Early career choices and successful career progression in surgery in the UK: prospective cohort studies.
Early career choices and successful career progression in surgery in the UK: prospective cohort studies.
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DOI：
10.1186/1471-2482-10-32
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发表时间：
2010-11-02
期刊：
影响因子：
1.9
通讯作者：
Parks RW
中科院分区：
文献类型：
--
作者：
Goldacre MJ;Laxton L;Harrison EM;Richards JM;Lambert TW;Parks RW
全世界医疗培训结构的变化要求医生在毕业后越来越早的阶段就决定他们的职业专业。我们研究了英国毕业生在手术职业选择方面的趋势，以及他们最终的职业目的地，这些毕业生宣布了对手术的早期偏好。邮寄问卷，在资格后的定期时间间隔，从1974年至2005年选定的资格年所有英国医学院的所有医疗资格。他们在取得资格后的第一年、取得资格后的第三年和第五年以及此后更长的时间间隔内被派遣。在第一年收到了38280名医生中的27749名（73%），第三年收到了33151名医生中的23468名（71%），第五年收到了24870名医生中的17689名（71%）。早期的职业偏好表明，在过去的二十年里，外科手术变得越来越受欢迎。从早期的职业选择来看，60%的受访者（64%的男性，48%的女性）在第一年首选外科专业，最终在外科工作（男女比较p < 0.001）。从最终的职业目标回顾，90%的外科工作者最初在第一年就指定了外科专业的第一选择。最终目的地和早期选择之间的“匹配”率在外科手术中比其他专业高得多。考虑到影响早期专业选择的因素“很多”，比较有抱负的外科医生和有抱负的全科医生（GP），选择手术的比例明显高于全科医生对专业的热情（73%对53%），一个特定的教师或部门（34%对12%），在医学院之前的倾向（20%对11%），以及未来的财务前景（24%对13%）;更低比例的人指出工作时间和工作条件影响了他们的选择（21%对71%）。选择手术的女性受医学院之前的倾向或未来经济前景的影响小于男性。外科是英国一个受欢迎的专业选择。绝大多数在外科职业生涯中取得进步的医生都很早就做出了明确的决定。
Changes to the structure of medical training worldwide require doctors to decide on their career specialty at an increasingly early stage after graduation. We studied trends in career choices for surgery, and the eventual career destinations, of UK graduates who declared an early preference for surgery. Postal questionnaires were sent, at regular time intervals after qualification, to all medical qualifiers from all UK medical schools in selected qualification years between 1974 and 2005. They were sent in the first year after qualification, at year three and five years after qualification, and at longer time intervals thereafter. Responses were received from 27 749 of 38 280 doctors (73%) at year one, 23 468 of 33151 (71%) at year three, and 17 689 of 24 870 (71%) at year five. Early career preferences showed that surgery has become more popular over the past two decades. Looking forward from early career choice, 60% of respondents (64% of men, 48% of women) with a first preference for a surgical specialty at year one eventually worked in surgery (p < 0.001 for the male-female comparison). Looking backward from eventual career destinations, 90% of responders working in surgery had originally specified a first choice for a surgical specialty at year one. 'Match' rates between eventual destinations and early choices were much higher for surgery than for other specialties. Considering factors that influenced early specialty choice 'a great deal', comparing aspiring surgeons and aspiring general practitioners (GPs), a significantly higher percentage who chose surgery than general practice specified enthusiasm for the specialty (73% vs. 53%), a particular teacher or department (34% vs. 12%), inclinations before medical school (20% vs. 11%), and future financial prospects (24% vs. 13%); and a lower percentage specified that hours and working conditions had influenced their choice (21% vs. 71%). Women choosing surgery were influenced less than men by their inclinations before medical school or by their future financial prospects. Surgery is a popular specialty choice in the UK. The great majority of doctors who progressed in a surgical career made an early and definitive decision to do so.
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