University Medical Center Utrecht, Center for Research and Development of Education, Utrecht, The Netherlands.
Central Board for Specialty training in Elderly Care Medicine in the Netherlands (SOON), Utrecht, The Netherlands.
GMS J Med Educ. 2023 Feb 15;40(1):Doc5. doi: 10.3205/zma001587. eCollection 2023.
The drop-out rate among residents across all medical specialties in the Netherlands approximates 12.7%. This implies a capacity loss in the medical workforce, a waste of educational resources and personal damage to individuals. The aim of our study was to investigate reasons for dropping out of residency and the relationship with medical work experience after medical school and prior to residency, which is common among Dutch graduates.
A questionnaire listing 28 reasons for drop-out was developed and tested. The questionnaire was sent in a nationwide survey to all residents who drop out between 1 September 2017 and 1 September 2019. The respondents were asked to indicate on a 5-point Likert scale, how they weighed reasons for drop-out. Factor analysis was applied to identify dominant factors.
The response rate was 39% (N=129; 99 females) representing all medical specialties. The factor structure of our measure showed 5 factors; high emotional job demands, lack of professional satisfaction, incompatible lifestyle, tensions in working relationships and disappointing career perspectives. Of the respondents 69 (54%) had prior clinical experience as a physician-not-in-training in the same medical specialty before residency. The factor "lack of professional satisfaction" weighed heavier for respondents without prior experience as a reason for drop-out.
Of influence on dropping out of residency is the lack of a clear image of the responsibilities as a physician within the residency of choice, fuelled by limited prior experience after medical school and before residency. One third of dropouts confirmed that prior physician experience within the same specialty could have prevented dropping out or prevented choosing this specialty in the first place.
荷兰所有医学专业住院医师的辍学率约为 12.7%。这意味着医疗劳动力的能力损失，教育资源的浪费和个人的损害。我们的研究目的是调查辍学的原因，并研究其与医学院毕业后和住院医师之前的医疗工作经验之间的关系，这在荷兰毕业生中很常见。
开发并测试了一份列出 28 个辍学原因的问卷。该问卷在全国范围内发送给 2017 年 9 月 1 日至 2019 年 9 月 1 日期间辍学的所有住院医师。要求受访者在 5 点李克特量表上对辍学原因的重要性进行评估。应用因子分析来确定主要因素。
回复率为 39%（N=129；99 名女性），代表所有医学专业。我们测量的因子结构显示有 5 个因素，即高情绪工作要求、缺乏职业满意度、生活方式不兼容、工作关系紧张和令人失望的职业前景。在受访者中，有 69 人（54%）在住院医师之前具有相同医学专业的医师非培训临床经验。对于没有先前经验的受访者，“缺乏职业满意度”是辍学的主要原因。
对住院医师辍学的影响是缺乏对选择的住院医师职责的明确形象，这是由医学院毕业后和住院医师之前的有限经验所助长的。三分之一的辍学者证实，以前在同一专业的医师经验本可以防止辍学或最初选择该专业。
