Department of Internal Medicine, Division of Geriatrics, Virginia Commonwealth University, Richmond, Virginia, US.
Department of Research and Education, Virginia Commonwealth University, Richmond, Virginia, US.
Gerontol Geriatr Educ. 2023 Jul 3;44(3):396-412. doi: 10.1080/02701960.2022.2078814. Epub 2022 May 23.
While the barriers to specializing in geriatrics are known, motivators behind why medical trainees choose geriatrics are not as well understood. It is also unknown if recruitment strategies in the literature address these barriers and motivators. The aim of this systematic scoping review is to examine the current literature on recruitment strategies alongside motivators and barriers for specializing in geriatrics. Eligible articles for this scoping review either focused on motivators or barriers among trainees (medical students, resident-physicians, fellows) or recruitment strategies. A scoping search was conducted in MEDLINE, Embase, CINAHL, and PsychINFO. Data was extracted on article characteristics and themes. 88 of 2064 articles were eligible and included. Personal fulfillment emerged as the most common theme for motivators, contrary to prior studies that cite positive role modeling. Financial disincentive remained the most common barrier, followed by limited exposure and "futile" practice. Promising interventions beyond financial compensation include defining geriatrics better, emphasizing the high job satisfaction rates, increasing clinical exposure for medical students, and additional funding for academic centers to recruit academic geriatricians. Policymakers and medical educators should consider multiple strategies that target the motivators, as well as the barriers to pursuing geriatrics.
尽管人们已经了解了专门从事老年医学的障碍,但医学实习生选择老年医学的动机还不是很清楚。目前也不清楚文献中的招聘策略是否针对这些障碍和动机。本系统评价综述的目的是研究当前关于老年医学专门化的招聘策略以及激励因素和障碍的文献。这项范围界定综述的合格文章要么侧重于培训生(医学生、住院医师、研究员)的激励因素或障碍,要么侧重于招聘策略。在 MEDLINE、Embase、CINAHL 和 PsychINFO 中进行了范围搜索。提取了关于文章特征和主题的数据。在 2064 篇文章中,有 88 篇符合条件并被纳入。个人成就感是激励因素中最常见的主题,与之前引用积极榜样作用的研究相反。经济激励不足仍然是最常见的障碍,其次是接触机会有限和“无效”实践。除了经济补偿之外,还有一些有前途的干预措施包括更好地定义老年医学、强调高工作满意度、增加医学生的临床接触以及为学术中心招募学术老年医学专家提供更多资金。政策制定者和医学教育者应考虑多种策略,既要针对激励因素,也要针对从事老年医学的障碍。