澳大利亚初级医生进入研究生专业培训的障碍：基于访谈的研究。
Barriers to getting into postgraduate specialty training for junior Australian doctors: An interview-based study.
机构信息
Rural Clinical School, The University of Queensland, Toowoomba, Queensland, Australia.
Rural Clinical School, The University of Queensland, Rockhampton, Queensland, Australia.
出版信息
PLoS One. 2021 Oct 21;16(10):e0258584. doi: 10.1371/journal.pone.0258584. eCollection 2021.
BACKGROUND
Medical training is a long process that is not complete until doctors finish specialty training. Getting into specialty training is challenging because of strong competition for limited places, depending on doctors' chosen field. This may have a negative impact on doctor well-being and reduce the efficiency of the medical training system. This study explored the barriers of pre-registrar (junior) doctors getting into specialty training programs to inform tailored support and re-design of speciality entry systems.
METHODS
From March to October 2019, we conducted 32 semi-structured interviews with early-career doctors in Australia, who had chosen their specialty field, and were either seeking entry, currently undertaking or had recently completed various fields of specialty training. We sought reflections about barriers and major influences to getting into specialty training. In comparing and contrasting generated themes, different patterns emerged from doctors targeting traditionally non-competitive specialty fields like General Practice (GP) and other specialties (typically more competitive fields). As a result we explored the data in this dichotomy.
RESULTS
Doctors targeting entry to GP specialties had relatively seamless training entry and few specific barriers. In contrast, those pursuing other specialties, regardless of which ones, relayed multiple barriers of: Navigating an unpredictable and complex system with informal support/guidance; Connecting to the right people/networks for relevant experience; Pro-actively planning and differentiating skills with recurrent failure of applications.
CONCLUSIONS
Our exploratory study suggests that doctors wanting to get into non-GP specialty training may experience strong barriers, potentially over multiple years, with the capacity to threaten their morale and resilience. These could be addressed by a clearinghouse of information about different speciality programs, broader selection criteria, feedback on applications and more formal guidance and professional supports. The absence of challenges identified for doctors seeking entry to GP could be used to promote increased uptake of GP careers.
背景
医学培训是一个漫长的过程，只有医生完成专业培训后才算完成。由于对有限名额的激烈竞争，进入专业培训具有挑战性，这取决于医生选择的领域。这可能对医生的幸福感产生负面影响，并降低医学培训系统的效率。本研究旨在探讨住院医师（初级）进入专科培训计划的障碍，以为有针对性的支持和专科入学系统的重新设计提供信息。
方法
在 2019 年 3 月至 10 月期间，我们对澳大利亚的早期职业医生进行了 32 次半结构化访谈，这些医生已经选择了自己的专业领域，要么正在寻求进入专业培训领域，要么正在接受或最近完成了各种专业培训领域的培训。我们探讨了进入专业培训的障碍和主要影响因素。通过比较和对比生成的主题，来自目标是传统非竞争性专业领域（如全科医学）和其他专业领域（通常是更具竞争力的领域）的医生的模式出现了不同。因此，我们在这种二分法中探讨了数据。
结果
目标进入全科医学专业的医生的培训入学相对顺利，障碍较少。相比之下，那些追求其他专业的人，无论选择哪个专业，都会遇到多个障碍，包括：在没有正式指导的情况下，在不可预测和复杂的系统中进行导航；与合适的人/网络建立联系，以获得相关经验；积极规划和区分技能，因为申请经常失败。
结论
我们的探索性研究表明，那些希望进入非全科医学专业培训的医生可能会经历多年的强烈障碍，这可能会威胁到他们的士气和适应力。这些问题可以通过提供不同专业项目的信息中心、更广泛的选拔标准、对申请的反馈以及更正式的指导和专业支持来解决。对于那些寻求进入全科医学的医生来说，确定不存在挑战的情况，可以用来促进更多人从事全科医学职业。
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