Kahn Steven Alexander, Goldman Matthew, Daul Matthew, Lentz Christopher W
Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.
J Burn Care Res. 2011 Jan-Feb;32(1):39-45. doi: 10.1097/BCR.0b013e318204b318.
The nation is faced with a shortage of subspecialty physicians, including burn surgeons. Exposure to a specialty in medical school has been shown to influence students' career choices. The authors postulate that exposure to burn surgery increases their interest in the field. Students from a medical school with an American Burn Association-verified burn center and from a school without a burn center were anonymously surveyed and asked to report their interest and knowledge regarding burn surgery using a 5-point Likert scale. They were asked about their current year in school, gender, overall interest in surgery, and any prior exposure to burn surgery (eg, preceptorship or rotation). Students were asked whether exposure to burn surgery or to a strong mentor might increase their interest in the field. Finally, they were asked to pick the most important factor in a list of deterrents to pursuing a career in burn surgery. Predictors of interest in burn surgery were determined with regression analyses. A total of 380 of 662 students responded to the survey (57.4%). Significant predictors of interest in burn surgery were an interest in surgery (P < .001, odds ratio [OR] = 56.3), prior exposure to burn surgery (P = .02, OR = 5.7), and year in school (P = .006, OR = 1.7). First- and second-year students were more likely to report interest in burn surgery (P < .001). Gender and medical school attended were not significant predictors. Prior exposure to burn surgery became a stronger predictor in subgroup analysis of the fourth-year students (P < .001, OR = 24.5). The majority of students reported that exposure to burn surgery (76%) and a strong mentor (87%) would make them more likely to consider burn surgery as a career. "Not interested in surgery" was the most important deterrent to pursuing a career in burn surgery, which was selected by 33% of students. However, 25% of students chose "I don't know anything about burn surgery" as the most important deterrent. Factors specific to burn surgery were less frequently selected (eg, wound care and hot operating room). The majority of students reported ignorance of the field of burns: 64% disagreed that they understood what a burn surgeon does on a daily basis, and 74% agreed they did not know enough about the field to consider it as a career. Exposure to burn surgery in the form of a clinical rotation fosters medical student interest. However, the majority of medical students lack knowledge about the field of burn surgery. Many consider this a deterrent to selecting it as a career. More exposure during medical school and strong mentorship may influence more students to become burn surgeons. Mentorship and recruiting efforts should be focused on students with a general interest in surgery.
该国面临包括烧伤外科医生在内的亚专科医生短缺的问题。研究表明，在医学院接触某一专科会影响学生的职业选择。作者推测，接触烧伤外科手术会增加学生对该领域的兴趣。对一所设有经美国烧伤协会认证的烧伤中心的医学院学生以及一所没有烧伤中心的医学院学生进行了匿名调查，要求他们使用5分李克特量表报告对烧伤外科手术的兴趣和了解程度。询问了他们当前所在的年级、性别、对手术的总体兴趣以及之前是否接触过烧伤外科手术（例如，见习或轮转）。询问学生接触烧伤外科手术或一位强有力的导师是否会增加他们对该领域的兴趣。最后，要求他们从一系列阻碍从事烧伤外科手术职业的因素中挑选出最重要的因素。通过回归分析确定了对烧伤外科手术感兴趣的预测因素。662名学生中有380名（57.4%）回复了调查。对烧伤外科手术感兴趣的显著预测因素包括对手术的兴趣（P <.001，优势比[OR]=56.3）、之前接触过烧伤外科手术（P =.02，OR = 5.7）以及所在年级（P =.006，OR = 1.7）。大一和大二学生更有可能表示对烧伤外科手术感兴趣（P <.001）。性别和就读的医学院不是显著的预测因素。在四年级学生的亚组分析中，之前接触烧伤外科手术成为更强的预测因素（P <.001，OR = 24.5）。大多数学生报告说，接触烧伤外科手术（76%）和一位强有力的导师（87%）会使他们更有可能考虑将烧伤外科手术作为职业。“对手术不感兴趣”是从事烧伤外科手术职业最重要的阻碍因素，33%的学生选择了这一因素。然而，25%的学生选择“我对烧伤外科手术一无所知”作为最重要的阻碍因素。烧伤外科手术特有的因素被选中的频率较低（例如，伤口护理和炎热的手术室）。大多数学生表示对烧伤领域不了解：64%的学生不同意他们了解烧伤外科医生的日常工作，74%的学生同意他们对该领域了解不足，无法将其视为一种职业。以临床轮转形式接触烧伤外科手术会促进医学生的兴趣。然而，大多数医学生对烧伤外科手术领域缺乏了解。许多人认为这是选择该职业的一个阻碍因素。在医学院期间增加接触机会和强有力的指导可能会影响更多学生成为烧伤外科医生。指导和招募工作应侧重于对手术有普遍兴趣的学生。
