical education in Spanish vs less than 3% of non-Hispanic native US citizen IMGs.
Nearly 25% of physicians in US allopathic training programs in 2002-2003 were IMGs, and the percentage of DOs continues to increase. The number of residents conversant in Spanish could serve a need for a large US minority population.
通过选择培训专业，进入毕业后医学教育（GME）培训的医生会提供有关未来医生劳动力的预先信息。
确定进入GME培训的医学院毕业生在住院医师选择方面的趋势。
设计、地点和参与者：美国医学协会和美国医学院协会在2002 - 2003学年联合调查了活跃项目以及联合项目中的在职、转岗和毕业的住院医师。2002年，调查问卷被发送给8064名项目主任；其中84.2%确认了所有在职住院医师的状态，82.6%完成了项目调查。
除总体趋势外，还包括整骨疗法学校（DOs）毕业生和国际医学毕业生（IMGs）的专业选择。此外，美国本土公民住院医师若不在美国就读医学院，需关注其西班牙裔种族和西班牙语能力。
2002 - 2003学年的人口普查统计显示，GME项目中有98258名住院医师，与5年前相似，扭转了过去几年的下降趋势。一年级住院医师（GY1）岗位有23443人，这些岗位无需先前的GME培训，与2001 - 2002年相比略有增加。与2001 - 2002年相比，无先前GME培训的GY1住院医师比例略有增加（从92.3%增至93.3%）。1996 - 1997年，624名DOs是无先前GME培训的GY1住院医师（占2.9%）；到2002 - 2003年，这一数字增至1312人（占6.0%）。同期，无先前GME培训的GY1岗位IMGs数量也有所增加，从5033人（占23.5%）增至5623人（占25.7%）。在过去6年中，普通外科、妇产科和急诊医学等专业中，无先前GME培训的IMG和DO GY1住院医师数量的增长速度远超总体增速。美国本土西班牙裔公民比非西班牙裔美国本土公民更有可能成为IMGs（分别为9.6%和5.0%）。三分之一的美国本土西班牙裔公民IMGs接受的是西班牙语医学教育，而非西班牙裔美国本土公民IMGs这一比例不到3%。
2002 - 2003年，美国对抗疗法培训项目中近25%的医生是IMGs，DOs的比例持续上升。会说西班牙语的住院医师数量可满足美国大量少数族裔人群的需求。
