Ledley F D, Lovejoy F H
Howard Hughes Medical Institute, Department of Cell Biology, Baylor College of Medicine, Houston, TX 77030.
Pediatrics. 1993 Sep;92(3):436-41.
This study was undertaken to characterize the professional activity of a cohort of young pediatricians who completed an academically oriented residency program, to analyze factors which influenced their interests, career choices, and research activity, and to understand what steps might be effective in attracting more young physicians into academic and research career paths.
We studied by questionnaire a cohort of 150 pediatric residents from the Children's Hospital in Boston who completed residency training between 1976 and 1981.
Questionnaires were returned by 117 (78%) of 150 individuals. Of these, 73% were in academic medicine and 37% were in clinical practice. Individuals were engaged in various activities with a mean of 47% effort in clinical care, 25% effort in administration and teaching, and 28% effort in basic or clinical research. The majority of respondents (71 [61%] of 117) reported at least 10% effort in all three activities. Only 9 (8%) of 117 reported no clinical activity, 8 (7%) of 117 reported no teaching or administrative activity, and 35 (30%) of 117 reported no research activity. Few individuals dedicated more than 50% of their time to research, and none reported a 100% commitment to research. Clinical sources provided 71% of all salary support, research grants 17%, government salaries 7%, and other sources 5%. For most respondents, interest in clinical practice predated medical school, whereas interest in research increased during preclinical training, particularly among those who engaged in research activities. Respondents identified previous research experience as the principle factor enhancing their decision and ability to do research. Factors that adversely influenced their decision or ability to do research included salary expectancy, funding, the perceived competitiveness of academic life, administrative duties, and family responsibilities.
Efforts to encourage more young physicians to enter academic careers should focus on providing research experience during preclinical training and providing long-term support for research which enables physician scientists to maintain their interest and involvement in clinical medicine.
本研究旨在描述一批完成学术导向型住院医师培训项目的年轻儿科医生的专业活动，分析影响他们兴趣、职业选择和研究活动的因素，并了解哪些措施可能有效地吸引更多年轻医生走上学术和研究职业道路。
我们通过问卷调查了1976年至1981年间在波士顿儿童医院完成住院医师培训的150名儿科住院医师。
150名个体中有117名（78%）回复了问卷。其中，73%从事学术医学，37%从事临床实践。个体参与各种活动，平均将47%的精力用于临床护理，25%用于管理和教学，28%用于基础或临床研究。大多数受访者（117人中的71人[61%]）报告在所有三项活动中至少投入了10%的精力。117人中只有9人（8%）报告没有临床活动，117人中8人（7%）报告没有教学或管理活动，117人中35人（30%）报告没有研究活动。很少有人将超过50%的时间用于研究，也没有人报告完全致力于研究。临床来源提供了所有薪资支持的71%，研究资助占17%，政府薪资占7%，其他来源占5%。对于大多数受访者来说，对临床实践的兴趣在医学院学习之前就有了，而对研究的兴趣在临床前培训期间增加，特别是在那些从事研究活动的人中。受访者认为以前的研究经验是增强他们进行研究的决心和能力的主要因素。对他们进行研究的决心或能力产生不利影响的因素包括薪资期望、资金、学术生活的竞争程度、行政职责和家庭责任。
鼓励更多年轻医生进入学术职业的努力应集中于在临床前培训期间提供研究经验，并为研究提供长期支持，使医生科学家能够保持对临床医学的兴趣和参与度。
