Akdeniz University, Faculty of Medicine, Department of Family Medicine, Antalya, Turkey.
Postgrad Med. 2011 May;123(3):144-9. doi: 10.3810/pgm.2011.05.2292.
Turkey's family practice training program is aimed at providing further training to clinically proficient family physicians who serve the community. A survey conducted in 2001 revealed that there was a need for providing additional training and more time in a specially dedicated family practice placement for family practitioners. Recent changes in the Turkish health care system have also impacted the training environment of family practice residents. Clearly, training needs to change with time. The aims of this study are to investigate the attitudes of resident family practice physicians regarding their training in the health care system in order to gather their views on the hospital learning environment, and to estimate their burnout levels. For this research, the design included a 1-phase cross-sectional study. This study was undertaken in 2008 in departments of family medicine at universities (n = 21) and training and research hospitals of the Ministry of Health (n = 11). Approximately 250 family practice residents in Turkey were approached. In total, 174 residents participated (70% response rate). The survey instruments included a questionnaire with 25 queries and 2 scales: The Postgraduate Hospital Educational Environment Measure and the Maslach Burnout Questionnaire-Human Services Survey. The average age of the participants was 32.2 years (standard deviation, 4.5 years; range, 24-57 years). The gender distribution was 57.6% women and 42.4% men. Marital status was 34.7% single, 62.9% married, and 2.4% divorced/widowed. In our results, residents affirmed that university hospitals were the best facilities for residency training. Their future plans confirmed that most would like to work in family health centers. This sample showed average levels of emotional exhaustion, depersonalization, and lack of personal accomplishment. Perceptions of professional autonomy, quality of training, and social support were below average. It may be concluded that certain milestones in the development of family practice in Turkey have been fulfilled. The new regulation for postgraduate training has increased the share of family practice training to 50% (18 months). Establishment of educational family health centers has been planned. Introduction of the formative and summative assessment processes in family practice training is anticipated. It is expected that an assessment such as the Membership of the Royal College of General Practitioners (International) (mRCGP[INT]) examination would be helpful for Turkish residents in reaching these goals.
土耳其的家庭医学培训计划旨在为在社区服务的临床能力熟练的家庭医生提供进一步的培训。2001 年进行的一项调查显示，家庭医生需要额外的培训和更多时间专门用于家庭医学实习。土耳其医疗保健系统的最近变化也影响了家庭医学住院医师的培训环境。显然，培训需要与时俱进。本研究的目的是调查住院家庭医生对其在医疗保健系统中培训的态度，以了解他们对医院学习环境的看法，并评估他们的倦怠程度。为此研究，设计采用了 1 个阶段的横断面研究。该研究于 2008 年在大学的家庭医学系（n=21）和卫生部的培训和研究医院（n=11）进行。土耳其约有 250 名家庭医学住院医师参与了这项研究。共有 174 名住院医师参与（70%的回应率）。调查工具包括一个包含 25 个问题和 2 个量表的问卷：研究生医院教育环境量表和马斯拉赫职业倦怠问卷-人力资源服务调查。参与者的平均年龄为 32.2 岁（标准差 4.5 岁；范围 24-57 岁）。性别分布为 57.6%为女性，42.4%为男性。婚姻状况为 34.7%单身，62.9%已婚，2.4%离婚/丧偶。在我们的结果中，住院医师肯定了大学医院是住院医师培训的最佳设施。他们的未来计划证实，大多数人希望在家庭健康中心工作。这个样本显示出平均水平的情绪耗竭、去人性化和缺乏个人成就感。对专业自主、培训质量和社会支持的看法低于平均水平。可以得出结论，土耳其家庭医学发展的某些里程碑已经实现。研究生培训的新规定将家庭医学培训的比例提高到 50%（18 个月）。计划建立教育性家庭健康中心。预计在家庭医学培训中引入形成性和总结性评估过程。预计像皇家全科医师学院（国际）（mRCGP[INT]）考试这样的评估将有助于土耳其住院医师实现这些目标。
