Hegmann K, Barrier P, Moser R
Department of Family and Preventive Medicine, University of Utah Health Sciences Center, Salt Lake City.
J Occup Med. 1993 Aug;35(8):768-75. doi: 10.1097/00043764-199308000-00012.
Although the quantity of Occupational Medicine (OM) residents in training programs has risen in the past 15 years, there remains a significant shortage of OM physicians in the United States. A survey of OM residency program directors and residents and fellows (trainees) was accomplished to answer questions relevant to recruiting and supplying OM trained physicians. Twenty-six of 29 program directors (89.7%) replied. One hundred forty-three of 174 (82.2%) trainees responded. Fifty percent of responding program directors were satisfied with the current quantity of program applicants. Medical students were provided a median of 3 hours (range, 0 to 20 hours; mean, 5.35 hours) of formal OM teaching by the responding programs. Almost half of trainees, 68 (48.6%), did not receive formal OM instruction in medical school. An average of 5.4 +/- 13.3 hours of OM was taught to OM trainees in medical school. Disproportionate numbers of trainees were taught OM as fourth-year medical students and in other residencies. Reasons for pursuing OM training were diverse and often related to postgraduate clinical experience with OM. Only a total of 84 primary care residents (0.32%) rotate through the OM residency programs in an average year. We conclude that an insufficient quantity of qualified applicants, combined with limited exposure to OM in medical schools and low levels of contact with residents in primary care programs, will continue to hinder efforts to reduce the shortage of OM residents and physicians. Further training specifically targeting the fourth year of medical school and the primary care residencies may have the most impact on recruitment.
尽管在过去15年里,参加职业医学(OM)培训项目的住院医师数量有所增加,但美国仍严重缺乏职业医学医生。为了回答与招募和供应经过职业医学培训的医生相关的问题,我们对职业医学住院医师培训项目主任以及住院医师和研究员(学员)进行了一项调查。29名项目主任中有26名(89.7%)回复。174名学员中有143名(82.2%)做出了回应。50%的回复项目主任对当前项目申请人的数量感到满意。回复的项目为医学生提供的职业医学正式教学时间中位数为3小时(范围为0至20小时;平均为5.35小时)。近一半的学员,即68名(48.6%),在医学院没有接受过职业医学的正式教学。医学院向职业医学学员教授职业医学的平均时长为5.4±13.3小时。在医学院四年级以及其他住院医师培训项目中学习职业医学的学员数量不成比例。选择职业医学培训的原因多种多样,且往往与职业医学的研究生临床经验有关。平均每年只有84名初级保健住院医师(0.32%)轮转至职业医学住院医师培训项目。我们得出结论,合格申请人数量不足,再加上医学院对职业医学的接触有限以及与初级保健项目住院医师的接触水平较低,将继续阻碍减少职业医学住院医师和医生短缺的努力。专门针对医学院四年级和初级保健住院医师培训项目的进一步培训可能对招募工作产生最大影响。