Carr P, Noble J, Friedman R H, Starfield B, Black C
General Medicine Unit, Bulfinch I, Massachusetts General Hospital, Boston 02114.
Acad Med. 1993 Mar;68(3):219-23. doi: 10.1097/00001888-199303000-00015.
To examine the choices of career paths of women in internal medicine, specifically to determine (1) whether women continue to prefer primary care practice more often than men do and (2) whether differences in career paths between men and women result from differences in the natures of the training programs they complete.
A database containing demographic, training, and clinical-practice information on 19,151 physicians (3,569 women and 15,582 men) who had been trained in internal medicine was constructed by merging data from the National Resident Matching Program matches in internal medicine for 1977-1982 with data from the 1985 American Medical Association Physician Masterfile, which contains physician practice profiles.
Similar percentages of the men and the women chose primary care residencies (8% versus 9%, ns) and trained in the 100 major medical centers (49% versus 50%, ns). The women more frequently trained in programs affiliated with medical schools in the top prestige quartile (38% versus 33%, p < .05). The attrition rates of residents who left their training for careers in other medical fields were the same for the men and the women (14%). Fewer women obtained board certification (74% versus 80%, p < .01). The women chose to practice general internal medicine more frequently than did the men (52% versus 45%, p < .0001), regardless of the training program completed (primary care or traditional).
The women pursued primary-care-oriented internal medicine to a significantly greater degree than did the men, regardless of the type of training program completed (primary care or traditional).
研究内科领域女性的职业道路选择，具体确定：（1）女性是否比男性更倾向于从事初级保健工作；（2）男性和女性职业道路的差异是否源于他们完成的培训项目性质的不同。
通过将1977 - 1982年内科国家住院医师匹配项目的数据与1985年美国医学协会医师主文件（其中包含医师执业概况）的数据合并，构建了一个包含19151名内科培训医师（3569名女性和15582名男性）的人口统计学、培训和临床实践信息的数据库。
选择初级保健住院医师培训的男性和女性比例相似（8%对9%，无显著差异），且在100家主要医疗中心接受培训的比例也相似（49%对50%，无显著差异）。女性更频繁地在处于声望排名前四分之一的医学院附属项目中接受培训（38%对33%，p < 0.05）。离开培训转而从事其他医学领域职业的住院医师流失率，男性和女性相同（14%）。获得委员会认证的女性较少（74%对80%，p < 0.01）。无论完成的培训项目类型（初级保健或传统项目）如何，女性比男性更频繁地选择从事普通内科工作（52%对45%，p < 0.0001）。
无论完成的培训项目类型是初级保健还是传统项目，女性从事以初级保健为导向的内科工作的程度都显著高于男性。
