Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA.
BMC Med Educ. 2020 Jul 28;20(1):238. doi: 10.1186/s12909-020-02154-w.
The unique traits of residents who matriculate into subspecialty fellowships are poorly understood. We sought to identify characteristics of internal medicine (IM) residents who match into cardiovascular (CV) fellowships.
We conducted a retrospective cohort study of 8 classes of IM residents who matriculated into residency from 2007 to 2014. The primary outcome was successful match to a CV fellowship within 1 year of completing IM residency. Independent variables included residents' licensing exam scores, research publications, medical school reputation, Alpha Omega Alpha (AOA) membership, declaration of intent to pursue CV in the residency application personal statement, clinical evaluation scores, mini-clinical evaluation exercise scores, in-training examination (ITE) performance, and exposure to CV during residency.
Of the 339 included residents (59% male; mean age 27) from 120 medical schools, 73 (22%) matched to CV fellowship. At the time of residency application, 104 (31%) had ≥1 publication, 38 (11%) declared intention to pursue CV in their residency application personal statement, and 104 (31%) were members of AOA. Prior to fellowship application, 111 (33%) completed a CV elective rotation. At the completion of residency training, 108 (32%) had ≥3 publications. In an adjusted logistic regression analysis, declaration of intention to pursue CV (OR 6.4, 99% CI 1.7-23.4; p < 0.001), completion of a CV elective (OR 7.3, 99% CI 2.8-19.0; p < 0.001), score on the CV portion of the PGY-2 ITE (OR 1.05, 99% CI 1.02-1.08; p < 0.001), and publication of ≥3 manuscripts (OR 4.7, 99% CI 1.1-20.5; p = 0.007) were positively associated with matching to a CV fellowship. Overall PGY-2 ITE score was negatively associated (OR 0.93, 99% CI 0.90-0.97; p < 0.001) with matching to a CV fellowship.
Residents' matriculation into CV fellowships was associated with declaration of CV career intent, completion of a CV elective rotation, CV medical knowledge, and research publications during residency. These findings may be useful when advising residents about pursuing careers in CV. They may also help residents understand factors associated with a successful match to a CV fellowship. The negative association between matching into CV fellowship and overall ITE score may indicate excessive subspecialty focus during IM residency.
进入专业奖学金的住院医师的独特特征了解甚少。我们试图确定符合心血管（CV）奖学金要求的内科（IM）住院医师的特征。
我们对 2007 年至 2014 年期间从住院医师转为住院医师的 8 个班级的 IM 住院医师进行了回顾性队列研究。主要结局是在完成 IM 住院医师后 1 年内成功匹配到 CV 奖学金。自变量包括住院医师执照考试成绩、研究出版物、医学院声誉、Alpha Omega Alpha（AOA）会员资格、在住院医师申请个人陈述中声明打算从事 CV、临床评估分数、迷你临床评估练习分数、在培训考试（ITE）表现以及住院期间接受 CV。
在 339 名来自 120 所医学院的住院医师（59%为男性；平均年龄 27 岁）中，有 73 名（22%）符合 CV 奖学金要求。在住院医师申请时，有 104 名（31%）有≥1 篇论文发表，38 名（11%）在住院医师申请个人陈述中声明打算从事 CV，104 名（31%）是 AOA 会员。在申请奖学金之前，有 111 名（33%）完成了 CV 选修课程。在住院医师培训结束时，有 108 名（32%）有≥3 篇论文发表。在调整后的逻辑回归分析中，意向声明追求 CV（OR 6.4，99%CI 1.7-23.4；p<0.001）、完成 CV 选修课程（OR 7.3，99%CI 2.8-19.0；p<0.001）、PGY-2 ITE 中 CV 部分的分数（OR 1.05，99%CI 1.02-1.08；p<0.001）和发表≥3 篇论文（OR 4.7，99%CI 1.1-20.5；p=0.007）与匹配 CV 奖学金呈正相关。总体 PGY-2 ITE 评分与匹配 CV 奖学金呈负相关（OR 0.93，99%CI 0.90-0.97；p<0.001）。
住院医师进入 CV 奖学金与 CV 职业意向声明、完成 CV 选修课程、CV 医学知识和住院期间研究出版物有关。这些发现可能对住院医师从事 CV 职业提供有用的建议。它们还可以帮助住院医师了解与成功匹配 CV 奖学金相关的因素。与 CV 奖学金匹配的 ITE 总分呈负相关（OR 0.93，99%CI 0.90-0.97；p<0.001），可能表明在 IM 住院医师培训期间过度专注于专业。
