Davidson R C, Nesbitt T, Fox-Garcia J
Department of Family Practice, School of Medicine, University of California-Davis, Sacramento, USA.
Fam Med. 1995 Feb;27(2):112-6.
Graduate follow-up studies provide medical educators with important evaluation information and insight into graduates' practices. This study compares early practice choices of two cohorts of family practice residents who graduated a decade apart. The earlier cohort's changes in practice characteristics over a 10-year period were also analyzed.
Using a mailed survey, graduates of the University of California-Davis Family Practice Residency Network have been periodically surveyed since 1978. Using data from these surveys, early practice choices of the two cohorts were compared. In addition, the responses of the earlier cohort were tracked over time to determine whether any early practice patterns still existed.
Significant differences in the early practice choices of the two cohorts of graduates were found in the areas of practice organization, use of mid-level practitioners, perception of need for primary care physicians, and inclusion of pregnancy care in practice. A significantly lower percentage of recent graduates had entered private practice, compared with the earlier cohort (37% vs 50%, P = .02). Recent graduates were more likely to perceive a need for primary care physicians. Finally, the early practice choice differences between the two cohorts had all but disappeared 10 years later as the earlier cohort's practices had changed to resemble more closely those of the recent graduates.
This study concludes that the practices of both established family physicians and recent graduates are changing. Residency faculty must understand how these changes influence the skill and knowledge needs of their future graduates and should design practice management curricula accordingly.
毕业生随访研究为医学教育工作者提供了重要的评估信息,有助于深入了解毕业生的执业情况。本研究比较了相隔十年毕业的两批家庭医学住院医师的早期执业选择。同时还分析了较早一批毕业生在10年期间执业特征的变化。
自1978年以来,通过邮寄调查问卷的方式,对加利福尼亚大学戴维斯分校家庭医学住院医师网络的毕业生进行定期调查。利用这些调查数据,比较了两批毕业生的早期执业选择。此外,对较早一批毕业生的回答进行长期跟踪,以确定是否仍存在任何早期执业模式。
在执业组织、中级执业人员的使用、对初级保健医生需求的认知以及执业中是否包含妊娠护理等方面,两批毕业生的早期执业选择存在显著差异。与较早一批毕业生相比,近期毕业生进入私人执业的比例显著较低(37%对50%,P = .02)。近期毕业生更有可能认为需要初级保健医生。最后,十年后两批毕业生在早期执业选择上的差异几乎消失,因为较早一批毕业生的执业情况已发生变化,更接近近期毕业生。
本研究得出结论,既有家庭医生和近期毕业生的执业情况都在发生变化。住院医师培训教师必须了解这些变化如何影响未来毕业生的技能和知识需求,并应据此设计执业管理课程。