Melgar Thomas, Chamberlain John K, Cull William L, Kaelber David C, Kan Brian D
Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, Michigan, USA.
Acad Med. 2006 May;81(5):440-6. doi: 10.1097/01.ACM.0000222276.83082.87.
To investigate the demographics and training experiences of internal medicine and pediatrics (med-peds) physicians.
A cross-sectional survey addressing demographics, training experiences, and career plans of fourth-year residents graduating from combined internal medicine and pediatrics programs that were identified in the American Academy of Pediatrics database was initiated in May 2003. Questionnaires were mailed up to four times to nonresponders through August 2003.
Valid responses were received from 212 of the 340 graduating residents (62% response rate). The majority (186/208 [89%]) reported that they would choose med-peds training again. Career planning (135/210 [64%]), office management (173/212 [82%]), and outpatient procedures (155/211 [73%]) were the only areas where the majority desired more training. Neonatal intensive care training was the only topic area that the majority of residents (142/212 [67%]) reported could have been carried out in less time. Nearly all residents (183/196 [93%]) planned to care for children and adults. Residents' self-assessment of their preparation was good to excellent for evidence-based medicine (192/210 [91%]), caring for patients with special health care needs (179/209 [86%]), and use of information technology (169/208 [81%]). Residents felt equally well prepared for postgraduate activities in internal medicine and pediatrics primary care (170/212 [80%] versus 163/211 [77%], p = .305, NS) and internal medicine and pediatric fellowships (186/207 [90%] versus 181/208 [87%], p = .058, NS). Only 112 of 209 residents (54%) felt their preparation for research was good to excellent.
The study findings suggest that med-peds residents are satisfied with their decision to train in med-peds and with their level of preparation. They feel equally well prepared to care for adults and children, and well prepared to care for patients that may transition to adulthood with complex needs, to assess evidence, and to use information technology.
调查内科与儿科(内科 - 儿科)医师的人口统计学特征及培训经历。
2003年5月启动了一项横断面调查,涉及美国儿科学会数据库中确定的内科与儿科联合项目毕业的四年级住院医师的人口统计学特征、培训经历及职业规划。问卷最多向未回复者邮寄四次,直至2003年8月。
340名毕业住院医师中有212人给出有效回复(回复率62%)。大多数人(186/208 [89%])表示会再次选择内科 - 儿科培训。职业规划(135/210 [64%])、办公室管理(173/212 [82%])和门诊操作(155/211 [73%])是大多数人希望接受更多培训的仅有的几个领域。新生儿重症监护培训是大多数住院医师(142/212 [67%])表示可以用更少时间完成的唯一主题领域。几乎所有住院医师(183/196 [93%])计划同时照顾儿童和成人。住院医师对自身在循证医学(192/210 [91%])、照顾有特殊医疗需求的患者(179/209 [86%])以及信息技术使用(169/208 [81%])方面的准备情况自我评估为良好至优秀。住院医师认为自己在内科和儿科初级保健的研究生活动方面准备程度相当(170/212 [80%] 对 163/211 [77%],p = 0.305,无显著差异),在内科和儿科专科培训方面准备程度也相当(186/207 [90%] 对 181/208 [87%],p = 0.058,无显著差异)。209名住院医师中只有112人(54%)认为自己在研究方面的准备情况良好至优秀。
研究结果表明,内科 - 儿科住院医师对自己选择内科 - 儿科培训的决定及其准备程度感到满意。他们觉得自己在照顾成人和儿童方面准备程度相当,并且在照顾可能过渡到成年且有复杂需求的患者、评估证据以及使用信息技术方面准备充分。