Career plans for trainees in internal medicine residency programs
Career plans for trainees in internal medicine residency programs
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DOI：
10.1097/00001888-200505000-00021
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发表时间：
2005-05-01
影响因子：
7.4
通讯作者：
Bylsma, W
中科院分区：
文献类型：
--
作者：
Garibaldi, RA;Popkave, C;Bylsma, W
目的 接受初级保健学科住院医师培训的医学生越来越少。本报告描述了参加内科培训项目的住院医师的职业规划以及他们追求全科或亚专科职业道路的原因。方法从1998年至2003年，对参加内科培训考试的住院医师进行了问卷调查。每年的调查都包括有关职业选择的问题。 2002年，居民完成了一项关于他们职业选择的具体原因的更详细的调查。作者报告了他们的回应。 结果 计划从事全科职业的内科住院医师的比例稳步下降。 1998 年，54% 的 PGY3 计划从事普通内科工作，而 2003 年这一比例为 27%。引人注目的是，2003 年，只有 19% 的 PGY1 计划从事普通内科职业。选择通才职业的住院医师受到与患者建立长期关系的机会、广泛的实践内容领域、照顾门诊患者以及与家人相处的时间的影响。选择一个子专业而不是另一个子专业的具体原因在子专业学科之间差异很大。女性居民更喜欢能够有更多时间陪伴家人的纪律。出于相似的原因，两种性别都被特定的亚专业所吸引。 结论 计划从事全科医学职业的内科住院医师人数急剧减少。这种趋势至少在未来几年可能会持续下去，并可能对未来满足患者健康需求的方式产生影响。
Purpose Fewer medical students are pursuing residency training in primary care disciplines. This report describes the career plans of residents enrolled in internal medicine training programs and their reasons for pursuing either generalist or subspecialist career paths.Method From 1998 to 2003, questionnaires were administered to residents participating in the Internal Medicine In-Training Examination. Each year, the survey included questions on career choices. In 2002, residents completed a more detailed survey about the specific reasons for their career choices. The authors report their responses.Results There has been a steady decline in the percentage of internal medicine residents planning to pursue generalist careers. in 1998, 54% of PGY3s planned to practice general internal medicine compared with 27% in 2003. Strikingly, in 2003, only 19% of PGY1s planned to pursue careers in general medicine. Residents choosing careers as generalists were influenced by opportunities for long-term relationships with patients, a broad content area of practice, caring for ambulatory patients, and time with family. The specific reasons for choosing one subspecialty over another varied greatly among the subspecialty disciplines. Women residents preferred disciplines that allowed more time for family. Both genders were attracted to a particular subspecialty for similar reasons.Conclusions There has been a dramatic decrease in the number of internal medicine residents planning to pursue careers in general medicine. This trend will likely continue for the next few years, at least, and may have an impact on the manner in which the health needs of patients are met in the future.