Shirley Otis C, Addison Ben, Poole Phillippa
Department of Orthopaedics, North Shore Hospital, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand.
N Z Med J. 2014 Nov 7;127(1405):54-60.
NZ needs a surgical workforce with the capacity to meet the increasing health demands of an aging population. This study determined longitudinal patterns of medical student interest in a surgical career and factors influencing that choice.
We studied medical students entering the Auckland medical programme from 2006-2008 who completed an entry and exit questionnaire on career intentions. Four notional groups were created, depending on the level of interest at entry and at exit. Demographic factors for each category were compared. Analysis of influencing factors was also undertaken.
Of 488 students, 310 (64%) completed both an entry and exit questionnaire. Over 50% of students had a strong interest in a surgical career at entry, dropping to 26% at exit. The 'Never Evers' (No interest at entry /No interest at exit) made up 39%,'Divergers' (Strong/No) 35%, 'Die Hards' (Strong/Strong) 18%, and 'Convertibles' (No/Strong) 8%. Less interest in a surgical career was seen among female (P=0.001) and older students (P=0.017). Influencing factors differentiating the 'Die Hards' from the 'Divergers' were work hours and flexibility (less influence among 'Die Hards'), with procedural nature and consultants/mentors (higher).
There is a significant reduction in interest in a surgical career over the course of the undergraduate programme, especially among female and older students. Yet the level appears sufficient for available training places. Consultant role models are an important career influence. Lack of flexibility in work and training programmes continue to provide challenges in creating a diverse surgical workforce.
新西兰需要一支能够满足老龄化人口日益增长的医疗需求的外科医疗队伍。本研究确定了医学生对外科职业兴趣的纵向模式以及影响该选择的因素。
我们研究了2006年至2008年进入奥克兰医学项目的医学生，他们完成了一份关于职业意向的入学和毕业调查问卷。根据入学和毕业时的兴趣水平创建了四个概念组。比较了每个类别的人口统计学因素。还对影响因素进行了分析。
在488名学生中，310名（64%）完成了入学和毕业调查问卷。超过50%的学生在入学时对外科职业有浓厚兴趣，毕业时降至26%。“从未感兴趣者”（入学时无兴趣/毕业时无兴趣）占39%，“转变者”（强烈/无）占35%，“坚定者”（强烈/强烈）占18%，“转变成功型”（无/强烈）占8%。女性（P=0.001）和年龄较大的学生（P=0.017）对外科职业的兴趣较低。将“坚定者”与“转变者”区分开来的影响因素是工作时间和灵活性（在“坚定者”中影响较小），而程序性质以及顾问/导师（影响较大）。
在本科课程过程中，对外科职业的兴趣显著下降，尤其是在女性和年龄较大的学生中。然而，这一水平似乎足以满足现有的培训名额。顾问榜样是重要的职业影响因素。工作和培训计划缺乏灵活性继续给创建多样化的外科医疗队伍带来挑战。
