Miller R S, Dunn M R, Whitcomb M E
Department of Research and Data Analysis, American Medical Association, Chicago, Ill 60610, USA.
JAMA. 1997 Jun 4;277(21):1699-704.
To assess the degree and type of difficulty encountered by resident physicians attempting to enter the workforce in 1995.
Employment information derived from a 1-page descriptive survey completed by residency program directors from January 1, 1996, to June 15,1996, is described and compared with the results of a similar survey completed 1 year earlier.
Directors of 4568 residency programs in 31 specialties and subspecialties accredited by the Accreditation Council for Graduate Medical Education.
The number of 1995 program graduates, their current professional status, and program directors' characterization of the experience of graduates who entered clinical practice, including the number who experienced major difficulties securing an acceptable practice position. Program directors reported actual and anticipated decreases in the number of residency positions and the likely availability of future professional opportunities.
The 3819 program directors (83.6%) who completed the survey reported that 20065 resident physicians completed a residency program during 1995. Of those seeking employment (n = 13215), most entered clinical practice (80.1%) or took an academic position (15.6%); 2.2% were unemployed or had taken a position in a specialty or subspecialty different from the one in which they were last trained. A portion (6.3%) of graduates who entered clinical practice in their specialty or subspecialty experienced difficulty finding a suitable position; the percentage was lowest among graduates of general surgery, psychiatry, and primary care specialties.
Survey results regarding the 1995 graduates are consistent with those obtained regarding the 1994 graduates and suggest that the market for physician services in some disciplines continues to be restrictive. We found that graduates of the specialties of anesthesiology and plastic surgery, whom we reported had the greatest difficulty finding acceptable positions in 1994, had less difficulty in 1995, suggesting a possible improvement in the market, less competition, a change in the respondents' perception of "acceptable," or a change in the resident physicians' willingness to pursue different opportunities. The general consistency of our results and their congruence with other published data suggest that this method is useful to identify and monitor trends in the physician market.
评估1995年试图进入职场的住院医师所遇到的困难程度及类型。
描述并比较了1996年1月1日至1996年6月15日由住院医师培训项目主任填写的一份1页描述性调查问卷得出的就业信息，以及1年前完成的类似调查结果。
由毕业后医学教育认证委员会认证的31个专业和亚专业的4568个住院医师培训项目的主任。
1995年项目毕业生的数量、他们当前的专业状态，以及项目主任对进入临床实践的毕业生经历的描述，包括在获得可接受的执业岗位时遇到重大困难的毕业生数量。项目主任报告了住院医师岗位数量的实际和预期减少情况以及未来专业机会的可能可得性。
完成调查的3819名项目主任（83.6%）报告称，20065名住院医师在1995年完成了住院医师培训项目。在那些寻求就业的人中（n = 13215），大多数进入了临床实践（80.1%）或获得了学术职位（15.6%）；2.2%失业或在与其最后培训的专业或亚专业不同的领域任职。进入其专业或亚专业临床实践的毕业生中有一部分（6.3%）在寻找合适岗位时遇到困难；在普通外科、精神病学和初级保健专业的毕业生中这一比例最低。
关于1995年毕业生的调查结果与关于1994年毕业生的结果一致，表明某些学科的医师服务市场仍然具有限制性。我们发现，麻醉学和整形外科专业的毕业生在1994年被报告在寻找可接受岗位时困难最大，但在1995年困难较小，这表明市场可能有所改善、竞争减少、受访者对“可接受”的认知发生了变化，或者住院医师追求不同机会的意愿发生了变化。我们结果的总体一致性以及它们与其他已发表数据的一致性表明，这种方法有助于识别和监测医师市场的趋势。
