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我们如何促进学术全科医生的职业发展?对影响学术全科医生队伍发展的因素进行定性框架分析。

How can we promote academic GP careers? A qualitative framework analysis of factors affecting the development of the academic GP workforce.

作者信息

McElhinney Zoë, Laidlaw Anita, Scully Robert, Gordon Lisi, Kennedy Catherine

机构信息

School of Medicine, University of St Andrews, St Andrews, UK

School of Medicine, University of Dundee, Dundee, UK.

出版信息

BMJ Open. 2025 Mar 26;15(3):e091833. doi: 10.1136/bmjopen-2024-091833.

Abstract

OBJECTIVES

General practice continues to be an under-represented career choice among medical school graduates, and the retention of the general practitioner (GP) workforce remains challenging. Academic general practice (AGP) is vital to the development of the evidence base for general practice and the education of the next generation of doctors and GPs. Academic careers and portfolio careers in general practice are seen as a means of increasing retention of GPs in the profession. However, AGP remains largely invisible to many and the number of AGPs is declining. There is no clear understanding of the reasons for this. The aim of this study was to explore factors that inhibit and promote AGP careers.

DESIGN

Secondary framework analysis of data from two qualitative studies.

PARTICIPANTS, SETTING AND MEASURES: 41 GPs, GP trainees and Academic GPs (25 females and 16 males) across Scotland. Analysis of the data employed a framework based on Feldman and Ng's model of the factors influencing career mobility, embeddedness and success in order to explore the barriers and enablers to GPs developing academic careers that exist at multiple levels from the personal to the structural.

RESULTS

GPs encountered barriers to entering AGP at multiple levels. Lack of clarity and visibility of training pathways, including the lack of clear routes into academia at multiple career stages, were significant barriers, as were the effects of taking on academic work on overstretched practices, and relative job insecurity and lower pay in academic careers.

CONCLUSION

The findings of this research demonstrate that unless the structural issues affecting the profession more generally are addressed, significant barriers to pursuing AGP careers will remain.

摘要

目标

在医学院毕业生中,全科医学仍然是一个代表性不足的职业选择,全科医生(GP)队伍的保留仍然具有挑战性。学术性全科医学对于全科医学证据基础的发展以及下一代医生和全科医生的教育至关重要。全科医学领域的学术职业和组合式职业被视为增加全科医生留在该行业的一种方式。然而,许多人对学术性全科医学仍然知之甚少,而且学术性全科医生的数量正在减少。目前尚不清楚造成这种情况的原因。本研究的目的是探讨抑制和促进学术性全科医学职业发展的因素。

设计

对两项定性研究的数据进行二次框架分析。

参与者、研究背景和测量方法:苏格兰各地的41名全科医生、全科医生培训学员和学术性全科医生(25名女性和16名男性)。数据分析采用了一个基于费尔德曼和吴关于影响职业流动、嵌入性和成功因素模型的框架,以探讨从个人到结构多个层面存在的阻碍全科医生发展学术职业的障碍和促进因素。

结果

全科医生在多个层面都遇到了进入学术性全科医学领域的障碍。培训途径缺乏清晰度和可见性,包括在多个职业阶段缺乏明确进入学术界的途径,是重大障碍,承担学术工作对过度繁忙的执业产生的影响、学术职业相对的工作不安全感和较低薪酬也是如此。

结论

本研究结果表明,除非更广泛地解决影响该行业的结构性问题,否则追求学术性全科医学职业仍将存在重大障碍。

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