General Medicine Center, Shimane University Hospital, 89-1, Enya-Cho, Izumo Shi, Shimane, 693-8501, Japan.
Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
BMC Med Educ. 2023 Jun 22;23(1):464. doi: 10.1186/s12909-023-04429-4.
Standardized examinations assess both learners and training programs within the medical training system in Japan. However, it is unknown if there is an association between clinical proficiency as assessed by the General Medicine In-Training Examination (GM-ITE) and pursuing specialty.
To determine the relative achievement of fundamental skills as assessed by the standardized GM-ITE based on pursuing career specialty among residents in the Japanese training system.
Nationwide cross-sectional study.
Medical residents in Japan who attempted the GM-ITE in their first or second year were surveyed.
A total of 4,363 postgraduate years 1 and 2 residents who completed the GM-ITE were surveyed between January 18 and March 31, 2021.
GM-ITE total scores and individual scores in each of four domains assessing clinical knowledge: 1) medical interview and professionalism, 2) symptomatology and clinical reasoning, 3) physical examination and treatment, and 4) detailed disease knowledge.
When compared to the most pursued specialty, internal medicine, only those residents who chose general medicine achieved higher GM-ITE scores (coefficient 1.38, 95% CI 0.08 to 2.68, p = 0.038). Conversely, the nine specialties and "Other/Not decided" groups scored significantly lower. Higher scores were noted among residents entering general medicine, emergency medicine, and internal medicine and among those who trained in community hospitals with higher numbers of beds, were more advanced in their training, spent more time working and studying, and cared for a moderate but not an extreme number of patients at a time.
Levels of basic skill achievement differed depending on respective chosen future specialties among residents in Japan. Scores were higher among those pursuing careers in general medical fields and lower among those pursuing highly specialized careers. Residents in training programs devoid of specialty-specific competition may not possess the same motivations as those in competitive systems.
标准化考试在日本的医学培训系统中既评估学习者，也评估培训计划。然而，目前尚不清楚通用医学住院医师培训考试（GM-ITE）评估的临床熟练程度与专业追求之间是否存在关联。
确定在日本培训系统中，根据住院医师的职业专业追求，通过标准化 GM-ITE 评估的基本技能的相对成就。
全国性的横断面研究。
对参加 GM-ITE 考试的日本住院医师进行调查。
共有 4363 名研究生 1 年级和 2 年级住院医师参加了 GM-ITE 考试，调查于 2021 年 1 月 18 日至 3 月 31 日进行。
GM-ITE 总分和评估临床知识的四个领域的个人分数：1）医学访谈和专业精神，2）症状和临床推理，3）体检和治疗，4）详细疾病知识。
与最受欢迎的专业相比，只有选择普通医学的住院医师 GM-ITE 得分更高（系数 1.38，95%CI 0.08 至 2.68，p=0.038）。相反，九个专业和“其他/未决定”组的得分明显较低。在选择普通医学、急诊医学和内科的住院医师中，以及在床位数量较多的社区医院接受培训的住院医师中，得分较高，培训进展较快，工作和学习时间较多，每次照顾中等但不是极端数量的患者。
日本住院医师根据各自未来的专业选择，基本技能的掌握程度存在差异。从事普通医学领域职业的人得分较高，从事高度专业化职业的人得分较低。在缺乏专业特定竞争的培训计划中的住院医师可能没有与竞争系统中的住院医师相同的动力。
