兼职和住院医师报酬：仅仅是为了钱吗？一项巴西的横断面研究。

Moonlighting and physician residents' compensation: is it all about money? A cross-sectional Brazilian study.

机构信息

MD, PhD. Professor, Medical School, Division of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil; Professor, Neurology Unit, Medical School, Uninassau, Recife (PE), Brazil; Physician, Neurology Unit, Hospital da Restauração, Recife (PE), Brazil.

MD, PhD. Professor, Medical School, Division of Neuropsychiatry, Universidade Federal de Pernambuco (UFPE), Recife (PE), Brazil. Professor, Postgraduate Program in Neuropsychiatry and Behavioral Sciences (Posneuro), Universidade Federal do Pernambuco (UFPE), Recife (PE), Brazil; and Physician, Headache Clinic, Hospital Universitario Oswaldo Cruz, Universidade do Pernambuco (UPE), Recife (PE), Brazil.

出版信息

Sao Paulo Med J. 2022 Oct 24;141(4):e2022187. doi: 10.1590/1516-3180.2022.0187.R2.23082022. eCollection 2022.

DOI:10.1590/1516-3180.2022.0187.R2.23082022

PMID:36287516

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10065092/

Abstract

BACKGROUND

Moonlighting is a largely discussed, however under-explored, subject among physician residents.

OBJECTIVES

To analyze the frequency of moonlighting and its related factors.

DESIGN AND SETTING

This cross-sectional study enrolled medical residents from all geographical regions of Brazil.

METHODS

A web-based structured closed-ended survey was applied that explored the frequency and type of moonlighting, residency programs characteristics, and psychological distress. The questionnaire was published on social networks.

RESULTS

The completion rate was 71.4% (n = 1,419) and 37.7% were males aged 28.8 ± 3.2 (mean ± standard deviation) years, and 571 (40.2%) were post-graduate year (PGY) 1. There were residents from 50 medical specialties (the most common training area was clinical, 51.9%). A total of 80.6% practiced moonlighting, with an average weekly workload of 14.1 ± 9.4 h, usually overnight or in weekend shifts. Factors related to it were being PGY-2 or higher (adjusted odds ratio = 3.90 [95% confidence interval = 2.93-5.18], logistic regression), lower weekly residency duty hours (0.98 [0.97-0.99]), and a higher salary (1.23 [1.08-1.40]). In contrast, perception of a "fair/adequate" compensation was influenced by age (1.02 [1.01-1.02]), not being single (1.05 [1.01-1.10]), and residency duty hours (1.51 [1.22-1.88]). Depression, anxiety, diurnal somnolence scores, and work-personal life conflicts were not correlated with moonlighting status.

CONCLUSION

Moonlighting frequency is high, and it is related to higher PGY, briefer residency duty hours, and the perception that remuneration should be higher. This study provides insights into the motivations for moonlighting and effort-reward imbalance.

摘要

背景

“兼职”是医师住院医师中一个讨论较多但研究较少的话题。

目的

分析兼职的频率及其相关因素。

设计和设置

本横断面研究招募了来自巴西所有地理区域的住院医师。

方法

采用基于网络的结构化封闭式调查问卷，调查兼职的频率和类型、住院医师培训项目的特点以及心理困扰。问卷发布在社交网络上。

结果

完成率为 71.4%（n=1419），男性占 37.7%，年龄为 28.8±3.2（平均值±标准差）岁，571 名（40.2%）为住院医师 1 年。有来自 50 个医学专业的住院医师（最常见的培训领域是临床，占 51.9%）。共有 80.6%的人从事兼职工作，平均每周工作 14.1±9.4 小时，通常是夜班或周末轮班。与之相关的因素是住院医师 2 年或以上（调整后的优势比=3.90[95%置信区间 2.93-5.18]，逻辑回归）、每周住院义务工作时间较短（0.98[0.97-0.99]）和更高的工资（1.23[1.08-1.40]）。相反，对“公平/足够”补偿的看法受到年龄（1.02[1.01-1.02]）、非单身（1.05[1.01-1.10]）和住院义务工作时间（1.51[1.22-1.88]）的影响。抑郁、焦虑、日间嗜睡评分和工作-个人生活冲突与兼职状态无关。