初级保健，少有人走的路：一年级医学生对专业的期望。

Primary care, the ROAD less traveled: what first-year medical students want in a specialty.

机构信息

Ms. Clinite is a fourth-year medical student, University of Chicago Pritzker School of Medicine, Chicago, Illinois. Dr. Reddy is associate professor, Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois. Ms. Kazantsev is a third-year medical student, University of Chicago Pritzker School of Medicine, Chicago, Illinois. Dr. Kogan is associate professor, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Dr. Durning is professor of medicine and pathology, Uniformed Services University, Bethesda, Maryland. Ms. Blevins is director, Student and Career Development, University of Colorado School of Medicine, Denver, Colorado, and member, Association of American Medical Colleges Careers in Medicine Advisory Committee. Dr. Chou is professor, Department of Medicine, University of California, San Francisco, and Veterans Affairs Medical Center, San Francisco, California. Dr. Diemer is director, Undergraduate Medical Education, and residency program director, Internal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania. Dr. Dunne is professor and internal medicine clerkship director, Yale University School of Medicine, and associate program director, Yale Traditional Internal Medicine Residency, New Haven, Connecticut. Dr. Fagan is professor of medicine and internal medicine clerkship director, Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Hartung is professor of family and community medicine, Northeast Ohio Medical University, Rootstown, Ohio. Dr. Mechaber is assistant professor of medicine and assistant dean of student services, University of Miami Miller School of Medicine, Miami, Florida. Dr. Paauw is professor of medicine, University of Washington School of Medicine, and Rathmann Family Foundation Endowed Chair for Patient Centered Clinical Education, Seattle, Washington. Dr. Wong is senior associate dean emeritus of medical education an

出版信息

Acad Med. 2013 Oct;88(10):1522-8. doi: 10.1097/ACM.0b013e3182a316eb.

DOI:10.1097/ACM.0b013e3182a316eb

PMID:23969353

Abstract

PURPOSE

Medical students are increasingly choosing non-primary-care specialties. Students consider lifestyle in selecting their specialty, but how entering medical students perceive lifestyle is unknown. This study investigates how first-year students value or rate lifestyle domains and specialty-selection characteristics and whether their ratings vary by interest in primary care (PC).

METHOD

During the 2012-2013 academic year, the authors conducted a cross-sectional survey of first-year medical students from 11 MD-granting medical schools. Using a five-point Likert-type scale (1 = not important at all; 5 = extremely important), respondents rated the importance of 5 domains of good lifestyle and 21 characteristics related to specialty selection. The authors classified students into five groups by PC interest and assessed differences by PC interest using one-way analysis of variance.

RESULTS

Of 1,704 participants, 1,020 responded (60%). The option "type of work I am doing" was the highest-rated lifestyle domain (mean 4.8, standard deviation [SD] 0.6). "Being satisfied with the job" was the highest-rated specialty-selection characteristic (mean 4.7, SD 0.5). "Availability of practice locations in rural areas" was rated lowest (mean 2.0, SD 1.1). As PC interest decreased, the importance of "opportunities to work with underserved populations" also decreased, but importance of "average salary earned" increased (effect sizes of 0.98 and 0.94, respectively).

CONCLUSIONS

First-year students valued enjoying work. The importance of financial compensation was inversely associated with interest in PC. Examining the determinants of enjoyable work may inform interventions to help students attain professional fulfillment in PC.

摘要

目的

越来越多的医学生选择非基层医疗专业。学生在选择专业时会考虑生活方式，但医学生对生活方式的看法尚不清楚。本研究调查了一年级医学生如何看待生活方式领域和专业选择特征，以及他们的评价是否因对初级保健（PC）的兴趣而异。

方法

在 2012-2013 学年，作者对 11 所 MD 授予医学学校的一年级医学生进行了横断面调查。使用五点 Likert 量表（1 = 一点也不重要；5 = 极其重要），受访者对 5 个良好生活方式领域和 21 个与专业选择相关的特征的重要性进行了评分。作者按对 PC 的兴趣将学生分为五组，并使用单向方差分析评估 PC 兴趣的差异。

结果

在 1704 名参与者中，有 1020 人（60%）做出了回应。“我正在做的工作类型”是生活方式领域中评分最高的选项（平均 4.8，标准差 [SD] 0.6）。“对工作满意”是评分最高的专业选择特征（平均 4.7，SD 0.5）。“农村地区实践地点的可用性”的评分最低（平均 2.0，SD 1.1）。随着对 PC 的兴趣降低，“与服务不足人群合作的机会”的重要性也降低，但“平均收入”的重要性增加（效应大小分别为 0.98 和 0.94）。