University of Pennsylvania, Department of Sociology, Philadelphia, PA 19104, USA.
J Health Soc Behav. 2012 Sep;53(3):344-58. doi: 10.1177/0022146512451130. Epub 2012 Aug 3.
Medical residency is a period of intense socialization with a heavy workload. Previous sociological studies have identified efficiency as a practical skill necessary for success. However, many contextual features of the training environment have undergone dramatic change since these studies were conducted. What are the consequences of these changes for the socialization of residents to time management and the development of a professional identity? Based on observations of and interviews with internal medicine residents at three training programs, we find that efficiency is both a social norm and strategy that residents employ to manage a workload for which the demand for work exceeds the supply of time available to accomplish it. We found that residents struggle to be efficient in the face of seemingly intractable "systems" problems. Residents work around these problems, and in doing so develop a tolerance for organizational vulnerabilities.
住院医师规范化培训是一个与高强度工作负荷相伴的社会化过程。以往的社会学研究已经确定，效率是取得成功所必需的一种实际技能。然而，自这些研究开展以来，培训环境的许多背景特征已经发生了巨大变化。这些变化对住院医师进行时间管理和职业身份发展的社会化有何影响？通过对三个培训项目的内科住院医师进行观察和访谈，我们发现，效率既是一种社会规范，也是一种策略，住院医师用它来管理工作量，因为对工作的需求超过了可用时间来完成工作的供应。我们发现，住院医师在面对看似棘手的“系统”问题时，努力提高效率。住院医师绕过这些问题，在这个过程中对组织的脆弱性产生了容忍。
