Department of Radiation Oncology, University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin 53792, USA.
Int J Radiat Oncol Biol Phys. 2011 Nov 15;81(4):1120-7. doi: 10.1016/j.ijrobp.2010.07.018. Epub 2010 Oct 6.
To document clinical training and resident working conditions reported by chief residents during their residency.
During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time.
Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 to 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties.
Trends in clinical training and resident working conditions over 3 years are documented to allow residents and program directors to assess their residency training.
记录住院医师在住院期间的临床培训和住院医师工作条件。
在 2005 年至 2006 年、2006 年至 2007 年和 2007 年至 2008 年期间,放射肿瘤学住院医师协会对美国所有放射肿瘤学住院医师进行了一项全国性调查。使用卡方检验来评估随时间变化的临床培训和住院医师工作条件的变化。
2005 年至 2006 年完成了 55 个项目(应答率为 71.4%)的调查,2006 年至 2007 年完成了 60 个项目(75.9%)的调查,2007 年至 2008 年完成了 74 个项目(93.7%)的调查。几乎所有的住院医师都报告说在常见的治疗疾病部位(如乳腺癌和泌尿生殖系统恶性肿瘤)和常见的治疗程序(如三维适形放疗和调强放疗)方面获得了足够的临床经验。颅外立体定向放疗的临床经验随时间推移而增加(p<0.001),而血管内近距离放疗的临床经验随时间推移而减少(p<0.001)。妇科和前列腺近距离放疗病例的分布保持稳定,而乳腺癌近距离放疗的临床病例负荷增加(p=0.006)。一小部分居民报告说,在儿科方面的临床经验不足,在住院期间只看到 10 例或更少的儿科病例。涉及更高资本成本的治疗程序,如粒子束治疗和术中放疗,以及临床应用不频繁的治疗程序,如头颈部近距离放疗,仅限于少数机构。大多数与至少一个卫星设施相关的住院医师培训计划已经将住院医师轮转纳入其临床培训中,并且这些计划中的大多数住院医师认为这是宝贵的经验。大多数住院医师报告说,每周需要进行 60 小时或更少的临床工作。
记录了 3 年来临床培训和住院医师工作条件的趋势,以便住院医师和项目主任评估他们的住院医师培训。