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了解儿科麻醉学住院医师培训意向:一项关于住院医师经历的全国性调查。

Understanding Pediatric Anesthesiology Fellowship Interest: A National Survey of the Resident Experience.

作者信息

Carullo Philip, Khan Sabina, Nause-Osthoff Rebecca, Gupta Ruchika, Xie James, Azamfirei Razvan, Tran Lieu, Wang Tammy

机构信息

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, Houston, Texas, USA.

出版信息

Paediatr Anaesth. 2025 Mar;35(3):223-231. doi: 10.1111/pan.15049. Epub 2024 Dec 7.

Abstract

BACKGROUND

The field of pediatric anesthesiology faces an impending shortage of fellowship-trained physicians. Despite this projection, fewer anesthesiology residents are opting to pursue a fellowship. To better understand the current perspective and motivation of trainees to pursue a career in pediatric anesthesiology, we surveyed anesthesiology residents across the United States.

AIMS

Our primary aims were to assess the understanding of the current workforce shortage as well as explore the impact of both exposure and characteristics of the anesthesia resident rotation on the decision to pursue pediatric anesthesiology fellowship.

METHODS

A 25-question Qualtrics survey was distributed to members of the Pediatric Anesthesia Leadership Council and Education Committee within the Society for Pediatric Anesthesia and to anesthesiology residency program directors based in the United States.

RESULTS

The survey received 201 responses. Of the respondents, 29% were in Clinical Anesthesia Year 3, 25% in Year 2, 19% in Year 1, and 10% in their intern year. The analysis revealed that self-reported adequate exposure to high-acuity cases and advanced procedures (arterial lines, central lines, and nerve blocks) significantly increased the likelihood of planning to pursue pediatric anesthesiology fellowship (adjusted Odd Ratio 8.47, 95% Confidence Interval, 1.65-43.4). Perceptions of faculty teaching, mentor availability, planned practice environment, and the presence of fellowship programs at the institution were not significantly associated with intentions to pursue pediatric anesthesiology fellowship.

CONCLUSIONS

The journey toward specializing in pediatric anesthesiology is influenced by a complex interplay of factors. Among these, enhanced exposure to challenging cases and advanced procedures during the residency phase is emerging as a critical element. Such exposure not only equips residents with the necessary skills and confidence to handle complex pediatric anesthesia cases but also plays a pivotal role in attracting more trainees to this essential subspecialty.

摘要

背景

儿科麻醉学领域即将面临专科培训医师短缺的问题。尽管有此预测,但选择攻读专科培训的麻醉学住院医师却越来越少。为了更好地了解当前学员选择儿科麻醉学职业的观点和动机,我们对美国各地的麻醉学住院医师进行了调查。

目的

我们的主要目的是评估对当前劳动力短缺的理解,并探讨麻醉住院医师轮转的接触经历和特点对攻读儿科麻醉学专科培训的决定的影响。

方法

向儿科麻醉学会的儿科麻醉领导委员会和教育委员会成员以及美国的麻醉学住院医师培训项目主任发放了一份包含25个问题的Qualtrics调查问卷。

结果

该调查共收到201份回复。在受访者中,29%处于临床麻醉第3年,25%处于第2年,19%处于第1年,10%处于实习年。分析显示,自我报告有足够机会接触高难度病例和先进操作(动脉置管、中心静脉置管和神经阻滞)显著增加了计划攻读儿科麻醉学专科培训的可能性(调整后的优势比为8.47,95%置信区间为1.65 - 43.4)。对教员教学、导师可获得性、计划中的执业环境以及机构中专科培训项目的存在的看法与攻读儿科麻醉学专科培训的意愿没有显著关联。

结论

专攻儿科麻醉学的过程受到多种因素的复杂相互作用的影响。其中,住院医师阶段增加对具有挑战性的病例和先进操作的接触正成为一个关键因素。这种接触不仅使住院医师具备处理复杂儿科麻醉病例所需的技能和信心,而且在吸引更多学员投身这一重要亚专业方面也起着关键作用。

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