Cull William L, Yudkowsky Beth K, Shipman Scott A, Pan Richard J
American Academy of Pediatrics, Division of Health Policy Research, Elk Grove Village, Illinois 60007, USA.
Pediatrics. 2003 Oct;112(4):787-92. doi: 10.1542/peds.112.4.787.
To examine trends in pediatric residents' training and job search experiences from 1997-2002.
Annual national random samples of 500 graduating pediatric residents were surveyed, and responses were compared across survey years to identify trends. The overall response rate was 71%.
From 1997-2002, there were more female residents and US underrepresented minorities and fewer international medical graduates. Each successive group of residents rated higher their preparation for fellowship training, for child advocacy, and for assessing community needs. These increases paralleled an increase in resident exposure to community sites as part of their residency education. Educational debt (in 2002 dollars) for residents increased substantially across survey years from an average of 64 070 dollars in 1997 to 87 539 dollars in 2002. Meanwhile, starting salaries (in 2002 dollars) for residents entering general pediatrics actually decreased. Interest in general pediatrics among residents decreased, whereas interest in subspecialty practice increased during this time period. Fewer residents with general pediatrics as a career goal had a job when surveyed, and fewer obtained their first-choice positions across years.
Experiences of graduating residents over the past 6 years provide insights into changes in pediatric residency education and the pediatric workforce. Efforts by pediatric educators and academic leaders to increase community experiences and child advocacy and to encourage greater interest in pediatric subspecialty careers seem to be succeeding. Unfortunately, demand for general pediatricians is weakening, and residents are experiencing increasing debt burdens.
研究1997年至2002年儿科住院医师培训及求职经历的趋势。
每年对500名即将毕业的儿科住院医师进行全国随机抽样调查,并比较各调查年份的回复情况以确定趋势。总体回复率为71%。
1997年至2002年,女性住院医师、美国代表性不足的少数族裔增多,国际医学毕业生减少。每一批次的住院医师对专科培训准备、儿童权益倡导及社区需求评估的评分都更高。这些提升与住院医师在住院医师培训教育中接触社区机构的增加相平行。住院医师的教育债务(以2002年美元计算)在各调查年份大幅增加,从1997年的平均64,070美元增至2002年的87,539美元。与此同时,进入普通儿科的住院医师起薪(以2002年美元计算)实际上有所下降。在此期间,住院医师对普通儿科的兴趣降低,而对专科实践的兴趣增加。接受调查时,以普通儿科为职业目标的住院医师找到工作的人数减少,多年来获得首选职位的人数也减少。
过去6年即将毕业的住院医师的经历为儿科住院医师培训教育及儿科劳动力的变化提供了见解。儿科教育工作者和学术领袖为增加社区经历和儿童权益倡导以及鼓励对儿科专科职业产生更大兴趣所做的努力似乎正在取得成功。不幸的是,对普通儿科医生的需求正在减弱,住院医师正面临日益加重的债务负担。