Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
Acad Emerg Med. 2011 Oct;18 Suppl 2:S48-53. doi: 10.1111/j.1553-2712.2011.01181.x.
The future of academic emergency medicine (EM) is based on the continued successful recruitment and cultivation of new faculty from EM residents. Little data exist as to the current rate of residents initially choosing an academic career path or which residency programs are best situated to result in new faculty.
Our study was designed to initially describe the current career demographics of graduating residents and then through statistical analysis investigate likely programmatic factors that affect academic career selection.
Data were collected via an online survey sent to EM residency program directors. Responders were asked to describe their graduates and their program characteristics over the past 5 years. A total of 103 survey responses, with complete data from 65 (76 responses contained enough data for national career selection rates), were received. Relevant covariates were tested for association with academic career entry using t-tests or analysis of variance. An adjusted multivariable linear regression analysis model was then fitted.
Survey responses indicated that 26.1% of residents chose an academic career (community 57.1%, fellowship 13.5%, military/Veteran's Administration [VA] 2.6%, other 0.6%) with an approximately normal distribution. There were no significant differences found between programs when presence of mentorship programs, career track programs, or city size were analyzed. Multivariable linear regression analysis demonstrated significantly greater academic career choice among programs located in the Northeast/Mid-Atlantic and the Midwest, larger programs (>12 residents/year), and programs with increased resident academic productivity (presentations given, non-peer-reviewed publications), but did not demonstrate a difference between 3- and 4-year programs. Overall, the model fitted using the above variables accounted for approximately 30% of the variation seen between programs (adjusted R(2)=0.295).
Our data indicate that program region, size, and research productivity were best associated with academic career selection. Program length was not found to be significantly associated with academic career selection by residents, in contrast to previous studies. While many of these factors are not changeable, academic productivity can be cultivated by decision-makers wishing to increase their residents' academic career selection as opposed to changing program length to extend training for an additional year. It is our belief that our model provides a good description of programmatic factors affecting career choice. Additional research is necessary to further validate these findings, as well to provide important context to their general applicability for policy-makers and program directors.
学术急诊医学（EM）的未来取决于继续成功招募和培养来自 EM 住院医师的新教师。目前，关于住院医师最初选择学术职业道路的比率，或者哪些住院医师项目最有可能成为新教师，几乎没有数据。
我们的研究旨在首先描述毕业住院医师的当前职业人口统计学特征，然后通过统计分析研究可能影响学术职业选择的计划因素。
通过向 EM 住院医师项目主任发送在线调查收集数据。受访者被要求描述他们过去 5 年的毕业生及其项目特征。共收到 103 份调查回复，其中 65 份（76 份回复包含足够的数据来计算全国职业选择率）的回复包含完整数据。使用 t 检验或方差分析测试相关协变量与学术职业进入的关联。然后拟合了调整后的多变量线性回归分析模型。
调查回复表明，26.1%的住院医师选择了学术职业（社区 57.1%，奖学金 13.5%，军事/退伍军人管理局 [VA]2.6%，其他 0.6%），呈近似正态分布。当分析导师计划、职业轨道计划或城市规模的存在时，各项目之间没有发现显著差异。多变量线性回归分析表明，位于东北/大西洋中部和中西部的项目、规模较大的项目（>12 名住院医师/年）和学术成果较高的项目（演讲、非同行评议出版物）选择学术职业的比例显著更高，但在 3 年制和 4 年制项目之间没有差异。总体而言，使用上述变量拟合的模型解释了项目之间约 30%的差异（调整后的 R(2)=0.295）。
我们的数据表明，项目所在地区、规模和研究生产力与学术职业选择最相关。与之前的研究相反，住院医师的项目长度并未被发现与学术职业选择显著相关。虽然这些因素中的许多是不可改变的，但决策者可以通过培养学术生产力来增加他们的住院医师的学术职业选择，而不是为了延长培训时间而将项目长度延长一年。我们相信，我们的模型很好地描述了影响职业选择的计划因素。需要进一步的研究来进一步验证这些发现，并为决策者和项目主任提供这些发现的普遍适用性的重要背景。
