Yoon John D, Ham Sandra A, Reddy Shalini T, Curlin Farr A
J Grad Med Educ. 2018 Apr;10(2):149-154. doi: 10.4300/JGME-D-17-00063.1.
Role models in medical school may influence students' residency specialty choice.
We examined whether medical students who reported clinical exposure to a role model during medical school would have an increased likelihood of selecting the role model's specialty for their residencies.
We conducted a 5-year prospective, national longitudinal study (2011-2016) of medical students from 24 US allopathic medical schools, starting from the middle of their third year. The primary outcome measure was type of residency specialty choice 4 years after graduation. Main predictors were the clinical specialty of a student's most admired physician and the relative importance of 7 potentially influential factors for specialty choice in the fourth year of medical school.
From 919 eligible participants, 564 (61%) responded to the first survey; 474 of the respondents (84%) completed the follow-up survey. We excluded 29 participants who were not in their fourth year by the time of the follow-up survey. Of the follow-up respondents, 427 (96%) had specialty data 4 years after graduation. In our multivariate models, exposure to an admired generalist physician prior to medical school (odds ratio [OR] = 2.21, 95% confidence interval [CI] 1.03-4.73) and during medical school (OR = 2.62, 95% CI 1.69-4.05) had the strongest odds with respect to training in a generalist residency 4 years after graduation. Role model exposure also predicted specialty choice among those training in surgical and radiology, ophthalmology, anesthesiology, and dermatology (ROAD) specialties.
Personal exposure to role models in medical school is an important predictor of residency training in that role model's specialty.
医学院校中的榜样可能会影响学生对住院医师培训专业的选择。
我们研究了那些在医学院校期间报告有临床接触榜样经历的医学生，是否更有可能选择榜样的专业作为他们的住院医师培训专业。
我们对来自美国24所全科医学医学院校的医学生进行了一项为期5年的前瞻性全国纵向研究（2011 - 2016年），从他们三年级中期开始。主要结局指标是毕业后4年的住院医师培训专业类型。主要预测因素是学生最钦佩的医生的临床专业，以及医学院四年级时7个可能影响专业选择的因素的相对重要性。
在919名符合条件的参与者中，564人（61%）回复了第一次调查；474名受访者（84%）完成了后续调查。我们排除了29名在后续调查时不在四年级的参与者。在后续受访者中，427人（96%）有毕业后4年的专业数据。在我们的多变量模型中，医学院校之前（优势比[OR] = 2.21，95%置信区间[CI] 1.03 - 4.73）和医学院校期间（OR = 2.62，95% CI 1.69 - 4.05）接触到令人钦佩的全科医生，对于毕业后4年接受全科住院医师培训的可能性影响最大。榜样接触也预测了外科、放射科、眼科、麻醉科和皮肤科（ROAD）专业培训学生的专业选择。
在医学院校中亲身接触榜样是住院医师培训选择榜样专业的一个重要预测因素。
