Fischer Jonathan P, Clinite Kimberly, Sullivan Eric, Jenkins Tania M, Bourne Christina L, Chou Calvin, Diemer Gretchen, Dunne Dana, Hartung Paul J, Paauw Doug, Reddy Shalini
University of Chicago Pritzker School of Medicine, 924 E 57th St., Suite 104, Chicago, IL 60637 USA.
Santa Rosa Family Medicine Residency, University of California, San Francisco, San Francisco, CA USA.
Med Sci Educ. 2019 Aug 8;29(4):995-1001. doi: 10.1007/s40670-019-00790-6. eCollection 2019 Dec.
Medical student specialty choices have significant downstream effects on the availability of physicians and, ultimately, the effectiveness of health systems. This study investigated how medical student specialty preferences change over time in relation to their demographics and lifestyle preferences.
Students from ten medical schools were surveyed at matriculation (2012) and graduation (2016). The two surveys included questions about specialty and lifestyle preferences, demographics, educational background, and indebtedness. Student data from 2012 to 2016 were paired together and grouped into those whose specialty preferences remained constant or switched.
Response rates in 2012 and 2016 were 65% (997/1530) and 50% (788/1575), respectively. Fourth-year students ranked "enjoying the type of work I am doing" as less important to a good physician lifestyle than did first-year students (from 59.6 to 39.7%). The lifestyle factors "having control of work schedule" and "having enough time off work" were ranked as more important to fourth-year students than first-year students (from 15.6 to 18.2% and 14.8 to 31.9%, respectively). The paired dataset included 19% of eligible students (237/1226). Demographic and lifestyle factors were not significantly associated with specialty preference switching. Additionally, no significant association existed between changing lifestyle preferences and switching specialty preference ( 0.85).
During the course of medical school, lifestyle preferences became more focused on day-to-day factors and less on deeper motivational factors. Neither demographics nor lifestyle preferences appear to relate to a student's decision to switch specialty preference during medical school. These findings represent an important step in uncovering causes of specialty preference trends.
医学生的专业选择对医生的可获得性以及最终卫生系统的有效性具有重大的下游影响。本研究调查了医学生的专业偏好如何随时间变化,以及与他们的人口统计学和生活方式偏好之间的关系。
对来自十所医学院校的学生在入学时(2012年)和毕业时(2016年)进行了调查。这两次调查包括有关专业和生活方式偏好、人口统计学、教育背景以及债务情况的问题。将2012年至2016年的学生数据进行配对,并分为专业偏好保持不变或发生转变的学生。
2012年和2016年的回复率分别为65%(997/1530)和50%(788/1575)。与一年级学生相比,四年级学生将“享受我正在从事的工作类型”列为对良好医生生活方式不太重要的因素(从59.6%降至39.7%)。生活方式因素“能够控制工作时间表”和“有足够的休假时间”对四年级学生而言比一年级学生更为重要(分别从15.6%升至18.2%和从14.8%升至31.9%)。配对数据集包括19%的符合条件的学生(237/1226)。人口统计学和生活方式因素与专业偏好转变没有显著关联。此外,生活方式偏好的改变与专业偏好的转变之间也不存在显著关联(P = 0.85)。
在医学院学习期间,生活方式偏好变得更加关注日常因素,而较少关注更深层次的动机因素。人口统计学和生活方式偏好似乎都与医学生在医学院期间改变专业偏好的决定无关。这些发现是揭示专业偏好趋势原因的重要一步。