Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida.
Department of Radiation Oncology, University of Wisconsin, Madison, Wisconsin.
Int J Radiat Oncol Biol Phys. 2020 Mar 15;106(4):683-689. doi: 10.1016/j.ijrobp.2019.11.030.
Data regarding the amount and use of nonclinical time (NCT) in radiation oncology residency programs are scarce. We surveyed every U.S. radiation oncology residency program to obtain benchmark data to inform decisions about optimal program structure.
An anonymous, web-based survey was distributed to postgraduate year 5 residents at Accreditation Council for Graduate Medical Education-accredited radiation oncology training programs. The survey included 33 yes/no, Likert-scale, and free-response questions. Program data were analyzed for all programs, including those considered "top 10" per Doximity and those "not top 10." Likert-scale responses were dichotomized as "not as satisfied" (1, 2, 3) or "very satisfied" (4, 5).
One hundred twenty-six residents (69%) completed the survey. Program-specific data were obtained for 100% of programs (n = 82). Almost all training programs (98%) provide residents with protected NCT. Including programs with no NCT, the median NCT is 10 months in all programs. The median NCT is 12 months in "top 10" programs and 9 months in "not top 10" programs (P < .01). Most programs (68%) reported >6 months of NCT. The proportion of residents wanting more NCT decreased as the amount of NCT increased (73%, 52%, and 19% for 4-6, 7-9, and 10-12 months, respectively; P < .01). The proportion of residents who were very satisfied with NCT flexibility increased with more NCT (64%, 79%, and 94% for 4-6, 7-9, and 10-12 months, respectively; P < .01), as did the proportion of residents who were very satisfied with accomplishments during NCT (35%, 53%, and 72% for 4-6, 7-9, and 10-12 months, respectively; P < .01). When asked whether residents would theoretically give up some NCT to shorten residency, the proportion of residents willing to shorten their residencies decreased as the amount of NCT increased (65%, 47%, and 33% for 4-6, 7-9, and 10-12 months respectively; P = .04).
Programs should maintain an emphasis on NCT and implement measures to ensure meaningful resident experiences.
有关放射肿瘤学住院医师培训计划中非临床时间（NCT）的数量和使用情况的数据很少。我们调查了每个美国放射肿瘤学住院医师培训计划，以获取基准数据，为优化计划结构提供信息。
向美国研究生医学教育认证委员会（Accreditation Council for Graduate Medical Education）认可的放射肿瘤学培训计划的五年级住院医师发放了一项匿名的、基于网络的调查。该调查包括 33 个是/否、李克特量表和自由回答问题。对所有项目的数据进行了分析，包括那些被 Doximity 认为是“前 10 名”的项目和那些“不在前 10 名”的项目。李克特量表的反应被分为“不满意”（1、2、3）或“非常满意”（4、5）。
126 名居民（69%）完成了调查。对 100%的项目（n=82）获得了项目特定的数据。几乎所有的培训项目（98%）都为住院医师提供了受保护的 NCT。包括没有 NCT 的项目，所有项目的 NCT 中位数为 10 个月。“前 10 名”项目的 NCT 中位数为 12 个月，“不在前 10 名”项目的 NCT 中位数为 9 个月（P<.01）。大多数项目（68%）报告的 NCT 超过 6 个月。随着 NCT 的增加，希望获得更多 NCT 的居民比例下降（分别为 73%、52%和 19%，用于 4-6、7-9 和 10-12 个月；P<.01）。对 NCT 灵活性非常满意的居民比例随着 NCT 的增加而增加（分别为 64%、79%和 94%，用于 4-6、7-9 和 10-12 个月；P<.01），对 NCT 期间完成的工作非常满意的居民比例也随之增加（分别为 35%、53%和 72%，用于 4-6、7-9 和 10-12 个月；P<.01）。当被问及居民是否理论上愿意放弃一些 NCT 来缩短住院医师培训时间时，愿意缩短住院医师培训时间的居民比例随着 NCT 的增加而下降（分别为 65%、47%和 33%，用于 4-6、7-9 和 10-12 个月；P=0.04）。
各项目应保持对 NCT 的重视，并实施措施以确保住院医师获得有意义的体验。
