Factors influencing the choice of specialty of Australian medical graduates
Factors influencing the choice of specialty of Australian medical graduates
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DOI：
10.5694/j.1326-5377.2005.tb07058.x
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发表时间：
2005-09-19
影响因子：
11.4
通讯作者：
Young, JR
中科院分区：
文献类型：
--
作者：
Harris, MG;Gavel, PH;Young, JR
目的：确定医生选择专业的外在决定因素的相对重要性。设计：自填式邮寄调查问卷。背景：澳大利亚职业培训项目。参与者：2002 年 9 月在提供职业培训项目的 16 所澳大利亚临床学院之一注册的 4259 名澳大利亚医学毕业生。主要结果指标：专科职业培训项目的选择；影响项目选择的外在因素，以及性别、年龄、婚姻状况和出生国家的差异。结果：总体而言，79％的受访者认为“对自身技能和才能的评估”对其专业选择有影响，其次是“专业的知识内容”（75％）。影响最大的外在因素是“工作文化”（72%）、“工作安排的灵活性”（56%）和“工作时间”（54%）。我们观察到，不同培训项目中影响专业选择的因素以及性别、年龄和婚姻状况的重要性存在差异。与男性相比，对女性特别重要的因素是“对家庭环境的评估”（比值比[OR]，1.9）、“工作时间”（OR，1.8）和“弹性工作时间的机会”（OR，2.6）。与单身医生相比，合伙医生认为“工作时间”和“灵活工作时间的机会”更重要（OR，1.3），而对于有孩子的医生来说，“家庭情况”比没有孩子的医生更重要（OR，1.7）。总共有 80% 的医生在毕业后第三年年底选择了自己的专业。结论：基于学科的工作文化和工作条件的体验贯穿于医学院和研究生早期，大多数医生在这些年里选择了自己的专业。因此，影响医生专业选择的干预措施需要针对这些关键年份。
Objective: To identify the relative importance of extrinsic determinants of doctors' choice of specialty.Design: A self-administered postal questionnaire.Setting: Australian vocational training programs.Participants: 4259 Australian medical graduates registered in September 2002 with one of 16 Australian clinical colleges providing vocational training programs.Main outcome measures: Choice of specialist vocational training program; extrinsic factors influencing choice of program, and variation by sex, age, marital status and country of birth.Results: In total, 79% of respondents rated "appraisal of own skills and aptitudes" as influential in their choice of specialty followed by "intellectual content of the specialty" (75%). Extrinsic factors rated as most influential were "work culture" (72%), "flexibility of working arrangements" (56%) and "hours of work" (54%). We observed variation across training programs in the importance ascribed to factors influencing choice of specialty, and by sex, age and marital status. Factors of particular importance to women, compared with men, were "appraisal of domestic circumstances" (odds ratio [OR], 1.9), "hours of work" (OR, 1.8) and "opportunity to work flexible hours" (OR, 2.6). Partnered doctors, compared with single doctors, rated "hours of work" and "opportunity to work flexible hours" as more important (OR, 1.3), while "domestic circumstances" was more important to doctors with children than those without children (OR, 1.7). In total, 80% of doctors had chosen their specialty by the end of the third year after graduation.Conclusions: Experience with discipline-based work cultures and working conditions occurs throughout medical school and the early postgraduate years, and most doctors choose their specialty during these years. It follows that interventions to influence doctors' choice of specialty need to target these critical years.