West P A, Norris T E, Gore E J, Baldwin L M, Hart L G
Department of Family Medicine, University of Washington, Seattle 98195-4715, USA.
J Am Board Fam Pract. 1996 Mar-Apr;9(2):100-8.
There is a clear national mandate to increase the proportion of generalist physicians within the medical community and to increase their numbers within rural and underserved urban locations. Little is known, however, about the geographic and temporal career patterns of family physicians or about how these patterns differ by sex and graduation cohort.
Using information from a follow-up survey of the University of Washington Family Practice Residency Network, we analyzed the characteristics of 358 graduate physicians and their 493 practices, including data on geographic practice locations.
Two thirds of graduates began their practices in urban locations, and one third initially settled in rural communities. Female graduates were much less likely than their male peers to choose rural practice locations. Few physicians left practices after they had practiced in them for 5 or 6 years. The majority of graduates were still in the practice where they started as long as 18 years earlier.
The most important career decision made by the graduate of a family medicine residency involves practice location. Because women are less likely to practice in rural areas, the increasing proportion of women graduating from family practice residencies might presage shortages of rural physicians in the future.
国家明确要求提高全科医生在医学界的比例，并增加其在农村及城市医疗服务欠缺地区的数量。然而，对于家庭医生的地理分布和职业生涯模式，以及这些模式如何因性别和毕业批次而有所不同，我们知之甚少。
利用来自华盛顿大学家庭医学住院医师网络后续调查的信息，我们分析了358名毕业医生及其493次执业经历的特征，包括地理执业地点的数据。
三分之二的毕业生在城市地区开始执业，三分之一最初定居在农村社区。女性毕业生选择在农村执业的可能性远低于男性同行。很少有医生在执业5或6年后离开。大多数毕业生仍在他们18年前开始执业的地方工作。
家庭医学住院医师毕业生做出的最重要的职业决定涉及执业地点。由于女性在农村地区执业的可能性较小，家庭医学住院医师中女性毕业生比例的增加可能预示着未来农村地区医生短缺。
