Rosenthal M P, Turner T N, Diamond J, Rabinowitz H K
Department of Family Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107.
Acad Med. 1992 May;67(5):328-31. doi: 10.1097/00001888-199205000-00012.
The recent decline in the number of medical students choosing careers in the primary care specialties has engendered increasing concern that economic factors are becoming more important in influencing the career choices of medical students. In order to assess the relationship of first-year medical students' income expectations to whether they chose to specialize in family practice, the authors analyzed data from 532 graduates of Jefferson Medical College (classes of 1987-1989), using the Jefferson Longitudinal Study. At entrance to medical school, each student listed his or her initial specialty preference and future expected peak income; the determination of actual specialty choice was based on the first year of postgraduate training. Both expected peak incomes and freshman specialty choices were independent predictors of actual specialty choices. The students who entered family practice residencies had lower initial expected peak incomes than did the students entering other specialties, especially the surgery specialties. In addition, according to logistic regression analysis, the students with relatively lower income expectations and a freshman preference for family practice were predicted to be nine times more likely to enter family practice residencies than were students with higher income expectations and no initial family practice preference (56% versus 6%). This study suggests that a freshman's income expectation is an important predictor of family practice specialty choice, independent of age, sex, degree of indebtedness, and initial specialty preference. The authors discuss their results in light of the decline in the number of medical students choosing family practice and the other primary care specialties.
最近，选择基层医疗专业作为职业的医学生数量有所下降，这引发了人们越来越多的担忧，即经济因素在影响医学生职业选择方面正变得越来越重要。为了评估一年级医学生的收入期望与他们是否选择从事家庭医疗专业之间的关系，作者利用杰斐逊纵向研究分析了532名杰斐逊医学院毕业生（1987 - 1989届）的数据。在进入医学院时，每名学生列出了自己最初的专业偏好和未来预期的最高收入；实际专业选择的确定基于研究生培训的第一年。预期最高收入和大一专业选择都是实际专业选择的独立预测因素。进入家庭医疗住院医师培训项目的学生，其最初预期的最高收入低于进入其他专业的学生，尤其是外科专业的学生。此外，根据逻辑回归分析，收入期望相对较低且大一就偏好家庭医疗专业的学生，预计进入家庭医疗住院医师培训项目的可能性是收入期望较高且最初没有家庭医疗专业偏好的学生的九倍（56%对6%）。这项研究表明，大一学生的收入期望是家庭医疗专业选择的一个重要预测因素，与年龄、性别、负债程度和最初的专业偏好无关。作者根据选择家庭医疗和其他基层医疗专业的医学生数量下降的情况讨论了他们的研究结果。
