Morales-Pico Brenda M, Cotton Cary C, Morrell Dean S
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Dermatol Online J. 2016 Nov 15;22(11):13030/qt7295783b.
The demand for dermatologic services and training at academic medical centers has outpaced the growth in the field's academic workforce. Recruitment of graduating residents has been proposed as a solution to the shortage of academic dermatologists. The purpose of this study was to further our current understanding of the factors that support the recruitment and retention of academicians. A survey questionnaire was mailed to graduates of the dermatology residency program at the University of North Carolina, and data were gathered retrospectively from participants' residency application materials. The factors from residency applications that predicted initial practice setting and the driving factors behind the choice of initial practice in academia were analyzed using generalized linear models. Of the department's 39 graduates between 2005 and 2014, 37 (95%) completed our survey. Sixteen graduates (43%) remained in academia upon completion of residency, whereas fourteen graduates (38%) are currently in academic practices. Those who had obtained a PhD before starting residency were more likely than their peers to initially accept academic positions (RR 2.73, 95% CL 1.64, 4.71, p = 0.05). However, other applicant characteristics available from residency application materials poorly predicted graduates' likelihood of remaining in academia at the time of graduation. In free-text survey responses, graduates who joined academic practices upon completion of residency were significantly more likely to cite teaching opportunities (PR 3.01, 95% CL 1.60-5.78, p = 0.05) and practice environment (PR 2.97, 95% CL 1.51-6.37, p = 0.05) as factors that had strongly influenced their initial career decisions. Because it is difficult to predict which residency applicants will ultimately pursue careers in academia, promoting the desirable aspects of the academic practice setting during residency training may be a better strategy for addressing the academic workforce shortage than the selection of residency applicants who possess specific characteristics.
学术医疗中心对皮肤科服务和培训的需求超过了该领域学术劳动力的增长速度。招募即将毕业的住院医师被提议作为解决学术皮肤科医生短缺问题的一种方法。本研究的目的是进一步加深我们目前对支持院士招募和留用的因素的理解。一份调查问卷被邮寄给北卡罗来纳大学皮肤科住院医师项目的毕业生，并从参与者的住院医师申请材料中进行回顾性数据收集。使用广义线性模型分析住院医师申请中的因素，这些因素预测了初始执业环境以及选择在学术界进行初始执业背后的驱动因素。在该部门2005年至2014年期间的39名毕业生中，37名（95%）完成了我们的调查。16名毕业生（43%）在完成住院医师培训后留在了学术界，而14名毕业生（38%）目前从事学术工作。那些在开始住院医师培训前获得博士学位的人比同龄人更有可能最初接受学术职位（相对风险2.73，95%置信区间1.64，4.71，p = 0.05）。然而，从住院医师申请材料中获得的其他申请人特征很难预测毕业生在毕业时留在学术界的可能性。在自由文本调查回复中，完成住院医师培训后加入学术工作的毕业生更有可能将教学机会（相对风险3.01，95%置信区间1.60 - 5.78，p = 0.05）和执业环境（相对风险2.97，95%置信区间1.51 - 6.37，p = 0.05）作为对其初始职业决策有强烈影响的因素。由于很难预测哪些住院医师申请人最终会在学术界追求职业发展，因此在住院医师培训期间宣传学术执业环境的理想方面可能是解决学术劳动力短缺问题比挑选具有特定特征的住院医师申请人更好的策略。
