MEDICAL-STUDENTS CAREER INDECISION AND SPECIALTY REJECTION - ROADS NOT TAKEN
MEDICAL-STUDENTS CAREER INDECISION AND SPECIALTY REJECTION - ROADS NOT TAKEN
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DOI：
10.1097/00001888-199510000-00018
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发表时间：
1995-10-01
影响因子：
7.4
通讯作者：
SZENAS, PL
中科院分区：
文献类型：
--
作者：
KASSEBAUM, DG;SZENAS, PL
作者使用了来自AAMC录取学生问卷和医学院毕业问卷的数据，以确定1991年和1994年美国医学院毕业生的专业或亚专业选择与他们入学时所宣称的偏好的匹配程度;这些学生强烈考虑并拒绝医学院期间出现的选择的程度;以及两个班级中相当数量的学生在进入医学院时对自己的职业还没有决定的毕业选择。两个班级中大约80%的毕业生拒绝了他们在进入医学院时宣布的专业意向。然而，在1994年的队列中，对全科医学专业（家庭医学、普通儿科学和普通内科学）的入学兴趣更持久，而对内科、外科和支持专业的兴趣则不那么持久。1991年和1994年的学生中有很大比例的人在入学时对自己的职业没有决定（分别为20.8%和26.2%），毕业时仍然没有决定的人也有几乎同样的比例。然而，与1991年同期的毕业生相比，1994年同期的毕业生中，最初犹豫不决的毕业生做出了更倾向于某个通才专业的决定。近一半的1994年毕业生强烈考虑过，然后拒绝了他们在医学院期间产生的入学兴趣的替代方案。在全科医学专业中，早期和后期对家庭实践的兴趣都比普通儿科和普通内科更持久：对于每一个从家庭实践的初步兴趣中退缩的学生，另一个学生的兴趣得到了加强或点燃。作者讨论了这些研究结果对未来生产的全科医生的影响。
The authors used data from the AAMC Matriculating Student Questionnaire and Medical School Graduation Questionnaire to ascertain how closely the specialty or subspecialty choices of the 1991 and 1994 graduates of U.S medical schools matched the preferences they had declared when they were matriculated; the extent to which these students strongly considered and then rejected choices that arose during medical school; and the graduation choices of the substantial number of students in both cohorts who were undecided about their careers when they entered medical school.Approximately 80% of the graduates in both classes rejected the specialty intentions they had declared when they began medical school. However, matriculation interests in the generalist specialties-family practice, general pediatrics, and general internal medicine-were more enduring for the 1994 cohort, while interests in the medical, surgical, and support specialties were less so. Large percentages of the 1991 and 1994 cohorts were undecided about their careers at matriculation (20.8% and 26.2%, respectively), and nearly the same proportions remained undecided at graduation. However, more of the graduates in the 1994 cohort who had initially been undecided reached decisions favoring one of the generalist specialties than was true for the 1991 cohort.Nearly half the 1994 graduates had strongly considered and then rejected an alternative to their matriculation interest that arose during medical school. Within the generalist specialties, both early and later interests in family practice were more durable than were those in general pediatrics and general internal medicine: for every student who retreated from tentative interest in family practice, another student's interest was reinforced or kindled. The authors discuss the implications of these findings for the future production of generalist physicians.