Weiss Yoram G, Zisk-Rony Rachel Yaffa, Tandeter Howard, Elchalal Uriel, Avidan Alex, Schroeder Josh E, Weissman Charles
Department of Anesthesiology and Critical Care Medicine, Hadassah-Hebrew University Medical Center, Hebrew University - Hadassah School of Medicine, Kiryat Hadassah, POB 12000, Jerusalem, 91120, Israel.
Hebrew University - Hadassah Henrietta Szold School of Nursing, Jerusalem, Israel.
BMC Med Educ. 2017 Jan 18;17(1):17. doi: 10.1186/s12909-017-0854-y.
During their final year of medical school, Israeli students must consider which specialty to choose for residency. Based on the vocational counseling literature we presumed that choices are made by selecting from a cluster of related specialties while considering professional and socio-economic issues.
Questionnaires distributed to final-year medical students at two Israeli medical schools ascertained inclinations toward various medical specialties and the importance of various selection criteria. Analysis focused on seven specialties where >20% of students reported they had positive inclinations. For each such specialty, the specialty and selection criteria query were compared using unpaired two-tailed Student's t-tests to determine differences between students with positive inclinations toward the specialty with those not so inclined. These data were placed in tables, with the significant differences highlighted to facilitate visual recognition of cluster patterns.
Completed questionnaires were obtained from 317 of 455 students. Students often had positive inclinations toward more than one specialty (specialty clusters) associated with a group of selection criteria (selection criteria clusters). For example, interest in internal medicine was clustered with interest in internal medicine subspecialties, cardiology and research. Furthermore, there was a "reciprocal" aspect to some specialty cluster patterns. For example, those interested in internal medicine had little interest in surgical specialties. Selection criteria clusters revealed occupational interests and socio-environmental factors associated with the specialty clusters. For example, family medicine, which clustered with pediatrics and psychiatry, had a sub-cluster of: Bedside specialty with family orientation affording long-term patient care. Another sub-cluster was time for childrearing and family, only daytime work and outpatient care. Clusters also revealed students' perceptions that differed from expected: Cardiology is changing from a cognitive to a procedure-oriented subspecialty, clustering not only with internal medicine and its subspecialties but also with emergency medicine, surgical subspecialties and anesthesiology.
The concept that career choice involves selecting from a cluster of related specialties provides information about the specialties students might be considering. Moreover, students are not only looking for individual aspects of a specialty, but for a package including clusters of socio-economic and occupational features. Practically, examining clusters can help in career counseling of medical students and assist residency program directors in marketing their specialties.
在医学院校的最后一年，以色列学生必须考虑选择哪个专业进行住院医师培训。基于职业咨询文献，我们推测学生是在考虑专业和社会经济问题的同时，从一组相关专业中进行选择来做出决定的。
向两所以色列医学院校的最后一年医学生发放问卷，以确定他们对各种医学专业的倾向以及各种选择标准的重要性。分析集中在七个专业，超过20%的学生表示他们对这些专业有积极的倾向。对于每个这样的专业，使用非配对双尾学生t检验比较专业和选择标准的问题，以确定对该专业有积极倾向的学生与没有这种倾向的学生之间的差异。这些数据被列入表格，突出显示显著差异以方便直观识别聚类模式。
从455名学生中的317名获得了完整的问卷。学生们通常对与一组选择标准（选择标准聚类）相关的多个专业（专业聚类）有积极的倾向。例如，对内科的兴趣与对内科学亚专业、心脏病学和研究的兴趣聚集在一起。此外，一些专业聚类模式存在“相互”的方面。例如，对内科感兴趣的人对外科专业兴趣不大。选择标准聚类揭示了与专业聚类相关的职业兴趣和社会环境因素。例如，与儿科学和精神病学聚集在一起的家庭医学有一个子聚类：以家庭为导向的床边专业，提供长期患者护理。另一个子聚类是有时间抚养孩子和陪伴家人、只上白天班和门诊护理。聚类还揭示了学生与预期不同的看法：心脏病学正从一个以认知为主的亚专业转变为一个以手术为主的亚专业，不仅与内科及其亚专业聚集在一起，还与急诊医学、外科亚专业和麻醉学聚集在一起。
职业选择涉及从一组相关专业中进行选择的概念提供了有关学生可能正在考虑的专业的信息。此外，学生们不仅在寻找一个专业的各个方面，而且在寻找一个包括社会经济和职业特征聚类的组合。实际上，研究聚类有助于对医学生进行职业咨询，并协助住院医师培训项目主任推销他们的专业。
