留不住新一代医生：来自高收入国家的定性见解
Failing to retain a new generation of doctors: qualitative insights from a high-income country.
作者信息
Humphries Niamh, Crowe Sophie, Brugha Ruairí
机构信息
Division of Population Health Sciences, Royal College of Surgeons in Ireland (RCSI), 123 St Stephens Green, Dublin 2, Ireland.
Present Address: Research Department, Royal College of Physicians of Ireland (RCPI), Frederick House, 19 South Frederick Street, Dublin 2, Ireland.
出版信息
BMC Health Serv Res. 2018 Feb 27;18(1):144. doi: 10.1186/s12913-018-2927-y.
BACKGROUND
The failure of high-income countries, such as Ireland, to achieve a self-sufficient medical workforce has global implications, particularly for low-income, source countries. In the past decade, Ireland has doubled the number of doctors it trains annually, but because of its failure to retain doctors, it remains heavily reliant on internationally trained doctors to staff its health system. To halve its dependence on internationally trained doctors by 2030, in line with World Health Organisation (WHO) recommendations, Ireland must become more adept at retaining doctors.
METHOD
This paper presents findings from in-depth interviews conducted with 50 early career doctors between May and July 2015. The paper explores the generational component of Ireland's failure to retain doctors and makes recommendations for retention policy and practice.
RESULTS
Interviews revealed that a new generation of doctors differ from previous generations in several distinct ways. Their early experiences of training and practice have been in an over-stretched, under-staffed health system and this shapes their decision to remain in Ireland, or to leave. Perhaps as a result of the distinct challenges they have faced in an austerity-constrained health system and their awareness of the working conditions available globally, they challenge the traditional view of medicine as a vocation that should be prioritised before family and other commitments. A new generation of doctors have career options that are also strongly shaped by globalisation and by the opportunities presented by emigration.
DISCUSSION
Understanding the medical workforce from a generational perspective requires that the health system address the issues of concern to a new generation of doctors, in terms of working conditions and training structures and also in terms of their desire for a more acceptable balance between work and life. This will be an important step towards future-proofing the medical workforce and is essential to achieving medical workforce self-sufficiency.
背景
爱尔兰等高收入国家未能实现医疗劳动力的自给自足，这具有全球影响，尤其是对低收入的人才输出国而言。在过去十年中，爱尔兰每年培养的医生数量增加了一倍，但由于未能留住医生，其卫生系统仍严重依赖国际培训的医生。为了按照世界卫生组织（WHO）的建议，到2030年将对国际培训医生的依赖减半，爱尔兰必须更善于留住医生。
方法
本文介绍了2015年5月至7月对50名早期职业医生进行深入访谈的结果。本文探讨了爱尔兰未能留住医生的代际因素，并对留用政策和实践提出了建议。
结果
访谈显示，新一代医生在几个不同方面与前几代人有所不同。他们早期的培训和实践经历是在一个过度紧张、人员不足的卫生系统中，这影响了他们留在爱尔兰或离开的决定。也许是由于他们在紧缩政策限制的卫生系统中面临的独特挑战，以及他们对全球工作条件的了解，他们挑战了将医学视为一种应优先于家庭和其他责任的职业的传统观念。新一代医生的职业选择也受到全球化和移民带来的机会的强烈影响。
讨论
从代际角度理解医疗劳动力要求卫生系统解决新一代医生关心的问题，包括工作条件、培训结构，以及他们对工作与生活更可接受平衡的渴望。这将是朝着保障医疗劳动力未来发展迈出的重要一步，也是实现医疗劳动力自给自足的关键。
Zotero 插件