Shamseer Larissa, Roth Daniel E, Tallett Susan, Hilliard Robert, Vohra Sunita
CARE Program, University of Alberta, Department of Pediatrics, Faculty of Medicine, School of Public Health, 8213 Aberhart Centre 1, 11402 University Ave, Edmonton, Alberta, Canada T6G 2J3.
Pediatrics. 2008 Dec;122(6):e1199-209. doi: 10.1542/peds.2007-3512. Epub 2008 Nov 10.
Studies of pediatric resident career plans and preferences help to forecast changes in the demographic profile and practice patterns of North American pediatricians, providing insights that can guide child health care and medical education policy making. With this study we aimed to compare 4 aspects of Canadian pediatric resident career plans in 1998 and 2006: (1) weekly work hours; (2) scope of practice; (3) professional activities; and (4) community size.
Canadian pediatric residents were invited to participate in a national cross-sectional survey to explore career plans and preferences in 1998 (mailing) and 2006 (on-line).
Response rates were 69% in 1998 and 52% in 2006. In both survey years, the majority of respondents were female (69% and 73%, respectively). Overall, residents planned to work a similar number of weekly hours in both survey years (47.8 vs 48.8). Women planned to work significantly fewer hours than men; this gap was wider in 2006 than in 1998 (1998: 2.8 fewer hours; 2006: 7.8 fewer hours). After adjusted analysis, the association between proportion of time in primary care and study year became significant; however, time in consultant general or subspecialty pediatrics remained nonsignificantly changed. Residents planned to spend less time in clinical work in 2006 than 1998 (64.4% vs 58.1%), and more planned to work and reside in metropolitan areas (68% vs 78% of decided respondents).
Between 1998 and 2006, there was no overall change in the number of hours that Canadian pediatric residents planned to work, but the gender gap widened because of an increase in planned weekly work hours among men. The results also suggest that new strategies may be needed to improve future pediatrician availability in small communities by addressing barriers to nonmetropolitan practice, especially for women.
对儿科住院医师职业规划和偏好的研究有助于预测北美儿科医生人口结构和执业模式的变化，为指导儿童医疗保健和医学教育政策制定提供见解。通过本研究，我们旨在比较1998年和2006年加拿大儿科住院医师职业规划的四个方面：（1）每周工作时长；（2）执业范围；（3）专业活动；（4）社区规模。
邀请加拿大儿科住院医师参与一项全国性横断面调查，以探究1998年（邮寄方式）和2006年（在线方式）的职业规划和偏好。
1998年的回复率为69%，2006年为52%。在两个调查年份中，大多数受访者为女性（分别为69%和73%）。总体而言，住院医师在两个调查年份计划每周工作的时长相似（47.8小时对48.8小时）。女性计划工作的时长显著少于男性；2006年这一差距比1998年更大（1998年：少2.8小时；2006年：少7.8小时）。经过调整分析后，基层医疗工作时间占比与研究年份之间的关联变得显著；然而，普通儿科或儿科亚专科的会诊工作时间变化不显著。2006年住院医师计划用于临床工作的时间比1998年减少（64.4%对58.1%），更多人计划在大都市地区工作和居住（已做出决定的受访者中分别为68%和78%）。
1998年至2006年期间，加拿大儿科住院医师计划工作的时长总体上没有变化，但由于男性计划每周工作时长增加，性别差距扩大。结果还表明，可能需要新的策略来解决非大都市地区执业的障碍，尤其是对女性而言，以提高未来小社区儿科医生的可获得性。
