Department of Sociology, Red Deer College, Alberta T4N 5H5, Canada.
Sociol Health Illn. 2010 May;32(4):528-44. doi: 10.1111/j.1467-9566.2009.01231.x. Epub 2010 Feb 12.
This qualitative study examines the pre- and post-migration practice experiences of 73 physicians trained in South Africa who have relocated to Canada. The aims are to explore the workings of two different healthcare systems from an insider standpoint and to address the medical autonomy debate as it relates to international medical graduates (IMGs). While study respondents reported practice frustrations in both countries, they generally preferred working in a socialised health insurance environment that grants wider accessibility than a two-tiered system that favours a privileged few. Concerns such as family safety and opportunities for children also contributed to more satisfaction with Canada. We discuss our findings in relation to a broader international context and the sociological literature on medical autonomy. We argue that IMGs face different autonomy issues from other physicians and stress the need to broaden sociological inquiry of medical work by investigating how autonomy interfaces with other neglected aspects of physicians' work and non-work lives.
这项定性研究考察了 73 名在南非接受培训的医生在移民前后的实践经验，这些医生已经移居加拿大。目的是从内部人士的角度探讨两种不同的医疗保健系统的运作方式，并解决与国际医学毕业生（IMG）相关的医疗自主权辩论。虽然研究受访者报告说在这两个国家都有工作上的挫折感，但他们普遍更喜欢在一个社会化的医疗保险环境中工作，这种环境比有利于少数特权阶层的两级制更能提供更广泛的可及性。对家庭安全和儿童机会的关注也使他们对加拿大更满意。我们将我们的发现与更广泛的国际背景和关于医疗自主权的社会学文献联系起来进行讨论。我们认为，IMG 面临着与其他医生不同的自主权问题，并强调需要通过调查自主权如何与医生工作和非工作生活中其他被忽视的方面相互作用，来拓宽对医学工作的社会学研究。
