Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA.
Healthforce Center, UCSF School of Dentistry, San Francisco, California, USA.
J Dent Educ. 2022 Sep;86(9):1124-1132. doi: 10.1002/jdd.13073.
This study examines the individual, educational, and policy factors that predict dentists pursuing postgraduate dental (PGD) training.
Individual dentist records from the 2017 American Dental Association Masterfile were linked with pre-doctoral training attributes and state-level dental policy factors. Generalized logistic models, adjusted for individual, educational, and policy factors, were used to predict: (1) attending any PGD program, and (2) primary (i.e., advanced general practice, pediatrics, or dental public health, per the Health Resources and Services Administration [HRSA]) versus specialty care.
The majority of new PGD residency slots (77%) were in primary care. Women held 56% of primary care slots; men held 62% of specialty slots. Individual characteristics that predicted PGD primary care training included being Black, Hispanic, Asian, or other race; being male or older age reduced the odds. Pre-doctoral school characteristics that predicted PGD primary care training included having a pre-doctoral HRSA grant, affiliation with an academic medical center, and being a historically Black college/university; being a private school or in a small metro area lowered the odds. At the policy level, the strongest predictors of attending PGD primary care training are a residency requirement in the state you currently practice in and federal graduate medical education (GME) investment per residency slot.
Pursuing PGD training is variable based on the race/ethnicity/gender of the dentist. Federal investments in pre-doctoral dental education and GME can drive equity, as they significantly increase the odds that dentists will go on to PGD training, as do state licensure requirements.
本研究考察了预测牙医接受研究生牙科（PGD）培训的个人、教育和政策因素。
将 2017 年美国牙科协会主文件中的个体牙医记录与预科培训属性和州级牙科政策因素相关联。使用广义逻辑模型，根据个体、教育和政策因素进行调整，以预测：（1）参加任何 PGD 项目，以及（2）主要（即，根据卫生资源和服务管理局[HRSA]的高级普通实践、儿科或口腔公共卫生）与专科护理。
新的 PGD 住院医师职位（77%）主要集中在初级保健领域。女性占据了 56%的初级保健职位；男性占据了 62%的专科职位。预测 PGD 初级保健培训的个体特征包括是黑人、西班牙裔、亚洲人或其他种族；是男性或年龄较大则降低了可能性。预科学校特征预测 PGD 初级保健培训包括拥有预科 HRSA 赠款、与学术医疗中心有关联以及是历史上的黑人学院/大学；是私立学校或在小都会区则降低了可能性。在政策层面上，参加 PGD 初级保健培训的最强预测因素是您目前执业所在州的住院医师要求以及每个住院医师职位的联邦研究生医学教育（GME）投资。
接受 PGD 培训的情况因牙医的种族/族裔/性别而异。联邦对预科牙科教育和 GME 的投资可以促进公平，因为它们大大增加了牙医接受 PGD 培训的可能性，州许可要求也是如此。
