Scott M G, Sacks D B
Department of Pathology, Washington University School of Medicine, St. Louis, MO 63110, USA.
Clin Chem. 1995 Jun;41(6 Pt 1):934-41.
We surveyed directors of medical technology (MT) and postdoctoral clinical chemistry (CC) training programs and of clinical pathology (CP) and combined anatomic/clinical pathology (AP/CP) residency programs regarding the number, quality, training emphasis, and job-placement experience of trainees for 1985-95 as well as the directors' opinions on the impact of "healthcare reform." Responses were received from directors of 94 of 249 (38%) MT programs, 14 of 15 (93%) CC programs, and 63 of 138 (46%) pathology residency programs. In all four categories the numbers of trainees have increased steadily over the last 5 to 7 years but are expected to remain stable or decrease slightly. Directors of MT and CC programs expect increasing difficulty placing their graduates; directors of AP/CP and CP residency programs do not. Although > 60% of MT graduates have entered private hospitals, this is anticipated to decrease, with a concomitant increase in university hospital placements. Of the AP/CP residents, > 60% and < 5% accepted service- and research-oriented positions, respectively. In contrast, 83% of CP residents entered university hospitals, with half of these taking research-oriented positions. Among CC graduates, 41% joined university hospitals and 10-15% accepted positions in each of either private hospitals or industry or reference laboratories. The emphasis of training varies, with clinical service and pathophysiology the major focus in AP/CP programs. CP and CC programs take two distinct approaches--some accentuating management, and others emphasizing research. Finally, MT program directors appear the most optimistic regarding the opportunities that healthcare reform may present.
我们就1985 - 1995年期间医学技术（MT）和博士后临床化学（CC）培训项目以及临床病理学（CP）和解剖/临床病理学联合（AP/CP）住院医师培训项目的学员数量、质量、培训重点和就业经历，以及这些项目主任对“医疗改革”影响的看法进行了调查。我们收到了249个MT项目中94个项目（38%）、15个CC项目中14个项目（93%）以及138个病理学住院医师培训项目中63个项目（46%）主任的回复。在所有这四类项目中，过去5至7年学员数量稳步增加，但预计将保持稳定或略有下降。MT和CC项目的主任预计其毕业生的就业难度会增加；而AP/CP和CP住院医师培训项目的主任则不这么认为。虽然超过60%的MT毕业生进入了私立医院，但预计这一比例会下降，同时大学医院的就业比例会相应增加。在AP/CP住院医师中，分别有超过60%和不到5%的人接受了以服务和研究为导向的职位。相比之下，83%的CP住院医师进入了大学医院，其中一半担任以研究为导向的职位。在CC毕业生中，41%进入了大学医院，10% - 15%的人分别在私立医院、行业或参考实验室任职。培训重点各不相同，AP/CP项目主要侧重于临床服务和病理生理学。CP和CC项目采取了两种不同的方式——一些强调管理，另一些则强调研究。最后，MT项目主任似乎对医疗改革可能带来的机遇最为乐观。
