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住院医师对学术医学职业的看法:障碍与机遇

Residents' Perspectives on Careers in Academic Medicine: Obstacles and Opportunities.

作者信息

Lin Steven, Nguyen Cathina, Walters Emily, Gordon Paul

机构信息

Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine.

Society of Teachers of Family Medicine.

出版信息

Fam Med. 2018 Mar;50(3):204-211. doi: 10.22454/FamMed.2018.306625.

Abstract

BACKGROUND AND OBJECTIVES

Worsening faculty shortages in medical schools and residency programs are threatening the US medical education infrastructure. Little is known about the factors that influence the decision of family medicine residents to choose or not choose academic careers. Our study objective was to answer the following question among family medicine residents: "What is your greatest concern or fear about pursuing a career in academic family medicine?"

METHODS

Participants were family medicine residents who attended the Faculty for Tomorrow Workshop at the Society of Teachers of Family Medicine Annual Spring Conference in 2016 and 2017. Free responses to the aforementioned prompt were analyzed using a constant comparative method and grounded theory approach.

RESULTS

A total of 156 participants registered for the workshops and 95 (61%) answered the free response question. Eight distinct themes emerged from the analysis. The most frequently recurring theme was "lack of readiness or mentorship," which accounted for nearly one-third (31%) of the codes. Other themes included work-life balance and burnout (17%), job availability and logistics (15%), lack of autonomy or flexibility (11%), competing pressures/roles (10%), lower financial rewards (4%), politics and bureaucracy (4%), and research (3%).

CONCLUSIONS

To our knowledge, this is the first study to identify barriers and disincentives to pursuing a career in academic medicine from the perspective of family medicine residents. There may be at least eight major obstacles, for which we summarize and consider potential interventions. More research is needed to understand why residents choose, or don't choose, academic careers.

摘要

背景与目的

医学院校和住院医师培训项目师资短缺情况日益严重,正威胁着美国的医学教育基础设施。关于影响家庭医学住院医师选择或不选择学术职业的因素,我们知之甚少。我们的研究目的是在家庭医学住院医师中回答以下问题:“对于从事学术性家庭医学职业,你最担心或害怕的是什么?”

方法

参与者为参加2016年和2017年家庭医学教师协会年度春季会议“明日教师工作坊”的家庭医学住院医师。对上述提示的自由回答采用持续比较法和扎根理论方法进行分析。

结果

共有156名参与者报名参加了工作坊,95名(61%)回答了自由回答问题。分析得出八个不同的主题。最常出现的主题是“准备不足或缺乏指导”,占编码的近三分之一(31%)。其他主题包括工作与生活的平衡和职业倦怠(17%)、工作机会和后勤保障(15%)、缺乏自主权或灵活性(11%)、竞争压力/角色(10%)、经济回报较低(4%)、政治和官僚作风(4%)以及研究(3%)。

结论

据我们所知,这是第一项从家庭医学住院医师角度确定从事学术医学职业的障碍和不利因素的研究。可能至少存在八个主要障碍,我们对此进行了总结并考虑了潜在的干预措施。需要更多研究来了解住院医师选择或不选择学术职业的原因。

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