Robinson Lee A, Osborne Lauren M, Hsu Alan J, Park Henry, Arbuckle Melissa R
Cambridge Health Alliance, Cambridge, MA, USA.
The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Acad Psychiatry. 2019 Feb;43(1):46-50. doi: 10.1007/s40596-018-1004-5. Epub 2018 Nov 19.
This study sought to assess the prevalence of moonlighting among psychiatry residents; the perceived effects of moonlighting on resident recruitment, education, and liability; and policies and practices governing oversight.
In 2013, surveys were emailed to all general psychiatry residency programs that were accredited by the Accreditation Council for Graduate Medical Education and had available contact information (n = 183). Resident surveys were emailed to program coordinators with a request to forward the survey link to their residents.
Responses were received from 63 program directors (34% response rate) and 238 residents (about 5% of total general psychiatry residents). Most psychiatry program directors (95%) indicated that their programs permit moonlighting. Moonlighting participation increased with each year of training, culminating with 67% of fourth year residents. Most residents and faculty (87%) agreed that moonlighting enhanced resident education. Thirty-seven percent of program directors reported having no oversight procedures in place to monitor moonlighting activities. Thirty-nine percent of resident survey responders reported having no supervision for at least one of their moonlighting activities and only 9% reported always having access to on-site supervision.
Though limited by a low response rate, this study found that moonlighting seems to remain prevalent among psychiatry residents and widely accepted by psychiatry residency training programs. There appears to be relatively limited program oversight for moonlighting activities, many of which seem to lack close supervision.
本研究旨在评估精神科住院医师兼职的普遍性;兼职对住院医师招聘、教育及责任的感知影响;以及管理监督的政策与实践。
2013年,研究人员向所有经毕业后医学教育认证委员会认证且有可用联系信息的普通精神科住院医师培训项目发送了电子邮件调查问卷(n = 183)。住院医师调查问卷通过电子邮件发送给项目协调员,并请求他们将调查链接转发给住院医师。
收到了63位项目主任的回复(回复率为34%)以及238位住院医师的回复(约占普通精神科住院医师总数的5%)。大多数精神科项目主任(95%)表示他们的项目允许兼职。兼职参与率随着培训年份的增加而上升,四年级住院医师的参与率最高,达到67%。大多数住院医师和教员(87%)认为兼职能提高住院医师教育水平。37%的项目主任报告称没有监督兼职活动的程序。39%的住院医师调查问卷回复者报告称至少有一项兼职活动没有得到监督,只有9%的回复者报告称总能获得现场监督。
尽管受到低回复率的限制,但本研究发现兼职在精神科住院医师中似乎仍然普遍存在,并且被精神科住院医师培训项目广泛接受。对于兼职活动,项目监督似乎相对有限,其中许多活动似乎缺乏密切监督。