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基层医疗住院医师选择和参与课外医学院项目以促进为医疗服务不足人群服务的实践。

Primary care residency choice and participation in an extracurricular longitudinal medical school program to promote practice with medically underserved populations.

机构信息

Dr. Kost is assistant professor, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington. Mr. Benedict is a fourth-year student, University of Washington School of Medicine, Seattle, Washington. Ms. Andrilla is biostatistician and research scientist, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington. Dr. Osborn is assistant professor, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington. Dr. Dobie is professor, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington.

出版信息

Acad Med. 2014 Jan;89(1):162-8. doi: 10.1097/ACM.0000000000000075.

DOI:10.1097/ACM.0000000000000075

PMID:24280848

Abstract

PURPOSE

In 2006, the University of Washington School of Medicine (UWSOM) launched the Underserved Pathway (UP), an extracurricular longitudinal experience supporting student interest in caring for underserved populations. This study examined the association between UP participation and residency choice.

METHOD

The study population was 663 UWSOM graduates who matched to a residency from 2008 to 2011; 69 were UP participants. Outcomes included matching to primary care residencies (family medicine, internal medicine, pediatrics, or medicine-pediatrics). The authors calculated graduate rates and odds of UP participants versus nonparticipants matching to primary care residencies overall and to residencies in individual primary care specialties. This analysis included all graduates and 513 graduates who had dual interest in primary care and underserved care at matriculation. Of 336 graduates matching to primary care, the authors calculated rates of entering the individual specialties with respect to UP participation.

RESULTS

UP participants matched at significantly higher rates than nonparticipants to primary care (72.5% versus 48.1%, adjusted odds ratio [OR] 2.2) and family medicine residencies (33.3% versus 15.0%, adjusted OR 2.9). Of graduates with dual matriculation interest in primary care and underserved care, 73.4% of participants versus 53.5% of nonparticipants matched to primary care (adjusted OR 1.9), and 31.2% of participants versus 18.0% of nonparticipants matched to family medicine (adjusted OR 2.1). Of primary care matched graduates, 46.0% of participants versus 31.1% of nonparticipants entered family medicine.

CONCLUSIONS

Supporting student interest in underserved careers is associated with higher rates of graduates entering primary care residencies, specifically family medicine.

摘要

目的

2006 年，华盛顿大学医学院（UWSOM）启动了服务不足人群途径（UP），这是一个课外的纵向体验，旨在支持学生对服务不足人群的关注。本研究考察了 UP 参与与住院医师选择之间的关联。

方法

研究人群为 2008 年至 2011 年匹配住院医师的 663 名 UWSOM 毕业生；其中 69 名是 UP 参与者。结果包括匹配到初级保健住院医师（家庭医学、内科、儿科或内科-儿科）。作者计算了总体上以及在各个初级保健专业中 UP 参与者与非参与者匹配到初级保健住院医师的毕业率和可能性。该分析包括所有毕业生和 513 名在入学时对初级保健和服务不足的护理有双重兴趣的毕业生。在 336 名匹配到初级保健的毕业生中，作者计算了 UP 参与与进入各个专业的比率。

结果

与非参与者相比，UP 参与者匹配到初级保健的比例显著更高（72.5%对 48.1%，调整后的优势比[OR]2.2）和家庭医学住院医师（33.3%对 15.0%，调整后的 OR 2.9）。在有双重入学兴趣的初级保健和服务不足的护理的毕业生中，73.4%的参与者与 53.5%的非参与者匹配到初级保健（调整后的 OR 1.9），31.2%的参与者与 18.0%的非参与者匹配到家庭医学（调整后的 OR 2.1）。在匹配到初级保健的毕业生中，46.0%的参与者与 31.1%的非参与者进入家庭医学。