Healy Lydia, O'Grady Michael J, Fancourt Nigel, Mema Briseida
Department of Critical Care Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Education, University of Oxford, Oxford, UK.
J Med Educ Curric Dev. 2024 Oct 8;11:23821205241285599. doi: 10.1177/23821205241285599. eCollection 2024 Jan-Dec.
Difficulty attracting physicians to work in rural and remote areas is a worldwide problem. Specific to pediatrics, barriers to recruitment include burdensome on-call rosters, a lack of career opportunities for partners and professional isolation.
To examine attitudes to working in a community hospital in Ireland, a mixed-methods sequential analysis approach was undertaken. Pediatricians-in training (70) and attending community pediatricians (25) completed surveys. Six semistructured interviews were used to triangulate survey results.
Most trainees planned to stay in Ireland (66/70), with five (eight%) stating that a career in a community hospital was their first preference. Personal factors such as a partner's career prospects and closeness to family and friends were the most important deterrents to working in a community hospital for trainees. Both trainees and attendings were concerned regarding professional isolation. Trainees were concerned about the poor reputation of community units. This converged with attendings feeling their role was not adequately respected, even though their job had more variability and exposure to emergencies, with less support, than working in a large center. Both groups agreed that targeted postgraduate training pathways and better training opportunities within Ireland were the best way to improve recruitment. Financial bonuses were not highly ranked as potential incentives. Motivators for considering a career in community units included the desire to make an impact and to build something new. Concerns about job satisfaction, professional recognition, and limited support for service development were prevalent.
This study reveals critical challenges and motivators influencing the shortage of pediatricians in Irish community units. Addressing these issues requires a multifaceted approach, incorporating targeted training, support structures, and recognition to enhance recruitment and retention in these underserved areas. Insights from the Irish context could be applied to improve recruitment and retention of pediatricians in regions with similar contexts.
吸引医生到农村和偏远地区工作困难是一个全球性问题。具体到儿科，招聘障碍包括繁重的值班安排、缺乏合作伙伴职业机会以及职业孤立感。
为研究对在爱尔兰社区医院工作的态度，采用了混合方法序贯分析方法。70名儿科住院医师和25名社区儿科主治医师完成了调查。进行了6次半结构化访谈以验证调查结果。
大多数受训人员计划留在爱尔兰（66/70），5人（8%）表示在社区医院工作是他们的首选。伴侣的职业前景以及与家人和朋友的亲近程度等个人因素是受训人员在社区医院工作的最重要阻碍。受训人员和主治医师都担心职业孤立。受训人员担心社区单位声誉不佳。这与主治医师认为他们的角色未得到充分尊重的感觉一致，尽管他们的工作比在大型中心工作有更多变化和接触紧急情况的机会，但支持却更少。两组都认为有针对性的研究生培训途径以及爱尔兰境内更好的培训机会是改善招聘的最佳方式。经济奖励未被列为潜在激励因素。考虑在社区单位工作的动机包括希望产生影响和创建新事物。对工作满意度、职业认可和服务发展支持有限的担忧普遍存在。
本研究揭示了影响爱尔兰社区单位儿科医生短缺的关键挑战和动机。解决这些问题需要多方面的方法，包括有针对性的培训、支持结构和认可，以加强这些服务不足地区的招聘和留用。爱尔兰背景下的见解可应用于改善类似背景地区儿科医生的招聘和留用。
