Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (JJC).
Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS).
Hawaii J Health Soc Welf. 2020 Aug 1;79(8):240-245.
The objective of this study was to assess the impact of medical school, sex, career choice, and location of practice of one pediatric residency program on physician workforce. This is a retrospective study of all categorical pediatric graduates of a residency program located in Honolulu, Hawai'i from 1968 to 2015. Information on medical school training, sex, career choice (general pediatrics or specialty), and location of practice were studied by examining data into five 10-year graduation periods. The program graduated 319 residents over nearly a 50-year timespan. Of these, 181 (56.7%) residents remained in Hawai'i to practice (adjusted odds ratio [OR] = 7.46, 95% confidence interval [CI]: 3.61-15.43). There were 125 (39.1%) graduates who relocated to the continental US with the majority moving to the West (55.2%), while other graduates moved to the South, Midwest, and Northeast (25.6%, 13.6%, and 5.6%, respectively). The remaining 13 (4.1%) graduates moved internationally. Female residents steadily increased over time ( < .001), with females significantly choosing general pediatrics (OR = 3.05, 95% CI: 1.91-4.89). In the time periods with the highest percentage of University of Hawai'i medical school graduates, there was an increased percentage of graduates staying in Hawai'i. This study examined the regional and national impact of a small residency program. The results indicated that trends in gender and the impact of medical school location were important in establishing a pediatrician workforce for local communities. Support of both medical school and residency education should be considered when assessing future workforce needs.
本研究旨在评估医学专业、性别、职业选择和实习地点对医生队伍的影响。这是一项对位于夏威夷火奴鲁鲁的一个住院医师项目的所有儿科住院医师的回顾性研究，研究对象为 1968 年至 2015 年期间的所有住院医师。通过检查数据，将医学专业培训、性别、职业选择（普通儿科或专科）和实习地点等信息分为五个 10 年毕业期进行研究。该项目在近 50 年的时间里共培养了 319 名住院医师。其中，181 名（56.7%）住院医师选择留在夏威夷行医（调整后的优势比[OR] = 7.46，95%置信区间[CI]：3.61-15.43）。125 名（39.1%）毕业生搬迁到美国大陆，其中大部分人迁往西部（55.2%），其他毕业生则迁往南部、中西部和东北部（分别为 25.6%、13.6%和 5.6%）。其余 13 名（4.1%）毕业生则迁往国际。女性住院医师的比例随着时间的推移稳步上升（<0.001），且女性更倾向于选择普通儿科（OR = 3.05，95% CI：1.91-4.89）。在拥有最多夏威夷大学医学院毕业生的时间段，留在夏威夷的毕业生比例有所增加。本研究考察了一个小型住院医师项目对地区和全国的影响。结果表明，性别趋势和医学院所在地的影响在为当地社区建立儿科医生队伍方面非常重要。在评估未来劳动力需求时，应考虑对医学院和住院医师教育的支持。
