Hafferty F W, Boulger J G
Department of Behavioral Sciences, University of Minnesota, School of Medicine, Duluth 55812.
Fam Med. 1988 Jul-Aug;20(4):277-81.
All students at the University of Minnesota, Duluth, School of Medicine responded to a 65-item questionnaire about their perceptions of changes facing medicine, the future of family practice, and career choices. Three different orientations toward family practice were identified--"stayers," "defectors," and "potential defectors." Students who had abandoned their original preference for family medicine (defectors) were compared with students who had maintained an interest in family medicine (stayers). Defectors anticipated a diminishing clinical role for future family practitioners, expressed doubt about the financial viability of smaller community based family practices, and explicitly linked concerns about their anticipated debt load to their changes in career preferences. This study also identified a subgroup of "potential defector" students (within the stayer cohort) who maintained an interest in family practice but evidenced concerns similar to the defector students. Implications of these findings for the future supply of primary care physicians for rural and traditionally underserved communities are discussed.
明尼苏达大学德卢斯医学院的所有学生都对一份包含65个项目的问卷做出了回应，问卷内容涉及他们对医学面临的变化、家庭医疗的未来以及职业选择的看法。研究确定了三种不同的家庭医疗取向——“坚守者”、“背离者”和“潜在背离者”。将放弃最初对家庭医学偏好的学生（背离者）与一直对家庭医学感兴趣的学生（坚守者）进行了比较。背离者预计未来家庭医疗从业者的临床角色会逐渐减少，对小型社区家庭医疗实践的财务可行性表示怀疑，并明确将对预期债务负担的担忧与职业偏好的变化联系起来。这项研究还确定了一个“潜在背离者”学生亚组（在坚守者群体中），他们对家庭医疗仍感兴趣，但表现出与背离者学生类似的担忧。文中讨论了这些发现对农村和传统上服务不足社区未来初级保健医生供应的影响。
