Cantone Rebecca E, Deiorio Nicole M, Polston Alex, Schneider Benjamin
Department of Family Medicine, Oregon Health & Science University, Portland, OR.
Virginia Commonwealth University School of Medicine, Richmond, VA.
PRiMER. 2018 Dec 12;2:30. doi: 10.22454/PRiMER.2018.643028. eCollection 2018.
The medical education community is piloting early entry to residency as a potential outcome to competency-based education and as a way to more quickly train future physicians in specialties of need. However, there is limited knowledge of which specialties may be best suited to this streamlined training. Student career desires may change over the course of their undergraduate training. We aimed to understand which specialties have stable student interest from matriculation to residency match in an effort to highlight which fields may be reasonable to consider for such accelerated programs.
Medical students at one school of medicine who matriculated in the years 2009-2013 were surveyed upon entry regarding the medical specialty they were most interested in pursuing. Six hundred fifty-four students were eligible for inclusion and 535 of the records met all requirements. On completion of medical school, final specialty choice for students obtaining a residency position was recorded. The data were analyzed to assess specialties with the highest versus the lowest rates of retention.
Of 535 included students, the top specialties with retention of interest (no change in specialty choice for that student) from matriculation to match were physical medicine and rehabilitation, (100%, n=3 retention/3 initial), psychiatry (57.1%, 4/7), internal medicine (48.5%, 47/97), and family medicine (47.7%, 41/86). The specialties with the lowest retention were pathology (0%, 0/2), preventive medicine (0%, 0/4), dermatology (12%, 1/8), neurology (16.7%, 3/18) and radiation oncology (16.7%, 1/6).
Some specialties that attract student interest before matriculation may be more likely to maintain interest compared to others. This suggests a need for further research to determine if residency entry can begin earlier than traditionally thought, with certain fields better suited for accelerated training.
医学教育界正在试行提前进入住院医师培训阶段，将其作为基于能力的教育的一个潜在成果，以及一种更快地培养急需专业未来医生的方式。然而，对于哪些专业可能最适合这种简化培训，人们了解有限。学生的职业愿望可能在本科培训过程中发生变化。我们旨在了解从入学到住院医师匹配过程中，哪些专业能保持学生稳定的兴趣，以便突出哪些领域可能适合此类加速项目。
对一所医学院在2009年至2013年入学的医学生入学时就他们最感兴趣的医学专业进行了调查。654名学生符合纳入条件，其中535份记录满足所有要求。在医学院毕业时，记录获得住院医师职位的学生的最终专业选择。对数据进行分析，以评估兴趣保持率最高和最低的专业。
在纳入的535名学生中，从入学到匹配时兴趣保持（该学生专业选择无变化）的前几个专业是物理医学与康复（100%，n = 3人保持/3人初始选择）、精神病学（57.1%，4/7）、内科（48.5%，47/97）和家庭医学（47.7%，41/86）。兴趣保持率最低的专业是病理学（0%，0/2）、预防医学（0%，0/4）、皮肤病学（12%，1/8）、神经病学（16.7%，3/18）和放射肿瘤学（16.7%，1/6）。
与其他专业相比，一些在入学前就吸引学生兴趣的专业可能更有可能保持这种兴趣。这表明需要进一步研究，以确定住院医师培训是否可以比传统认为的更早开始，某些领域是否更适合加速培训。
