Resneck Jack S, Kostecki James
Department of Dermatology, and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco School of Medicine, San Francisco, CA 94143-0316, USA.
Arch Dermatol. 2011 Sep;147(9):1065-70. doi: 10.1001/archdermatol.2011.228.
To evaluate the migration patterns of dermatologists from residency training to eventual clinical practice to assess whether certain programs or regions were more likely to populate their own areas with graduates.
Analysis of existing data from the American Academy of Dermatology's membership database.
The United States and Puerto Rico.
Graduates of US dermatology residency programs completing training before 2005 and actively practicing in 2009. Data from 7067 practicing dermatologists were analyzed.
Distance from training to practice site and state locations of training and practice sites.
Almost half (43%) of dermatologists practice within 100 miles of their residency training site, although substantial variation was observed in distance (mean, 538 miles; median, 189 miles). More than 70% of graduates from all but 1 New York City program remain within a 100-mile radius, and several California and Florida programs were most likely to retain trainees in state. The Midwest was a net exporter of residents to the West and South.
The relationships between residency and eventual practice locations are complex, but certain regions and training programs have distinct graduate migration patterns. To the extent that further expansions in residency positions are undertaken with local supply and demand of dermatology services in mind, these patterns are among many factors that should be considered.
评估皮肤科医生从住院医师培训到最终临床实践的迁移模式，以确定某些项目或地区是否更有可能让其毕业生留在当地。
对美国皮肤科协会会员数据库中的现有数据进行分析。
美国和波多黎各。
2005年前完成培训并于2009年仍在积极执业的美国皮肤科住院医师培训项目毕业生。对7067名执业皮肤科医生的数据进行了分析。
培训地点与执业地点之间的距离以及培训地点和执业地点的所在州。
近一半（43%）的皮肤科医生在其住院医师培训地点100英里范围内执业，不过在距离上存在显著差异（均值为538英里；中位数为189英里）。除纽约市的1个项目外，其他所有项目超过70%的毕业生都留在了100英里半径范围内，加利福尼亚州和佛罗里达州的几个项目最有可能留住本州的受训人员。中西部地区是向西部和南部输送住院医师的净输出地区。
住院医师培训与最终执业地点之间的关系较为复杂，但某些地区和培训项目有明显不同的毕业生迁移模式。在考虑住院医师岗位进一步扩充时若兼顾当地皮肤科服务的供需情况，这些模式是众多应予以考虑的因素之一。
