Boex J R, Kirson S M, Keyes-Welch M, Evans A
Office of Health Services Organization and Research, Northeastern Ohio Universities College of Medicine, Rootstown 44272-0095.
Acad Med. 1994 Nov;69(11):903-6. doi: 10.1097/00001888-199411000-00012.
One response to the decline in interest among medical students in residency training in primary care has been the offering, by residency programs and hospitals, of financial recruitment incentives to medical students during their residency interviews. Few data on the breadth and effectiveness of this practice have been available.
To gain insight into how hospitals and/or programs offered incentives, the authors compared 1990 and 1992 survey data on this topic from the members of the Association of American Medical Colleges' Council of Teaching Hospitals (AAMC/COTH) with 1992 data from the members of the Association for Hospital Medical Education (AHME), employing responses to identical questionnaire items. Complementary data on students' experiences with recruitment incentives in 1991 and 1992 were also analyzed. These data have been collected since 1991 in the Medical School Graduation Questionnaire (GQ) of the AAMC's Section for Educational Research, but little or no information had been available on medical students' perceptions of the effectiveness of these incentives. Therefore, one of the authors surveyed members of the classes of 1992 at four Midwestern medical schools about their residency interviewing experiences, including their reactions to financial incentives they encountered.
The outcomes from these surveys indicate that, as expected, family practice, internal medicine, and pediatrics were the specialties most likely to offer financial incentives; that a wide variety of recruitment incentives was available to students; that the proportion of programs and hospitals offering such incentives was increasing (e.g., from 37% in the 1990 COTH survey to 54% in the 1992 survey); and that a large majority (79%) of students who encountered these incentives viewed them as at least somewhat effective in persuading them to consider matching with the programs that offered them.
The prevalence and persuasiveness of financial incentives raise a number of serious questions, including whether competition for residents will divert funds from improving educational quality to recruitment.
针对医学生对初级保健住院医师培训兴趣下降的一种应对措施是，住院医师培训项目和医院在医学生住院医师面试期间提供经济招聘激励措施。关于这种做法的范围和效果的数据很少。
为了深入了解医院和/或项目如何提供激励措施，作者将美国医学院协会教学医院委员会（AAMC/COTH）成员关于该主题的1990年和1992年调查数据与医院医学教育协会（AHME）成员的1992年数据进行了比较，采用了对相同问卷项目的回答。还分析了1991年和1992年学生在招聘激励方面的补充数据。这些数据自1991年以来一直在AAMC教育研究部门的医学院毕业问卷（GQ）中收集，但关于医学生对这些激励措施有效性的看法的信息很少或没有。因此，一位作者对四所中西部医学院1992届班级的成员进行了调查，了解他们的住院医师面试经历，包括他们对所遇到的经济激励措施的反应。
这些调查结果表明，正如预期的那样，家庭医学、内科和儿科是最有可能提供经济激励措施的专业；学生可以获得各种各样的招聘激励措施；提供此类激励措施的项目和医院的比例在增加（例如，从1990年COTH调查中的37%增加到1992年调查中的54%）；并且遇到这些激励措施的绝大多数学生（79%）认为它们至少在一定程度上有效地说服了他们考虑与提供这些措施的项目匹配。
经济激励措施的普遍性和说服力引发了一些严重问题，包括对住院医师的竞争是否会将资金从提高教育质量转移到招聘上。
