Department of Public Health, Oxford University, UK.
BMC Med Educ. 2010 Nov 11;10:78. doi: 10.1186/1472-6920-10-78.
The transition from medical student to junior doctor in postgraduate training is a critical stage in career progression. We report junior doctors' views about the extent to which their medical school prepared them for their work in clinical practice.
Postal questionnaires were used to survey the medical graduates of 1999, 2000, 2002 and 2005, from all UK medical schools, one year after graduation, and graduates of 2000, 2002 and 2005 three years after graduation. Summary statistics, chi-squared tests, and binary logistic regression were used to analyse the results. The main outcome measure was the level of agreement that medical school had prepared the responder well for work.
Response rate was 63.7% (11610/18216) in year one and 60.2% (8427/13997) in year three. One year after graduation, 36.3% (95% CI: 34.6, 38.0) of 1999/2000 graduates, 50.3% (48.5, 52.2) of 2002 graduates, and 58.2% (56.5, 59.9) of 2005 graduates agreed their medical school had prepared them well. Conversely, in year three agreement fell from 48.9% (47.1, 50.7) to 38.0% (36.0, 40.0) to 28.0% (26.2, 29.7). Combining cohorts at year one, percentages who agreed that they had been well prepared ranged from 82% (95% CI: 79-87) at the medical school with the highest level of agreement to 30% (25-35) at the lowest. At year three the range was 70% to 27%. Ethnicity and sex were partial predictors of doctors' level of agreement; following adjustment for them, substantial differences between schools remained. In years one and three, 30% and 34% of doctors specified that feeling unprepared had been a serious or medium-sized problem for them (only 3% in each year regarded it as serious).
The vast knowledge base of clinical practice makes full preparation impossible. Our statement about feeling prepared is simple yet discriminating and identified some substantial differences between medical schools. Medical schools need feedback from graduates about elements of training that could be improved.
从医学生到研究生培训中的初级医生的过渡是职业发展的关键阶段。我们报告了初级医生对医学院为他们在临床实践中的工作所做准备程度的看法。
使用邮寄问卷对所有英国医学院的 1999 年、2000 年、2002 年和 2005 年的医学毕业生以及 2000 年、2002 年和 2005 年的毕业生进行调查，在毕业后一年和三年进行调查。使用汇总统计、卡方检验和二元逻辑回归分析结果。主要观察指标是对医学院为应答者做好工作准备的程度的一致性程度。
在第一年的响应率为 63.7%（11610/18216），在第三年的响应率为 60.2%（8427/13997）。毕业后一年，1999/2000 届毕业生中有 36.3%（95%CI：34.6，38.0）、2002 届毕业生中有 50.3%（48.5，52.2）和 2005 届毕业生中有 58.2%（56.5，59.9）同意他们的医学院为他们做好了充分的准备。相反，在第三年，从 48.9%（47.1，50.7）降至 38.0%（36.0，40.0）至 28.0%（26.2，29.7）。将 cohort 合并在第一年，同意他们接受了良好培训的百分比范围为 82%（95%CI：79-87），最高水平的学校为 30%（25-35），最低水平的学校为 30%。在第三年，范围为 70%至 27%。种族和性别是医生对准备程度的部分预测因素；在对这些因素进行调整后，学校之间仍存在很大差异。在第一年和第三年，分别有 30%和 34%的医生表示，他们感到准备不足是一个严重或中等程度的问题（每年只有 3%的人认为这是一个严重的问题）。
临床实践的大量知识库使得全面准备成为不可能。我们关于准备程度的陈述很简单，但具有区分力，并且确定了医学院之间的一些实质性差异。医学院需要从毕业生那里获得有关可改进培训要素的反馈。
