Effect of the inpatient general medicine rotation on student pursuit of a generalist career
Effect of the inpatient general medicine rotation on student pursuit of a generalist career
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住院全科医学轮转对学生追求通才职业的影响
DOI：
10.1111/j.1525-1497.2006.00429.x
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发表时间：
2006
影响因子：
5.7
通讯作者：
D. Meltzer
中科院分区：
文献类型：
--
作者：
V. Arora;Tosha B. Wetterneck;J. Schnipper;A. Auerbach;P. Kaboli;R. Wachter;W. Levinson;H. Humphrey;D. Meltzer
背景：进入普通内科（GIM）的人数有所下降。住院全科医师轮转对医学生职业选择的影响是不确定的。目的：评估学生对住院全科医学轮转的满意度对其在GIM职业生涯的影响。设计：多中心队列研究。参与者：2001年7月至2003年6月的三年级医学生。测量方法：结束内科实习调查使用5分李克特量表评估轮换满意度。对GIM职业生涯的追求定义为：(1)对于“你有多大可能在GIM职业生涯”的问题，回答“非常有可能”或“肯定”；(2)利用机构匹配数据进入内科住院医师。结果：751名学生中有402名（54%）回答。在接受调查的学生中，307人（75%）在轮岗后的两年内得到了匹配。其中28%（87%）的人选择了内科住院医师。其中，8%（25/307）在GIM领域谋求职业发展。调整地点和职前兴趣后，对轮岗的总体满意度预测了对GIM职业的追求（优势比[OR] 3.91, P < .001）。虽然对个别项目的满意度并不能预测对通才职业的追求，但因子分析揭示了满意度的3个组成部分（主治医生、住院医生和教师）。调整职前兴趣后，两个因素（参加和教学）与学生在GIM的职业追求相关（P < 0.01）。结论：住院全科医生轮转满意度的提高促进了全科医生在GIM的职业追求。
BACKGROUND: Entry into general internal medicine (GIM) has declined. The effect of the inpatient general medicine rotation on medical student career choices is uncertain.OBJECTIVE: To assess the effect of student satisfaction with the ipatient general medicine rotation on pursuit of a career in GIM.DESIGN: Multicenter cohort study.PARTICIPANTS: Third-year medical students between July 2001 and June 2003.MEASUREMENTS: End-of-internal medicine clerkship survey assessed satisfaction with the rotation using a 5-point Likert scale. Pursuit of a career in GIM defined as: (1) response of “Very Likely” or “Certain” to the question “How likely are you to pursue a career in GIM?”; and (2) entry into an internal medicine residency using institutional match data.RESULTS: Four hundred and two of 751 (54%) students responded. Of the student respondents, 307 (75%) matched in the 2 years following their rotations. Twenty-eight percent (87) of those that matched chose an internal medicine residency. Of these, 8% (25/307) were pursuing a career in GIM. Adjusting for site and preclerkship interest, overall satisfaction with the rotation predicted pursuit of a career in GIM (odds ratio [OR] 3.91, P < .001). Although satisfaction with individual items did not predict pursuit of a generalist career, factor analysis revealed 3 components of satisfaction (attending, resident, and teaching). Adjusting for preclerkship interest, 2 factors (attending and teaching) were associated with student pursuit of a career in GIM (P < .01).CONCLUSIONS: Increased satisfaction with the inpatient general medicine rotation promotes pursuit of a career in GIM.