Hernandez Mark, Ibiwoye Michael O, Ledbetter Melinda, Thacker Richard, Diaz Sebastian
Medical Education, Quillen College of Medicine, Johnson City, USA.
Anatomy Department, Alabama College of Osteopathic Medicine, Dothan, USA.
Cureus. 2023 Dec 9;15(12):e50216. doi: 10.7759/cureus.50216. eCollection 2023 Dec.
Background An overwhelming majority of matriculating medical students in the USA are keen to deliver quality health care to all people, including the socioeconomically disadvantaged populations in remote, resource-scarce regions nationally and worldwide. Here, we describe a protocol developed to evaluate the interest of our medical students in global health activities. We also examined the relationship between students' interest in global health and readiness to pursue a future career in the primary care specialty. Materials and methods We designed a survey in Qualtrics online software and reached all first-year and third-year medical students between 2019 and 2022 enrolled at the Alabama College of Osteopathic Medicine (ACOM). The survey utilized ordinal scale items to explore the medical students' interest in primary care residency programs, their interest in global health and international travel, and their perceptions of how a range of factors might motivate their desire to participate in global health activities. The study was approved by ACOM's Institutional Review Board (IRB). In order to compare findings from this study with data from other medical schools, we developed constructs using the national aggregate data, in percentages, from matriculants and graduates of Doctor of Osteopathic Medicine (DO) degree-granting medical schools according to gender, published by the American Association of Colleges of Osteopathic Medicine (AACOM). Statistical analysis of national aggregate data was performed using the unpaired t-test. Results Both female and male participants had lived or traveled abroad before starting medical school. Female (98%, n=249) and male (95%, n=140) participants in the first-year cohorts considered helping the underserved population as important or very important as it is related to a career in medicine. Females in the third-year cohorts (97%, n=71) also ranked this statement as important or very important compared to male cohorts (89%, n=31). A higher proportion of females (43%, n=108) compared to males (35%, n=52) in first-year cohorts agreed or strongly agreed that they would likely pursue a residency in primary care. More females (59%, n=43) than males (46%, n=16) in the third-year cohorts agreed or strongly agreed with the same statement. Analysis of the aggregate national data (2009-2022) revealed that the percentage (actual count not available) of female students who plannedto practice in underserved/shortage area was higher both at the time of matriculation (M=51%, SD=4%) and before graduation (M=40%, SD=4%) compared to males (matriculation: M=40%, SD=5%; graduation: M=33%, SD=4%) presenting a significant difference (matriculation t(24)=6.7, p<0.0001; graduation t(24)=5.4, p<0.0001). Furthermore, a higher percentage of females at the time of matriculation (M=25%, SD=5%) and graduation (M=40%, SD=6%) plannedto practice in the primary care specialties compared to males (matriculation: M=17%, SD=4%; graduation: M=29%, SD=6%) presenting a significant difference (matriculation: t(24)=4.6, p = 0.0001; graduation: t(24)=4.8, p<0.0001). Conclusions Interest in global health activities may be associated with interest in pursuing a future career in the primary care specialty. In this study, more female medical students expressed interest in participating in global health experiences, serving the underserved population domestically and abroad, and expressing interest in primary care than males.
背景 在美国,绝大多数即将入学的医学生都渴望为所有人提供高质量的医疗服务,包括国内和全球偏远、资源匮乏地区的社会经济弱势群体。在此,我们描述了一项旨在评估我校医学生对全球健康活动兴趣的方案。我们还研究了学生对全球健康的兴趣与未来从事初级保健专业职业的意愿之间的关系。
材料与方法 我们在Qualtrics在线软件中设计了一项调查,并对2019年至2022年期间就读于阿拉巴马州整骨医学院(ACOM)的所有一年级和三年级医学生进行了调查。该调查采用有序量表项目,以探究医学生对初级保健住院医师项目的兴趣、对全球健康和国际旅行的兴趣,以及他们对一系列因素可能如何激发其参与全球健康活动愿望的看法。该研究获得了ACOM机构审查委员会(IRB)的批准。为了将本研究的结果与其他医学院的数据进行比较,我们根据美国整骨医学院协会(AACOM)公布的按性别划分的整骨医学博士(DO)学位授予医学院的入学新生和毕业生的全国汇总数据(以百分比表示)构建了指标。使用不成对t检验对全国汇总数据进行统计分析。
结果 女性和男性参与者在开始医学院学习之前都有过在国外生活或旅行的经历。一年级队列中的女性参与者(98%,n = 249)和男性参与者(95%,n = 140)认为帮助弱势群体与医学职业相关,是重要或非常重要的。三年级队列中的女性(97%,n = 71)与男性队列(89%,n = 31)相比,也将这一表述列为重要或非常重要。一年级队列中同意或强烈同意他们可能会从事初级保健住院医师工作的女性比例(43%,n = 108)高于男性(35%,n = 52)。三年级队列中同意或强烈同意同一表述的女性(59%,n = 43)多于男性(46%,n = 16)。对全国汇总数据(2009 - 2022年)的分析显示,计划在服务不足/短缺地区执业的女学生比例(实际计数不可用)在入学时(M = 51%,SD = 4%)和毕业前(M = 40%,SD = 4%)均高于男性(入学时:M = 40%,SD = 5%;毕业时:M = 33%,SD = 4%),存在显著差异(入学时t(24)=6.7,p<0.0001;毕业时t(24)=5.4,p<0.0001)。此外,入学时(M = 25%,SD = 5%)和毕业时(M = 40%,SD = 6%)计划从事初级保健专业的女性比例高于男性(入学时:M = 17%,SD = 4%;毕业时:M = 29%,SD = 6%),存在显著差异(入学时:t(24)=4.6,p = 0.0001;毕业时:t(24)=4.8,p<0.0001)。
结论 对全球健康活动的兴趣可能与未来从事初级保健专业职业的兴趣相关。在本研究中,表达对参与全球健康经历、服务国内外弱势群体以及对初级保健感兴趣的女性医学生多于男性。