肾脏病学的职业兴趣与认知：一项针对内科住院医师的重复横断面调查。

Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents.

作者信息

Daniels Michael N, Maynard Sharon, Porter Ivan, Kincaid Hope, Jain Deepika, Aslam Nabeel

机构信息

Department of Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania, United States of America.

Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic Florida, Jacksonville, Florida, United States of America.

出版信息

PLoS One. 2017 Feb 16;12(2):e0172167. doi: 10.1371/journal.pone.0172167. eCollection 2017.

DOI:10.1371/journal.pone.0172167

PMID:28207893

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5313227/

Abstract

BACKGROUND

Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents.

METHODS

This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology.

RESULTS

131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02).

CONCLUSIONS

The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents' interest in nephrology careers. Residents endorsed several negative perceptions of nephrology, which may affect career choice.

摘要

背景

美国内科住院医师对肾脏病学职业的兴趣正在下降。我们的目标是评估肾脏病学 fellowship 培训项目的存在对内科住院医师对肾脏病学的认知和职业兴趣的影响。次要目标是确定内科住院医师中普遍认可的对肾脏病学的负面看法。

方法

这是一项对两个机构肾脏病学 fellowship 项目设立前（第 1 组）和设立 3 年后（第 2 组）的内科住院医师进行的重复横断面调查。主要结果是第 1 组与第 2 组中表示对肾脏病学有职业兴趣的住院医师百分比。次要结果包括住院医师同意关于肾脏病学负面陈述的频率。

结果

162 名住院医师中有 131 名（80.9%）完成了调查。19 名（14.8%）住院医师表示对肾脏病学职业感兴趣，其中 8 名（6.3%）将肾脏病学列为首选。在住院医师培训期间接触过肾脏病学 fellowship 学员的住院医师（第 2 组）和未接触过的住院医师（第 1 组）之间，对肾脏病学的职业兴趣没有差异。对肾脏病学最普遍认可的负面看法是：肾脏病学 fellowship 学员工作时间长/值班负担重（36 名[28.1%]住院医师同意或强烈同意）、执业肾脏病学家必须频繁/艰难值班（35 名[27.6%]同意或强烈同意）以及肾脏病学进行操作的机会少（35 名[27.3%]同意或强烈同意）。第 2 组中更多住院医师同意肾脏病学报酬低（第 1 组为 8.9%，第 2 组为 20.8%，P = 0.04），而第 1 组中更多住院医师同意肾脏病学家必须频繁/艰难值班（第 1 组为 40.0%，第 2 组为 18.1%，P = 0.02）。