Going "Fourth" From Medical School: Fourth-Year Medical Students' Perspectives on the Fourth Year of Medical School
Going "Fourth" From Medical School: Fourth-Year Medical Students' Perspectives on the Fourth Year of Medical School
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DOI：
10.1097/acm.0000000000000802
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发表时间：
2015-10-01
影响因子：
7.4
通讯作者：
Raszka, William V., Jr.
中科院分区：
文献类型：
--
作者：
Benson, Nicole M.;Stickle, Timothy R.;Raszka, William V., Jr.
目的了解即将毕业的医学生认为医学院第四年的主要目的，他们选择住院医师的方法，以及他们在实现第四年目标时面临的挑战。方法2014年春季，对来自20所美国医学博士授予医学院的四年级学生进行了一项包含52个问题的网络调查。定量资料采用单因素方差分析、卡方分析或配对t检验进行分析。对一个开放式问题的回答被编入主题并加以确认。结果共有1,367/2,884名学生回应，占47.4%。学生平均申请了36.4个（SD = 22.6）住院医师项目，平均接受了12.3个（SD = 5.6）住院医师项目的采访。手术申请者申请的项目较多（mean = 58.2, SD = 22.3, P < .001）；放射学申请者在更多的项目中接受面试（mean = 16.9, SD = 8.5; P < .001）。学生们在他们选择的职业专业中平均选修了1.8个月（SD = 0.8）的选修课程；外科和急诊医学申请者更有可能完成选修课程（P < 0.001）。学生们一致认为，第四年有多种有价值的目的，包括最大限度地提高与他们选择的住院医师匹配的可能性，获得广泛的教育经验，并为住院医师做准备。主要目的因专业而异，但总体而言，学生们认为为住院医生做准备是最高的。修完选修课和面试都很昂贵；大约35%的学生因为经济拮据而无法完成选修课。结论医学生认为第四年是实习期的选择和准备阶段。
PurposeTo learn what graduating medical students considered the primary purposes of the fourth year of medical school, their approach to residency selection, and the challenges they faced in meeting their fourth-year goals.MethodA 52-question Web-based survey was administered to fourth-year students from 20 U.S. MD-granting medical schools in spring 2014. Quantitative data were analyzed with one-way analysis of variance, chi-square analysis, or paired t tests. Responses to an open-ended question were coded into themes and confirmed.ResultsA total of 1,367/2,884 (47.4%) students responded. Students applied to a mean of 36.4 (SD = 22.6) residency programs and interviewed at a mean of 12.3 (SD = 5.6) programs. Surgery applicants applied to more programs (mean = 58.2, SD = 22.3; P < .001); radiology applicants interviewed at more programs (mean = 16.9, SD = 8.5; P < .001). Students took a mean of 1.8 (SD = 0.8) monthlong away electives in their career specialty of choice; surgery and emergency medicine applicants were more likely to complete away electives (P < .001). Students agreed the fourth year has multiple valuable purposes, including maximizing the likelihood of matching into their residency of choice, gaining a broad educational experience, and preparing for residency. The main purpose varied by specialty, but overall students ranked preparing for residency highest. Completing away electives and interviewing were expensive; approximately 35% of students could not complete away electives because of financial constraints.ConclusionsMedical students view the fourth year as a time for residency selection and preparation.