May M, Wolff I, Bründl J, Kriegmair M C, Marghawal D, Wülfing C, Burger M, Necknig U, Schäfer C
Klinik für Urologie, St. Elisabeth-Klinikum Straubing, St.Elisabeth-Str. 23, 94315, Straubing, Deutschland.
Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, Greifswald, Deutschland.
Urologe A. 2019 Dec;58(12):1469-1480. doi: 10.1007/s00120-019-01028-4.
Attending physicians (AP) in urology represent a very heterogeneous group covering various clinical priorities and career objectives. To date, there are no reliable data on professional, personal and position-linked aspects of AP in urology working in university centers (univ-AP) opposed to those working in non-university centers (n-univ-AP).
The objective of this study was to analyze individual professional perspectives, professional and personal settings, specific job-related activities and individual professional goals of univ-AP opposed to n‑univ-AP. Thus, a web-based survey containing 55 items was designed to perform a cross-sectional study that was then forwarded using a link which was sent via a mailing list of the German Society of Urology. The survey was available for completion by AP at German urological centers from February to April 2019. Group-specific differences were evaluated using bootstrap-adjusted multivariate logistic regression models.
Of the 192 evaluable surveys, 61 (31.8%) and 131 (68.2%) were part of the univ-AP and n‑univ-AP study group, respectively. Participating n‑univ-AP compared to univ-AP held the position of AP (p = 0.022) significantly longer and were on call significantly more frequently (p < 0.001). AP in urology (self)-assessed themselves as autonomously confident in performing robotic, laparoscopic, open, endo-urologic, and plastic-reconstructive surgery in 12.4%, 25%, 59.6%, 92.1%, and 25.7%, respectively, with no significant differences between the two groups among all above mentioned surgical subdomains based on multivariate analysis. AP in urology were (very) content in 92% concerning the choice of their discipline, in 73.9% concerning their actual working circumstances, and in 60.2% concerning their level of surgical expertise. Only 27.1% and 19.9% were (very) content with the amount of available time for their personal professional development and for private affairs, respectively. As opposed to n‑univ-AP, univ-AP would choose a career in clinical centers once again significantly more frequently (OR 2.87; p = 0.041), but assess the position of AP as their definitive career goal significantly less frequently (OR 0.42; p = 0.40). Univ-AP state significantly more frequently that they were running for the position of head of department or full professor (OR 5.64; p = 0.001).
In this first survey study world-wide on AP in urology divided according to their academic background, similarities and variances were analyzed, baring the potential to further improve identification of AP for a career in clinical centers.
泌尿外科的主治医师群体非常多样化，涵盖了各种临床重点和职业目标。迄今为止，与在非大学中心工作的泌尿外科主治医师（n-univ-AP）相比，尚无关于在大学中心工作的泌尿外科主治医师（univ-AP）的专业、个人及与职位相关方面的可靠数据。
本研究的目的是分析univ-AP与n-univ-AP的个人专业观点、专业和个人背景、特定的与工作相关活动以及个人职业目标。因此，设计了一项包含55个项目的基于网络的调查问卷，以进行横断面研究，然后通过德国泌尿外科协会邮件列表发送的链接转发该问卷。2019年2月至4月，德国泌尿外科中心的主治医师可通过该链接完成调查。使用经自助法调整的多变量逻辑回归模型评估组间差异。
在192份可评估的调查问卷中，分别有61份（31.8%）和131份（68.2%）属于univ-AP和n-univ-AP研究组。与univ-AP相比，参与调查的n-univ-AP担任主治医师职位的时间显著更长（p = 0.022），且值班频率显著更高（p < 0.001）。泌尿外科主治医师自我评估在进行机器人手术、腹腔镜手术、开放手术、腔内泌尿外科手术和整形重建手术时的自主信心分别为12.4%、25%、59.6%、92.1%和25.7%，基于多变量分析，上述所有手术亚领域在两组之间均无显著差异。92%的泌尿外科主治医师对其学科选择（非常）满意，73.9%对其实际工作环境满意，60.2%对其手术专业水平满意。分别只有27.1%和19.9%的人对用于个人职业发展和私人事务的可用时间（非常）满意。与n-univ-AP相比，univ-AP再次选择在临床中心工作的频率显著更高（OR 2.87；p = 0.041），但将主治医师职位视为其最终职业目标的频率显著更低（OR 0.42；p = 0.40）。univ-AP更频繁地表示他们正在竞选科室主任或正教授职位（OR 5.64；p = 0.001）。
在这项全球范围内首次针对按学术背景划分的泌尿外科主治医师的调查研究中，分析了他们的异同，为进一步改善临床中心主治医师职业的识别提供了潜力。
