US Graduate Medical Education, 2004-2005 - Trends in primary care specialties
US Graduate Medical Education, 2004-2005 - Trends in primary care specialties
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DOI：
10.1001/jama.294.9.1075
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发表时间：
2005-09-07
影响因子：
120.7
通讯作者：
Etzel, SI
中科院分区：
文献类型：
--
作者：
Brotherton, SE;Rockey, PH;Etzel, SI
背景在过去的十年中，初级保健专业经历了低潮和流行。描述未来的初级保健劳动力可以告知我们population.Objectives的卫生保健需求规划描述在过去9年的初级保健专科医生培训的特点，并监测整个居住人口的特点的趋势。由美国医学协会和美国医学院协会进行，他们在2004-2005学年联合调查了8246个对抗疗法研究生医学教育（GME）项目，涉及活跃的、转移的和毕业的居民，以及节目的特点。项目负责人确认了97.3%的活跃居民的身份。7163（87%）的项目主任完成了伴随的项目调查。主要结果测量所有住院医师、研究员和培训项目的数量和特征的总体趋势，结果2004- 2009年全国在职医师101291人，2009 - 2009年在职医师101291人，2009 - 2009年在职医师101291人，2009 - 2009年在职医师101291人，2009 - 2009年在职医师101291人。2005学年，这是有史以来最多的调查记录。骨科医学院毕业生（DOS）在对抗疗法GME的人数从2003-2004年的5838人下降到5,675人，经过多年的年度增长。初级保健专科的住院医生人数在1990年代中期达到高峰。美国对抗疗法医学院（USMD）毕业的家庭医学住院医师人数从1998-1999年的8232人（77.6%）下降到2004-2005年的4848人（51.7%）。1995-1996年（n=1768）和2004-2005年（n=3304）之间，外国医学院毕业生和美国公民（USIMG）的初级保健住院医师人数几乎翻了一番。1995-1996年（n=622）和2004-2005年（n=906）之间，内科或儿科专科的USIMG培训数量增加了45.7%。儿科专科研究员的数量增长了55.7%，主要是因为USMD的数量几乎翻了一番，从813人增加到1617人。超过一半的初级保健住院医生是妇女（52.5%）。所有初级保健专业和亚专业的女性居民的比例经历了增长，最大的妇产科，增加了28.7%（57.9%，1995-1996年与74.5%，2004-2005年）。结论越来越多的医生正在追求亚专业培训的比例，而在初级保健专业的人数已经持平。GME的趋势表明，未来的初级保健医疗队伍将包括更多的女性，更多的IMG和更多的DOS。
Context Over the last decade, the primary care specialties have experienced an ebb and flow in popularity. A description of the future primary care workforce may inform planning for the health care needs of our population.Objectives To describe characteristics of physicians training in primary care specialties over the past 9 years and to monitor trends in the characteristics of the entire residency population.Design, Setting, and Participants Descriptive survey study of the National GME Census, conducted by the American Medical Association and Association of American Medical Colleges, which jointly surveyed 8246 allopathic graduate medical education (GME) programs during the academic year 2004-2005 about active, transferred, and graduated residents, as well as about program characteristics. Program directors confirmed the status of 97.3% of active residents. The accompanying program survey was completed by 7163 (87%) of the program directors.Main Outcome Measures General trends in the numbers and characteristics of all residents, fellows, and training programs, with specific trends for residents and fellows training in the primary care specialties and subspecialties over the past 9 years.Results The census counted 101291 physicians-in-training during the 2004-2005 academic year, the largest number ever recorded by this survey. The number of osteopathic medical school graduates (DOS) in allopathic GME decreased from 5838 in 2003-2004 to 5,675, following many years of annual increases. The number of residents in primary care specialties reached a peak in the mid 1990s. The number of family medicine residents who are graduates of US allopathic medical schools (USMDs) has fallen from 8232 (77.6%) in 1998-1999 to 4848 (51.7%) in 2004-2005. The number of primary care residents who are graduates of foreign medical schools and US citizens (USIMGs) nearly doubled between 1995-1996 (n=1768) and 2004-2005 (n=3304). The number of USIMGs training in internal medicine or pediatrics subspecialties increased by 45.7% between 1995-1996 (n=622) and 2004-2005 (n=906). The number of pediatric subspecialty fellows grew 55.7%, mostly because of the near doubling of USMDs, from 813 to 1617. More than half of primary care residents are women (52.5%). All primary care specialties and subspecialties experienced gains in the proportion of female residents, with the greatest in obstetrics/gynecology, which increased by 28.7% (57.9% in 1995-1996 vs 74.5% in 2004-2005).Conclusions An increasing proportion of physicians are pursuing subspecialty training, while the number in primary care specialties has leveled off. Trends in GME suggest that the primary care medical workforce of the future will include more women, more IMGs, and more DOS.