Lester H E, Carter Y H, Dassu D, Hobbs F D
Department of General Practice, Medical School, Birmingham.
Br J Gen Pract. 1998 Jun;48(431):1322-6.
Recent changes in the organization of the National Health Service have created new roles and responsibilities for academic general practice. Previous work on the constraints and opportunities of a career in academic general practice is largely anecdotal and is often based on the views of more senior members of the profession.
To survey the research activity, perceived level of training, support needs, and career intentions of junior academic general practitioners (GPs).
A postal, validated, semistructured questionnaire was sent to the 121 eligible junior academic GPs in the academic departments of general practice in the United Kingdom and Dublin. Main outcome measures were 'research activity score', as measured by publications in peer-reviewed journals and involvement in research projects, 'training score' devised from 13 skills required for both research and teaching, and perceived level of departmental support assessed by six different support mechanisms.
Response rate was 89% (n = 108). Forty-six responders (43%) had no publications. Twenty-five responders (23%) had no principal project. Thirty-nine responders (37%) had a mentor. Research activity appeared to be dependent on sex, having a predominantly research role rather than a full-time teaching role, and a positive perception of academic training (P < 0.05). Increasing departmental 'support scores' and length of time in the department were both significantly associated with more positive perceptions of academic training (P < 0.05). Only 29 (27%) responders wanted to progress to senior positions within academic general practice.
Training and departmental support and guidance available to junior academics in primary care are perceived as variable and often inadequate. If academic general practice is to thrive, improved academic training is required, such as taught Master's degrees, supervised personal projects or 'apprenticeship' as a co-investigator, and improved methods of departmental support.
英国国家医疗服务体系近期的变革为学术性全科医疗创造了新的角色和职责。以往关于学术性全科医疗职业的限制与机遇的研究大多是轶事性的,且往往基于该行业资深成员的观点。
调查初级学术性全科医生(GP)的研究活动、感知到的培训水平、支持需求及职业意向。
向英国和都柏林全科医疗学术部门的121名符合条件的初级学术性全科医生发送了一份经过验证的邮政半结构化问卷。主要结局指标包括通过同行评审期刊发表文章及参与研究项目衡量的“研究活动得分”、根据研究和教学所需的13项技能设计的“培训得分”,以及通过六种不同支持机制评估的部门支持感知水平。
回复率为89%(n = 108)。46名回复者(43%)没有发表过文章。25名回复者(23%)没有主要项目。39名回复者(37%)有导师。研究活动似乎取决于性别、主要担任研究角色而非全职教学角色,以及对学术培训的积极认知(P < 0.05)。部门“支持得分”的增加和在部门工作的时间长度均与对学术培训的更积极认知显著相关(P < 0.05)。只有29名(27%)回复者希望在学术性全科医疗领域晋升到高级职位。
初级学术人员在初级保健中可获得的培训以及部门支持和指导被认为参差不齐且往往不足。若要使学术性全科医疗蓬勃发展,需要改进学术培训,如授课型硕士学位、有监督的个人项目或作为共同研究者的“学徒制”,并改进部门支持方法。