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揭示全国精神病学培训学员队列的培训进展趋势:离散时间生存分析。

Uncovering trends in training progression for a national cohort of psychiatry trainees: discrete-time survival analysis.

作者信息

Silkens Milou E W M, Sarker Shah-Jalal, Medisauskaite Asta

机构信息

Research Department of Medical Education, UCL Medical School, University College London, UK.

Research Department of Medical Education, UCL Medical School, University College London, UK; and UCL Queen Square Institute of Neurology, School of Life & Medical Sciences, University College London, UK.

出版信息

BJPsych Open. 2021 Jun 28;7(4):e120. doi: 10.1192/bjo.2021.958.

Abstract

BACKGROUND

The global rise in mental health issues calls for a strong psychiatry workforce. Yet, psychiatry training worldwide is facing recruitment challenges, causing unfilled consultant posts and possibly threatening the quality of patient care. An in-depth understanding of trainees' progression through training is warranted to explore what happens to recruited trainees during training.

AIMS

To uncover current trends in psychiatry trainees' progression through training in the UK.

METHOD

This national retrospective cohort study with data from the UK Medical Education Database used discrete-time survival analysis to analyse training progression for those trainees who started their core psychiatry post in 2012-2017 (2820 trainees; 59.6% female, 67.6% UK graduates (UKGs)). The impact of sociodemographic characteristics on training progression were also investigated.

RESULTS

The overall probability of completing training in 6 years (minimum years required to complete psychiatry training in the UK) was 17.2% (ranging from 4.8% for non-UKG females to 29% for UKG males). The probability to not progress was highest (57.1%) from core to specialty training. For UKGs, trainees from ethnicities other than White, trainees with a disability, and trainees who had experienced childhood social deprivation (measured as entitlement to free school meals) had a significantly (P ≤ 0.02) lower probability of completing training in 6 years.

CONCLUSIONS

Less than one in five psychiatry trainees are likely to complete training in 6 years and this probability varies across groups of doctors. Completing psychiatry training in 6 years is, therefore, the exception rather than the norm and this has important implications for trainees, those planning psychiatry workforces or responsible for psychiatry training.

摘要

背景

全球心理健康问题的增加需要一支强大的精神科专业队伍。然而,全球精神科培训面临招募挑战,导致顾问职位空缺,可能威胁到患者护理质量。有必要深入了解学员在培训过程中的进展情况,以探究已招募学员在培训期间的情况。

目的

揭示英国精神科受训人员在培训过程中的当前趋势。

方法

这项全国性回顾性队列研究使用了来自英国医学教育数据库的数据,采用离散时间生存分析来分析2012 - 2017年开始核心精神科岗位培训的学员(2820名学员;59.6%为女性,67.6%为英国毕业生(UKG))的培训进展情况。还调查了社会人口学特征对培训进展的影响。

结果

在6年(英国完成精神科培训所需的最短年限)内完成培训的总体概率为17.2%(从非英国毕业生女性的4.8%到英国毕业生男性的29%不等)。从核心培训到专科培训不继续进展的概率最高(57.1%)。对于英国毕业生,非白人种族的学员、残疾学员以及经历过童年社会剥夺(以享受免费学校餐的资格衡量)的学员在6年内完成培训的概率显著较低(P≤0.02)。

结论

不到五分之一的精神科受训人员可能在6年内完成培训,且这一概率因医生群体而异。因此,在6年内完成精神科培训是例外而非常态,这对受训人员、规划精神科专业队伍的人员或负责精神科培训的人员具有重要意义。

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