Medical Career Choices: Traditional and New Possibilities
Medical Career Choices: Traditional and New Possibilities
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医疗职业选择：传统和新的可能性
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
J. H. Lockwood
中科院分区：
文献类型：
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作者：
G. Richard;D. M. Nakamoto;J. H. Lockwood
关于美国应如何雇用医生的争议仍在继续。一些劳动力专家认为，存在医生供过于求的情况，他们认为对抗疗法、整骨疗法和国际医学毕业生都在争夺管理医疗环境中有限的实践机会。其他专家主张扩大美国医学院的职位，声称尽管供应过剩，但医生的需求并未减少。然而其他人仍然认为，问题的根源在于医生“分布不均”到城市和郊区，而不是农村和内城区。最近的数据表明，这种实践差距（许多医学院初级保健举措的目标）并未消除，甚至可能扩大。无论医生队伍辩论的结果如何，医生都将面临临床实践角色不断变化的格局以及替代职业选择的增加。一些医学毕业生选择完全拒绝传统的临床角色。在本期中，我们探讨了医生临床和非临床角色的持续演变，包括额外的职业可能性。美国医学院协会自 1978 年以来一直在监测医学生未来的实践模式，每年在毕业前对医学生进行民意调查，询问他们的职业计划。在本期中，理查德博士及其同事检查了与医学生职业决策相关的调查问卷中的 10 年数据，尤其是传统临床医学以外的职业决策。寻求替代道路的医生经常寻求额外的研究生或专业学位来扩大他们的职业选择。许多医学院响应了这一需求，提供了综合学位课程，传统上是公共卫生和卫生政策领域，最近则提供商业和法律领域的学位课程。法学博士学位是过去十年中越来越受欢迎的一种可能性：在本期中，马修·霍华德（Matthew Howard）医学博士、法学博士概述了法律医学的发展以及受过法律培训的医生可以发挥的作用。在这个管理式医疗时代，商业培训可能是一种资产。不仅一些医生寻求商业知识以提高他们在医学财务事务方面的熟练程度，而且企业也在寻找拥有医学博士学位和医学博士/博士学位组合的人员，以便将新知识带入工作场所。迈克尔·恩南 (Michael Ennen) 探讨了公司为何聘请医生作为顾问。对于决定在传统研究之外为医学科学进步做出贡献的医学生来说，有哪些可能的选择？对于那些有耐心的人来说，医学编辑是一种可能。 《新英格兰医学杂志》前主编、医学博士杰罗姆·卡西尔 (Jerome Kassirer) 探讨了为您带来 JAMA 和 MSJAMA 的努力（长时间的编辑、重新编辑和文案编辑）。
CONTROVERSY CONTINUES OVER HOW PHYSICIANS SHOULD BE employed in the United States. Some workforce experts believe there is a physician oversupply, arguing that allopathic, osteopathic, and international medical graduates are all competing for limited practice opportunities in the managed care setting. Other experts have advocated the expansion of US medical school positions, claiming that physician demand has not lessened despite a perceived oversupply. Yet others continue to hold that a “maldistribution” of physicians into urban and suburban areas, rather than rural and inner-city regions, is the root of the problem. Recent data suggest that this practice disparity, the target of primary care initiatives in many medical schools, has not closed, and may even have widened. Whatever the outcome of the physician workforce debate, physicians will face a changing landscape of clinical practice roles as well as increased availability of alternate career options. Some medical graduates are choosing to reject traditional clinical roles altogether. In this issue, we explore the continuing evolution of physicians’ clinical and nonclinical roles, including additional career possibilities. The Association of American Medical Colleges has monitored medical students’ future practice patterns since 1978, polling medical students each year prior to graduation to ask them about their career plans. In this issue, Dr Richard and colleagues examine 10 years of data from the questionnaire relevant to medical student career decisions, especially those outside traditional clinical medicine. Physicians seeking an alternative path have frequently sought additional graduate or professional degrees to expand their career options. Many medical schools have responded to the demand by offering combined degree programs, traditionally in public health and health policy, and, more recently, in business and law. The juris doctor degree is one possibility that has grown in popularity in the past decade: in this issue, Matthew Howard, MD, JD, outlines the development of legal medicine and the roles that physicians with legal training can play. In this era of managed care, training in business may be an asset. Not only are some physicians seeking business knowledge to increase their proficiency in the financial affairs of medicine, but businesses are also seeking persons with MD and combined MD/PhD degrees to bring new knowledge to the workplace. Michael Ennen examines why firms are hiring physicians as consultants. What possible choices exist for medical students who decide to contribute, outside of traditional research, to the advancement of medical science? For those with patience, medical editing is a possibility. The effort that brings you JAMA and MSJAMA—long hours of editing, reediting, and copyediting—is explored by Jerome Kassirer, MD, a former editor-in-chief of the New England Journal of Medicine.