Frenk J
Educ Med Salud. 1985;19(4):426-51.
Using data from a survey of 923 medical interns in Mexico, this article analyzes preferences for type of medical activity (general or specialized practice), type of site (ambulatory or hospital), and type of medical care institution (public assistance, social security, or private). Four independent variables are examined: social origin, medical school, place of internship, and assimilation to the internship hospital. The great majority of the interns expressed a preference for specialty practice, hospitals, and social security institutions. The role of social origin was to selectively direct students into different medical schools. From then on, the structural attributes of the school itself and of the place of internship, as well as the socialization experiences that took place there, emerged as the most important determinants of career preferences. Such a process, however, tended to produce a "social specialization" of interns in terms of the role they expect to play in the medical field. It is argued that this kind of specialization has negative implications for the professional status of physicians, although it also poses a challenge to the development of innovative theories about the process of professionalization in medicine.
本文利用对墨西哥923名医学实习生的调查数据,分析了他们对医疗活动类型(全科或专科医疗)、实习地点类型(门诊或医院)以及医疗保健机构类型(公共援助、社会保障或私立)的偏好。研究考察了四个自变量:社会出身、医学院校、实习地点以及对实习医院的融入情况。绝大多数实习生表示倾向于专科医疗、医院和社会保障机构。社会出身的作用是有选择地引导学生进入不同的医学院校。从那时起,学校本身和实习地点的结构属性,以及在那里发生的社会化经历,成为职业偏好最重要的决定因素。然而,这样一个过程倾向于在实习生期望在医疗领域所扮演的角色方面产生一种“社会专业化”。有人认为,这种专业化对医生的职业地位有负面影响,尽管它也对医学专业化过程的创新理论发展构成挑战。