51
|
Kumwenda B, Cleland J, Prescott G, Walker K, Johnston P. Relationship between sociodemographic factors and specialty destination of UK trainee doctors: a national cohort study. BMJ Open 2019; 9:e026961. [PMID: 30918038 PMCID: PMC6475150 DOI: 10.1136/bmjopen-2018-026961] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Many countries are driving forward policies to widen the socioeconomic profile of medical students and to train more medical students for certain specialties. However, little is known about how socioeconomic origin relates to specialty choice. Nor is there a good understanding of the relationship between academic performance and specialty choice. To address these gaps, our aim was to identify the relationship between socioeconomic background, academic performance and accepted offers into specialty training. DESIGN Longitudinal, cohort study using data from the UK Medical Education Database (https://www.ukmed.ac.uk/). PARTICIPANTS 6065 (60% females) UK doctors who accepted offers to a specialty training (residency) post after completing the 2-year generic foundation programme (UK Foundation Programme) between 2012 and 2014. MAIN OUTCOME MEASURES Χ2 tests were used to examine the relationships between sociodemographic characteristics, academic ability and the dependent variable, specialty choice. Multiple data imputation was used to address the issue of missing data. Multinomial regression was employed to test the independent variables in predicting the likelihood of choosing a given specialty. RESULTS Participants pursuing careers in more competitive specialties had significantly higher academic scores than colleagues pursuing less competitive ones. After controlling for the presence of multiple factors, trainees who came from families where no parent was educated to a degree level had statistically significant lower odds of choosing careers in medical specialties relative to general practice (OR=0.78, 95% CI, 0.67 to 0.92). Students who entered medical school as school leavers, compared with mature students, had odds 1.2 times higher (95% CI, 1.04 to 1.56) of choosing surgical specialties than general practice. CONCLUSIONS The data indicate a direct association between trainees' sociodemographic characteristics, academic ability and career choices. The findings can be used by medical school, training boards and workforce planners to inform recruitment and retention strategies.
Collapse
Affiliation(s)
- Ben Kumwenda
- Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Jennifer Cleland
- Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Gordon Prescott
- Medical Statistics Team, University of Aberdeen, Aberdeen, UK
| | - Kim Walker
- Institute of Education for Medical and Dental Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, UK, Centre for Healthcare Education Research and Innovation (CHERI), Aberdeen, UK
| | - Peter Johnston
- NHS, NHS Grampian and The Scotland Deanery, Aberdeen, UK
| |
Collapse
|
52
|
Gameiro GR, Darcie ALF, Hazaki D, Gameiro GR, Carricondo PC. Why ophthalmology? Analysis of the motivating factors influencing the choice of ophthalmology as a career among different generations in Brazil. Clinics (Sao Paulo) 2019; 74:e1101. [PMID: 31508716 PMCID: PMC6724451 DOI: 10.6061/clinics/2019/e1101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 06/10/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The increasing demand for medical specialties with flexible working hours has been associated with the important role of quality of life as a determining factor when choosing a career in medicine, which might change the motivations for pursuing a career in ophthalmology. We aim to identify the main determinants of ophthalmology as a career choice as well as the reasons that motivated previous generations to follow this path. METHODS Responses to self-administered online questionnaires were analyzed. RESULTS A total of 225 responses were analyzed, including those of baby boomers (21), generation X (48), generation Y (131) and generation Z (25). Although the main reasons for choosing ophthalmology as a career are the same for all the generations in this study (flexible working hours, self-satisfaction from helping people improve their vision and the possibility of performing surgical procedures), some reasons for this career choice are more important to the younger generations (short-term results and short procedures), and some are more important to the older generations (the influence of an ophthalmologist in the family). CONCLUSION The main reasons for choosing ophthalmology as a career are essentially the same over time. The differences in secondary motivations could be explained by generational differences.
Collapse
Affiliation(s)
- Gustavo Rosa Gameiro
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Corresponding author. E-mail:
| | - Ana Letícia Fornazieri Darcie
- Departamento de Oftalmologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Daniel Hazaki
- Departamento de Oftalmologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Pedro Carlos Carricondo
- Departamento de Oftalmologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| |
Collapse
|
53
|
Venkatesh B, Mehta S, Angus DC, Finfer S, Machado FR, Marshall J, Mitchell I, Peake S, Zimmerman JL. Women in Intensive Care study: a preliminary assessment of international data on female representation in the ICU physician workforce, leadership and academic positions. Crit Care 2018; 22:211. [PMID: 30196796 PMCID: PMC6130077 DOI: 10.1186/s13054-018-2139-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 07/27/2018] [Indexed: 11/12/2022] Open
Abstract
Background Despite increasing female enrolment into medical schools, persistent gender gaps exist in the physician workforce. There are limited published data on female representation in the critical care medicine workforce. Methods To obtain a global perspective, societies (n = 84; 79,834 members (40,363 physicians, 39,471 non-physicians)) registered with the World Federation of Societies of Intensive and Critical Care Medicine were surveyed. Longitudinal data on female trainee and specialist positions between 2006-2017 were obtained from Australia and New Zealand. Data regarding leadership and academic faculty representation were also collected from national training bodies and other organisations of critical care medicine. Results Of the 84 societies, 23 had a registered membership of greater than 500 members. Responses were received from 27 societies (n = 55,996), mainly high-income countries, covering 70.1% of the membership. Amongst the physician workforce, the gender distribution was available from six (22%) participating societies—mean proportion of females 37 ± 11% (range 26–50%). Longitudinal data from Australia and New Zealand between 2006 and 2017 demonstrate rising proportions of female trainees and specialists. Female trainee and specialist numbers increased from 26 to 37% and from 13 to 22% respectively. Globally, female representation in leadership positions was presidencies of critical care organisations (0–41%), representation on critical care medicine boards and councils (8–50%) and faculty representation at symposia (7–34%). Significant gaps in knowledge exist: data from low and middle-income countries, the age distribution and the time taken to enter and complete training. Conclusions Despite limited information globally, available data suggest that females are under-represented in training programmes, specialist positions, academic faculty and leadership roles in intensive care. There are significant gaps in data on female participation in the critical care workforce. Further data from intensive care organisations worldwide are required to understand the demographics, challenges and barriers to their professional progress. Electronic supplementary material The online version of this article (10.1186/s13054-018-2139-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Bala Venkatesh
- Intensive Care, Wesley and Princess Alexandra Hospitals, Brisbane, QLD, Australia. .,College of Intensive Care Medicine, Prahran, VIC, Australia. .,The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
| | - Sangeeta Mehta
- Department of Medicine and Interdepartmental Division of Critical Care Medicine, Sinai Health System, University of Toronto, Toronto, ON, Canada
| | - Derek C Angus
- The Clinical Research, Investigation, and Systems Modeling of Acute illness [CRISMA] Center, Pittsburgh, PA, USA.,Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Simon Finfer
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Royal North Shore Hospital, Sydney, NSW, Australia
| | - Flavia R Machado
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, Sao Paulo, SP, Brazil
| | - John Marshall
- Department of Surgery and Critical Care Medicine, St. Michael's Hospital, Toronto, ON, Canada
| | - Imogen Mitchell
- Australian National University Medical School, Canberra, ACT, Australia
| | - Sandra Peake
- Department of Intensive Care Medicine, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, SA, Australia
| | - Janice L Zimmerman
- World Federation of Societies of Intensive and Critical Care Medicine, Houston, Texas, USA.,Societies of Intensive and Critical Care Medicine, Houston Methodist Hospital, Houston, TX, USA
| |
Collapse
|
54
|
Mills JMZ, Januszewski AS, Robinson BG, Traill CL, Jenkins AJ, Keech AC. Attractions and barriers to Australian physician-researcher careers. Intern Med J 2018; 49:171-181. [PMID: 30152020 DOI: 10.1111/imj.14086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 08/02/2018] [Accepted: 08/20/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a global concern that physician-researchers are 'a dying breed'. Recent studies of clinical career choices of Australian medical students and doctors have signalled the rising age of medical graduates, generational shifts in work-life attitudes and increased proportion of female graduates. There are scant data regarding Australian physician-researchers. AIMS To develop and utilise a questionnaire determining respondent characteristics and 'push' and 'pull' factors for medical graduates to incorporate research into their careers. METHODS We developed and administered an 88-item online survey, including quantitative and qualitative questions, to medical students, faculty and alumni of Sydney Medical School, The University of Sydney, asking about their medical career, research experience and interest and reasons for doing or not doing medical research. Responses to all 74 quantitative questions are reported here. RESULTS Data from 427 respondents (44% female; mean ± standard deviation age 38 ± 13 years; 56% completed or undertaking a PhD) were analysed. Attractions of research included a desire to improve human health, intellectual stimulation and career diversity. Barriers included low funding rates, job insecurity and low salaries. Although few were prepared to undertake or recommend full-time research, 71% would recommend part-time research. Respondents perceived a smaller-than-actual gap between clinical and research salaries, and if comparable (75-100% of a clinician's) salaries were available, 89% would like to spend 21-60% of their work time undertaking research. CONCLUSION Many Australian medical students and doctors are interested in research, especially part time. Perceived obstacles include job insecurity, low funding rates and salary. Respondents underestimated clinical and research salary differences.
Collapse
Affiliation(s)
- Joanna M Z Mills
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Andrzej S Januszewski
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Bruce G Robinson
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Caroline L Traill
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Alicia J Jenkins
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Anthony C Keech
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
55
|
Sun HY, Ko YM, Lee SW, Lee B, Kim JH. The application rate for urology specialty compared with other specialties from 2007 to 2014 in Korea: is it influenced by social interest manifested by internet trends? BMC Urol 2018; 18:65. [PMID: 30041640 PMCID: PMC6057043 DOI: 10.1186/s12894-018-0375-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 06/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reduced clinical exposure to urology at the undergraduate or internship level is the main explanation for the marked decrease in applicants to urology residencies. This manuscript was to access the application rate for urology specialty compared with that of other specialties and to investigate the relationship between the decreasing trend in urology applications and social interest using internet trend tests. METHODS We reviewed data collected by the Korean Hospital Association from 2007 to 2014. We assessed internet trends using Naver Trend for domestic social interest and Google Trends for international social interest (2007 to 2014). Trend tests and Spearman correlations were used for statistical analyses. RESULTS Among the all specialties, the application rates to obstetrics and gynecology, emergency medicine, and occupational medicine are significantly increasing (p = 0.015, 0.012, and 0.048, respectively). Application to other specialties is mostly decreasing. The decreasing trend is highest for urology (beta = - 12.21 and p < 0.001). The application rate and domestic social interest revealed by Naver trends were significantly correlated (r = 0.786 and p = 0.021). No correlation was found between Naver trends and Google trends (r = - 0.19 and p = 0.651). CONCLUSIONS The rate of application to urology specialty is decreasing the fastest, and this trend is related to domestic social interest. An attempt should be made to increase the number of urologic applicants.
Collapse
Affiliation(s)
- Hwa Yeon Sun
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul, 140-743, South Korea
| | - Young Myoung Ko
- Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, South Korea
| | - Seung Wook Lee
- Department of Urology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Bora Lee
- Department of Statistics, Graduate School of Chung-Ang University, 84, Heuksukro, Seoul, 156-756, South Korea.
| | - Jae Heon Kim
- Department of Urology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul, 140-743, South Korea.
| |
Collapse
|
56
|
Hindhede AL, Larsen K. Prestige hierarchies of diseases and specialities in a field perspective. SOCIAL THEORY & HEALTH 2018. [DOI: 10.1057/s41285-018-0074-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
57
|
Jaye C, Young J, Egan T, Williamson M. Moral Economy and Moral Capital in the Community of Clinical Practice. QUALITATIVE HEALTH RESEARCH 2018; 28:523-533. [PMID: 29110577 DOI: 10.1177/1049732317740347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This New Zealand study used focused ethnography to explore the activities of communities of clinical practice (CoCP) in a community-based long-term conditions management program within a large primary health care clinic. CoCP are the informal vehicles by which patient care was delivered within the program. Here, we describe the CoCP as a micro-level moral economy within which values such as trust, respect, authenticity, reciprocity, and obligation circulate as a kind of moral capital. As taxpayers, citizens who become patients are credited with moral capital because the public health system is funded by taxes. This moral capital can be paid forward, accrued, banked, redeemed, exchanged, and forfeited by patients and their health care professionals during the course of a patient's journey. The concept of moral capital offers another route into the "black box" of clinical work by providing an alternative theoretic for explaining the relational aspects of patient care.
Collapse
Affiliation(s)
| | | | - Tony Egan
- 1 University of Otago, Dunedin, New Zealand
| | | |
Collapse
|
58
|
van der Burgt SME, Kusurkar RA, Wilschut JA, Tjin A Tsoi SLNM, Croiset G, Peerdeman SM. Motivational Profiles and Motivation for Lifelong Learning of Medical Specialists. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2018; 38:171-178. [PMID: 29794548 DOI: 10.1097/ceh.0000000000000205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION Medical specialists face the challenge of maintaining their knowledge and skills and continuing professional development, that is, lifelong learning. Motivation may play an integral role in many of the challenges facing the physician workforce today including maintenance of a high performance. The aim of this study was to determine whether medical specialists show different motivational profiles and if these profiles predict differences in motivation for lifelong learning. METHODS An online questionnaire was sent to every medical specialist working in five hospitals in the Netherlands. The questionnaire included the validated Multidimensional Work Motivation Scale and the Jefferson Scale of Physician Lifelong Learning together with background questions like age, gender, and type of hospital. Respondents were grouped into different motivational profiles by using a two-step clustering approach. RESULTS Four motivational profiles were identified: (1) HAMC profile (for High Autonomous and Moderate Controlled motivation), (2) MAMC profile (for Moderate Autonomous and Moderate Controlled motivation), (3) MALC profile (for Moderate Autonomous and Low Controlled motivation), and (4) HALC profile (for High Autonomous and Low Controlled motivation). Most of the female specialists that work in an academic hospital and specialists with a surgical specialty were represented in the HALC profile. DISCUSSION Four motivational profiles were found among medical specialists, differing in gender, experience and type of specialization. The profiles are based on the combination of autonomous motivation (AM) and controlled motivation (CM) in the specialists. The profiles that have a high score on autonomous motivation have a positive association with lifelong learning.
Collapse
Affiliation(s)
- Stéphanie M E van der Burgt
- Ms. van der Burgt: Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands, and LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, the Netherlands. Dr. Kusurkar: Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands, and LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, the Netherlands. Dr. Wilschut: Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, the Netherlands. Dr. Tjin A Tsoi: Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands, and Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, the Netherlands. Dr. Croiset: Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands, LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, VU University Amsterdam, the Netherlands, and PAOFarmacie, the Netherlands Centre for Post-Academic Education in Pharmacy, Bilthoven, the Netherlands. Dr. Peerdeman: Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands, and Department of Neurosurgery, VU University Medical Center, Amsterdam, the Netherlands
| | | | | | | | | | | |
Collapse
|
59
|
Curbelo J, Romeo JM, Fernández-Somoano A, Sánchez Lasheras F, Baladrón J. Endocrinology and nutrition: Evolution of the choice of specialty in the last years. ENDOCRINOLOGIA, DIABETES Y NUTRICION 2017; 64:329-331. [PMID: 29056277 DOI: 10.1016/j.endinu.2017.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 02/17/2017] [Accepted: 02/18/2017] [Indexed: 10/19/2022]
Affiliation(s)
- José Curbelo
- Servicio de Medicina Interna, Hospital Universitario La Princesa, Madrid, España.
| | | | - Ana Fernández-Somoano
- Departamento de Medicina, IUOPA-Área de Medicina Preventiva y Salud Pública, Universidad de Oviedo, Oviedo, España; CIBER de Epidemiología y Salud Pública-CIBERESP, Instituto de Salud Carlos III, Madrid, España
| | | | | |
Collapse
|
60
|
Choice of the specialty of diagnostic radiology by results of the competitive examination to assign residency positions from 2006 to 2015. RADIOLOGIA 2017; 59:232-246. [PMID: 28457534 DOI: 10.1016/j.rx.2017.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 02/11/2017] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To analyze the profile of residency candidates choosing the specialty of diagnostic radiology in function of variables related to the positions available in different years. MATERIAL AND METHODS We compiled the data published on the Spanish Ministry of Health's website during the acts celebrated to allow residency candidates to choose positions based on the results of the competitive examinations held from 2006 to 2015, comparing the specialty of diagnostic radiology with the other specialties available in terms of positions available, net questions, sex, nationality, and order of choice of the position. RESULTS The specialty of diagnostic radiology occupied the 16th position in the ranking of specialties according to the median number of order in the choice for each of the positions offered in the years studied. The first diagnostic radiology residency position was usually assigned after 75 candidates had chosen other specialties, and the last position was usually assigned after 3700 to 4100 candidates had chosen their positions. During the period studied, of those who chose diagnostic radiology 58% were women and 76% were Spanish nationality. Candidates preferred hospitals in the Autonomous Community of Madrid, and the hospital chosen with the lowest median position (highest score on the competitive examination) was the Hospital Clínic de Barcelona. CONCLUSIONS Diagnostic radiology is chosen by candidates with good positioning in the ranking according to official examination results, is less likely than other specialties to be chosen by women, and is chosen mostly by Spanish physicians. Candidates prefer large hospitals in provincial capitals.
Collapse
|
61
|
Choice of the specialty of diagnostic radiology by results of the competitive examination to assign residency positions from 2006 to 2015. RADIOLOGIA 2017. [DOI: 10.1016/j.rxeng.2017.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
62
|
Gaski M, Abelsen B. Designing medical internships to improve recruitment and retention of doctors in rural areas. Int J Circumpolar Health 2017; 76:1314415. [PMID: 28417680 PMCID: PMC5405445 DOI: 10.1080/22423982.2017.1314415] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The medical internship as a way of exposing young doctors to training in a rural context is regarded as a useful tool to recruit and retain doctors in rural areas. Norwegian health authorities tested an arrangement of early sign-up for medical internships in the Finnmark County in Norway. OBJECTIVE To report on the effects of the early sign-up for medical internship. DESIGN This study compares the choice of workplace after internship among physicians who signed up early with those candidates assigned to the raffle model of internship in the study area, and in a comparison area experiencing similar recruitment and retention problems. RESULTS The proportion of interns who signed up early that still worked as physicians in the study area by April 2014 (29%) was twice as high as among the regular interns (15%) and interns in the comparison area (14%). Among the 59 interns who signed up early still working in the study area in April 2014, 33% had grown up in this area. However, the greatest benefits were for the most densely populated municipalities in the study area. CONCLUSIONS The early sign-up model had a net contribution of proving additional physicians in the study area.
Collapse
Affiliation(s)
- Margrete Gaski
- a National Centre of Rural Medicine , UiT The Arctic University of Norway , Tromsø , Norway
| | - Birgit Abelsen
- a National Centre of Rural Medicine , UiT The Arctic University of Norway , Tromsø , Norway
| |
Collapse
|
63
|
Album D, Johannessen LEF, Rasmussen EB. Stability and change in disease prestige: A comparative analysis of three surveys spanning a quarter of a century. Soc Sci Med 2017; 180:45-51. [PMID: 28319909 DOI: 10.1016/j.socscimed.2017.03.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 11/27/2022]
Abstract
In this paper, we present a comparative analysis of three survey studies of disease prestige in medical culture. The studies were conducted in 1990, 2002 and 2014 using the same research design. In each of the three rounds, a sample of Norwegian physicians was asked to rate a set of 38 diseases on a scale from 1 to 9 according to the prestige they believed health personnel in general would award them. The results show a remarkable stability in the prestige rank order over 25 years. The top three diseases in all three surveys were leukaemia, brain tumour and myocardial infarction. The four lowest ranked were fibromyalgia, depressive neurosis, anxiety neurosis and hepatocirrhosis. The most notable change concerns apoplexy (brain stroke), which moved from a rank of 33 to 29 and then to 23 over the three rounds. We argue that the stable pattern, as well as this change, substantiate the interpretation of previous research, i.e. that the prestige of a disease is affected by the localization of the affected organ or body part, the effect and style of its typical treatment, and the social attributes of the typical patient. Analysing physicians' shared evaluations of different diseases, the paper contributes to the cultural understanding of disease conceptions in medicine. Understanding these conceptions is important because disease prestige may influence decision-making in the healthcare sector.
Collapse
Affiliation(s)
- Dag Album
- Department of Sociology and Human Geography, University of Oslo, P.O.Box 1096, Blindern, 0317 Oslo, Norway.
| | - Lars E F Johannessen
- Centre for the Study of Professions, Oslo and Akershus University College of Applied Sciences, Norway
| | - Erik B Rasmussen
- Centre for the Study of Professions, Oslo and Akershus University College of Applied Sciences, Norway
| |
Collapse
|
64
|
Abstract
Medical education fails to prepare young doctors for the nature of the work they will encounter. Doctors face a rapidly changing medical landscape, which relies more and more upon interprofessional collaboration to optimise patient outcomes and upon non-clinical skills to provide care efficiently and cost effectively. The current response to change is a reactive and resource-intensive effort, where established doctors are directed towards new ways of working. A better response would be interprofessional clinical and non-clinical training, incorporating a philosophy and style that accommodate innovation, communication and change. This preparative training should be overseen by a single educational enterprise that links undergraduate and postgraduate instruction. Improved training might enable better design of the healthcare system from within.
Collapse
Affiliation(s)
- Josephine S Thomas
- Royal Adelaide Hospital, Adelaide, Australia
- School of Medicine, University of Adelaide, Australia
| | - Toby R Gilbert
- Royal Adelaide Hospital, Adelaide, Australia
- School of Medicine, University of Adelaide, Australia
| | - Campbell H Thompson
- Royal Adelaide Hospital, Adelaide, Australia
- School of Medicine, University of Adelaide, Australia
| |
Collapse
|
65
|
Cascón-Pereira R, Kirkpatrick I, Exworthy M. [The status of the medical profession: reinforced or challenged by the new public management?]. GACETA SANITARIA 2016; 31:273-275. [PMID: 27751642 DOI: 10.1016/j.gaceta.2016.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/18/2016] [Accepted: 07/22/2016] [Indexed: 11/29/2022]
Abstract
This article aims to assess if the status of the medical profession has been reinforced or weakened with the new public management. With this purpose, it collects the opinion of two international experts regarding situation in the United Kingdom, in order to apply some lessons to the Spanish case. Both agree that, far from losing status and power with the healthcare reform, the medical profession has protected its status and autonomy against other social agents such as managers, politicians and patients. However, the maintenance of the status quo has been at the expense of an intra-professional stratification that has caused status inequalities linked to social class within the medical profession.
Collapse
Affiliation(s)
- Rosalía Cascón-Pereira
- Departamento de Gestión de Empresas, Universidad Rovira i Virgili, Reus (Tarragona), España.
| | - Ian Kirkpatrick
- Warwick Business School, University of Warwick, Coventry, UK
| | - Mark Exworthy
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| |
Collapse
|
66
|
Ng-Sueng LF, Vargas-Matos I, Mayta-Tristán P, Pereyra-Elías R, Montenegro-Idrogo JJ, Inga-Berrospi F, Ancalli F, Bonilla-Escobar F, Diaz-Velez C, Gutierrez-Quezada E, Gomez-Alhach J, Muñoz-Medina CE, Sanchez-Pozo A, Vidal M. Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America. PLoS One 2016; 11:e0161000. [PMID: 27519055 PMCID: PMC4982605 DOI: 10.1371/journal.pone.0161000] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/28/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.
Collapse
Affiliation(s)
- Luis Fernando Ng-Sueng
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- Sociedad Científica Estudiantes de Medicina UPC, Lima, Perú
| | - Iván Vargas-Matos
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
| | - Percy Mayta-Tristán
- Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- * E-mail:
| | | | | | | | - Felix Ancalli
- Universidad Nacional Jorge Basadre Grohmann, Tacna, Perú
| | | | | | | | | | | | | | | | | |
Collapse
|
67
|
Ajaz A, David R, Brown D, Smuk M, Korszun A. BASH: badmouthing, attitudes and stigmatisation in healthcare as experienced by medical students. BJPsych Bull 2016; 40:97-102. [PMID: 27087996 PMCID: PMC4817656 DOI: 10.1192/pb.bp.115.053140] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aims and method We used an online questionnaire to investigate medical students' perceptions of the apparent hierarchy between specialties, whether they have witnessed disparaging comments ('badmouthing' or 'bashing') against other specialists and whether this has had an effect on their career choice. Results In total, 960 students from 13 medical schools completed the questionnaire; they ranked medical specialties according to the level of badmouthing and answered questions on their experience of specialty bashing. Psychiatry and general practice attracted the greatest number of negative comments, which were made by academic staff, doctors and students. Twenty-seven per cent of students had changed their career choice as a direct result of bashing and a further 25.5% stated they were more likely to change their specialty choice. Although 80.5% of students condemned badmouthing as unprofessional, 71.5% believed that it is a routine part of practising medicine. Clinical implications Bashing of psychiatry represents another form of stigmatisation that needs to be challenged in medical schools. It not only has an impact on recruitment into the specialty, but also has the wider effect of stigmatising people with mental health disorders.
Collapse
Affiliation(s)
- Ali Ajaz
- East London NHS Foundation Trust
| | | | - Damien Brown
- Barts and The London School of Medicine and Dentistry
| | - Melanie Smuk
- Barts and The London School of Medicine and Dentistry
| | - Ania Korszun
- Barts and The London School of Medicine and Dentistry
| |
Collapse
|
68
|
Lepièce B, Reynaert C, van Meerbeeck P, Dory V. Social dominance theory and medical specialty choice. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2016; 21:79-92. [PMID: 25991046 DOI: 10.1007/s10459-015-9612-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 05/09/2015] [Indexed: 06/04/2023]
Abstract
Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social dominance theory, to explain why some students, and not others, are drawn to more prestigious, technique-oriented specialties, based on their desire for hierarchy. We conducted a cross-sectional study among medical students at Institution X (N = 359). We examined the link between medical students' characteristics i.e. social dominance orientation (SDO), gender, age, and their career intention. We also examined level of medical students' SDO at different stages of the curriculum. SDO scores were significantly associated with technique-oriented career intentions (OR 1.56; 95 % CI [1.18, 2.06]; p = 0.001). The effect was independent of gender. Medical students' SDO scores were significantly higher in later stages of the medical curriculum (F = 6.79; p = 0. 001). SDO is a significant predictor of medical students' career intention. SDO scores are higher in students during the clinical phase of the curriculum. Medical socialization, involving the internalization of implicit and explicit norms, particularly in hospital settings, is likely to underpin our findings. This theory illuminates consistent findings in the literature on specialty prestige and the influence of medical school on career choice.
Collapse
Affiliation(s)
- Brice Lepièce
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium.
| | - Christine Reynaert
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium
| | - Philippe van Meerbeeck
- Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs 30, B1.30.15, 1200, Brussels, Belgium
| | - Valérie Dory
- Faculty of Medicine, Centre for Medical Education, McGill University, Montréal, Canada
| |
Collapse
|
69
|
Kaliyadan F, Amin TT, Qureshi H, Al Wadani F. Specialty preferences of 1(st) year medical students in a Saudi Medical School - Factors affecting these choices and the influence of gender. Avicenna J Med 2015; 5:134-9. [PMID: 26629470 PMCID: PMC4637952 DOI: 10.4103/2231-0770.165120] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and Aims: In recent years there has been a growing appreciation of the issues of career preference in medicine as it affects student learning and academic performance. Various factors influence the specialty choices of medical students. Some specialties tend to attract students more than others. One possible consequence of this would be a mismatch between health needs and specialist numbers in the region. This study investigated the career preferences of 1st year medical students in a Saudi medical school and to assess factors affecting these choices. Materials and Methods: The study was a cross-sectional survey carried out on the 1st year undergraduate students in the college of medicine, King Faisal University, Saudi Arabia. A total of 109 students (57 female and 52 males) responded to the questionnaire which was initially administered to all the students of the 1st year – A total of 120 students (response rate was 90.8%). A mixed method approach was used and qualitative data from open-ended questions were analyzed based on thematic analysis. Results: The top choices were general surgery, internal medicine, and pediatrics. Among female students; the top specialty choices were: General surgery (23%), pediatrics (18%), and dermatology (15%). Among the male students; the top choices were: General surgery (54%) and internal medicine (23%). Of the total, 57% of the students agreed or strongly agreed that primary aptitude was the main factor affecting the choice. Only 31% felt that there was a significant influence of role model, 48% felt that the advice of others – peers and family, would be a factor influencing their choices, and 53% agreed that specialty choice would influence their future learning patterns. Males were more likely to choose a specialty based on actual aptitude for the specialty, financial rewards, and scope for research; and this gender difference was statistically significant. Conclusion: Surgery was the top-choice in both genders. Other popular choices included internal medicine, pediatrics, and dermatology. Important factors affecting these choices included – primary aptitude, advice of peers, reputation, financial rewards, and the challenge involved.
Collapse
Affiliation(s)
- Feroze Kaliyadan
- Faculty of Dermatology, College of Medicine, King Faisal University, Hofuf, Saudi Arabia
| | - Tarek Tawfik Amin
- Department of Public Health and Community Medicine, Cairo University, Egypt
| | - Habib Qureshi
- Faculty of Biomedical Sciences, College of Medicine, King Faisal University, Hofuf, Saudi Arabia
| | - Fahad Al Wadani
- Faculty of Ophthalmology, College of Medicine, King Faisal University, Hofuf, Saudi Arabia
| |
Collapse
|
70
|
Abelsen B, Olsen JA. Young doctors' preferences for payment systems: the influence of gender and personality traits. HUMAN RESOURCES FOR HEALTH 2015; 13:69. [PMID: 26286555 PMCID: PMC4544792 DOI: 10.1186/s12960-015-0060-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/09/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Activity-based payment contracts are common among doctors, but to what extent are they preferred? The aim of this paper is to elicit young doctors' preferences for alternative payment systems before they have adapted to an existing system. We examine the existence of gender differences and the extent to which personality traits determine preferences. METHODS A cross-sectional survey of all final-year medical students and all interns in Norway examined the extent to which preferences for different payment systems depend on gender and personality traits. Data analysis relied on one-way ANOVA and multinomial logistic regression. RESULTS The current activity-based payment systems were the least preferred, both in hospitals (16.6%) and in general practice (19.7%). The contrasting alternative "fixed salary" achieved similar relative support. Approximately half preferred the hybrid alternative. When certainty associated with a payment system increased, its appeal rose for women and individuals who are less prestige-oriented, risk-tolerant or effort-tolerant. Activity-based systems were preferred among status- and income-oriented respondents. CONCLUSION The vast majority of young doctors prefer payment systems that are less activity-based than the current contracts offered in the Norwegian health service. Recruitment and retention in less prestigious medical specialities might improve if young doctors could choose payment systems corresponding with their diverse preferences.
Collapse
Affiliation(s)
- Birgit Abelsen
- National Centre of Rural Medicine, Department of Community Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
| | - Jan Abel Olsen
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.
| |
Collapse
|
71
|
Joyce CM, Wang WC, Cheng TC. Changes in Doctors' Working Hours: A Longitudinal Analysis. Med Care Res Rev 2015; 72:605-21. [PMID: 26044096 DOI: 10.1177/1077558715589705] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 05/05/2015] [Indexed: 11/15/2022]
Abstract
The study examined changes in doctors' working hours and satisfaction with working hours over five time points and explored the influence of personal characteristics on these outcomes. Latent growth curve modeling was applied to Medicine in Australia: Balancing Employment and Life data, collected from 2008 to 2012. Findings showed that working hours significantly declined over time, with a greater decrease among males, older doctors, and doctors with fewer children. Satisfaction increased faster over time among specialists, doctors with poorer health, those whose partners did not work full-time, and those with older children. The more hours the doctors worked initially, the lower satisfaction reported, and the greater the increase in satisfaction. Findings are consistent with a culture change in the medical profession, whereby long working hours are no longer seen as synonymous with professionalism. This is important to take into account in projecting future workforce supply.
Collapse
|
72
|
Emergency medicine as a primary specialty-French emergency medicine residents' attitudes. CAN J EMERG MED 2015; 17:689-91. [PMID: 26012721 DOI: 10.1017/cem.2014.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Emergency medicine (EM) has been a fellowship program (supra-specialty) in France since 2004. Even though the program can be accessed after completion of one of several primary specialties, the vast majority (97%) of its residents enter the program after having completed training in family medicine. A change to develop a primary EM specialty is being discussed. Our objective was to assess French residents and young EM physicians' attitudes toward EM as a primary specialty. We conducted a brief cross-sectional online survey among young EM physicians and trainees in November and December 2012. There were 288 respondents to the survey. Forty-nine percent (n=142) of respondents would have chosen EM if it was a primary specialty, but 73% (n=209) prefer maintaining the status quo, offering EM training as a supra-specialty fellowship program. Work-related quality of life was the main reason for those not choosing EM as a primary specialty.
Collapse
|
73
|
Guntern S, Korpershoek H, Werf GVD. Prestige Added to Holland’s Vocational Interest Scales for the Prediction of Medical Students’ Aspired Work Environments. JOURNAL OF CAREER ASSESSMENT 2015. [DOI: 10.1177/1069072715580418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current study examines the relative impact of vocational interests and prestige on medical students’ aspired work environments. The following areas were included: family doctor, specialist in a private practice, specialist in a hospital, scientific researcher, and dentist. We also added the category “undecided students.” The sample consisted of 788 medical students in their preclinical years. Multinomial logistic regression analysis showed that the impact of vocational interests and prestige varied as a function of the medical students’ aspired work environments. Students with investigative interests particularly aspired to become scientific researchers (compared to the reference category of family doctor), whereas students interested in prestigious careers aspired to become specialists in a private practice (but not specialists in a hospital). Students with realistic interests particularly aspired to become dentists or specialists in a hospital. This article is concluded by a discussion of the impact of the person–environment fit on students’ career decisions.
Collapse
Affiliation(s)
- Sabine Guntern
- Groningen Institute for Educational Research (GION), Groningen, the Netherlands
| | - Hanke Korpershoek
- Groningen Institute for Educational Research (GION), Groningen, the Netherlands
| | | |
Collapse
|
74
|
Hays RB, Lockhart KR, Teo E, Smith J, Waynforth D. Full medical program fees and medical student career intention. Med J Aust 2015; 202:46-9. [DOI: 10.5694/mja14.00454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 08/29/2014] [Indexed: 11/17/2022]
|
75
|
Rurik I, Szigethy E, Langmár Z. Medical doctors in Hungary: 30 years after graduation. Data on lifestyle, morbidity, demography and differences between specialties. Cent Eur J Public Health 2014; 22:183-8. [PMID: 25438396 DOI: 10.21101/cejph.a3910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There are few studies from East and Central European countries on health-status, lifestyle and social circumstances of medical professionals. We evaluated data of a cohort of physicians who had graduated 30 years ago in Hungary and compared the data of their professional carrier, life style, health outcomes, and medical specialties. Questionnaires compiled by an expert group and filled in by 208 physicians (83 men and 125 women) were analysed. Men mostly work as surgeons, women were mostly employed as primary care specialists. Women changed their specialty and/or place of work more often than men. Male primary care physicians had more children than women and others specialists. At graduation, most of them had a normal BMI. Since then, a significant increase in weight and BMI was observed in both genders and across all specialty groups. The largest increase in body weight and BMI (mean 5.27) was recorded among female primary care physicians. Recorded physical activity was low in general, with male primary care specialists being most active and female primary care physicians the least. Female doctors in surgical specialties had longer resting time. Male physicians rarely participated in regular health screenings. The incidence of hypertension was higher than the Hungarian national average for that age. About 5% of primary care physicians identified themselves as regular smokers. Abstinence and regular daily alcohol consumption were reported in equal ratio. Burn-out symptoms were rarely experienced. This generation had started its medical profession before the significant progressive changes in the medicine occurred in the last decades. While physicians do not always follow their own professional advices, their lifestyle proved a little bit healthier than that of the population at large, especially for women and their health outcomes, except hypertension, were also better. In general, they were not satisfied with the financial and working conditions of the recent Hungarian healthcare system.
Collapse
|
76
|
Johannessen LE. The narrative (re)production of prestige: How neurosurgeons teach medical students to valorise diseases. Soc Sci Med 2014; 120:85-91. [DOI: 10.1016/j.socscimed.2014.09.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 08/29/2014] [Accepted: 09/04/2014] [Indexed: 11/17/2022]
|
77
|
Scott A, Joyce CM. The future of medical careers. Med J Aust 2014; 201:82-3. [PMID: 25045978 DOI: 10.5694/mja13.00063] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 05/05/2014] [Indexed: 11/17/2022]
Affiliation(s)
- Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, VIC, Australia.
| | - Catherine M Joyce
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
78
|
Schroeder JE, Zisk-Rony RY, Liebergall M, Tandeter H, Kaplan L, Weiss YG, Weissman C. Medical students' and interns' interest in orthopedic surgery: the gender factor. JOURNAL OF SURGICAL EDUCATION 2014; 71:198-204. [PMID: 24602710 DOI: 10.1016/j.jsurg.2013.08.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 08/23/2013] [Accepted: 08/24/2013] [Indexed: 05/21/2023]
Abstract
OBJECTIVE There is an extremely small proportion of female medical students choosing to specialize in orthopedic surgery. The aim of the study was to assess medical students' and interns' interests and perceptions of orthopedic surgery and explore why women are not interested in orthopedic surgery. SETTING Questionnaires were distributed to final-year medical students and interns assessing their interests and perception of orthopedic surgery. PARTICIPANTS Final-year medical students and interns. RESULTS Responses were obtained from 317 students and 199 interns. Among the medical students, 15% were interested in orthopedic surgery, but only 2% were women. Both male and female students perceived orthopedics as an "action"-packed, procedure-based profession, providing instant gratification, time in the operating room, high income, and the option for private practice. Female medical students considered it boring. Among interns, 11% were interested in orthopedic surgery; however, only 2% were women. When compared with the interns who were not interested in orthopedic surgery, a greater number of the interns interested in orthopedic surgery rated time with family and a procedure-intensive profession as important. Female students and interns were also interested in other surgical fields. CONCLUSIONS The increasing majority of women among medical students will reshape the future of physician workforce by dictating changes in workforce participation, working conditions, and intercollegial relationships. Orthopedic surgery will need to adapt to these realities.
Collapse
Affiliation(s)
| | | | | | | | - Leon Kaplan
- Hospital of Special Surgery, New York, New York
| | | | | |
Collapse
|
79
|
Brown SD, Donelan K, Martins Y, Sayeed SA, Mitchell C, Buchmiller TL, Burmeister K, Ecker JL. Does professional orientation predict ethical sensitivities? Attitudes of paediatric and obstetric specialists toward fetuses, pregnant women and pregnancy termination. JOURNAL OF MEDICAL ETHICS 2014; 40:117-122. [PMID: 23572566 DOI: 10.1136/medethics-2012-101126] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND To determine (1) whether fetal care paediatric (FCP) and maternal-fetal medicine (MFM) specialists harbour differing attitudes about pregnancy termination for congenital fetal conditions, their perceived responsibilities to pregnant women and fetuses, and the fetus as a patient and (2) whether self-perceived primary responsibilities to fetuses and women and views about the fetus as a patient are associated with attitudes about clinical care. METHODS Mail survey of 434 MFM and FCP specialists (response rates 60.9% and 54.2%, respectively). RESULTS MFMs were more likely than FCPs to disagree with these statements (all p values<0.005): (1) 'the presence of a fetal abnormality is not an appropriate reason for a couple to consider pregnancy termination' (MFM : FCP-78.4% vs 63.5%); (2) 'the effects that a child born with disabilities might have on marital and family relationships is not an appropriate reason for a couple to consider pregnancy termination' (MFM : FCP-80.5% vs 70.2%); and (3) 'the cost of healthcare for the future child is not an appropriate reason for a couple to consider pregnancy termination' (MFM : FCP-73.5% vs 55.9%). 65% MFMs versus 47% FCPs disagreed that their professional responsibility is to focus primarily on fetal well-being (p<0.01). Specialists did not differ regarding the fetus as a separate patient. Responses about self-perceived responsibility to focus on fetal well-being were associated with clinical practice attitudes. CONCLUSIONS Independent of demographic and sociopolitical characteristics, FCPs and MFMs possess divergent ethical sensitivities regarding pregnancy termination, pregnant women and fetuses, which may influence clinical care.
Collapse
Affiliation(s)
- Stephen D Brown
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, , Boston, Massachusetts, USA
| | | | | | | | | | | | | | | |
Collapse
|
80
|
How do doctors choose where they want to work? - motives for choice of current workplace among physicians registered in Finland 1977-2006. Health Policy 2013; 114:109-17. [PMID: 24370113 DOI: 10.1016/j.healthpol.2013.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Revised: 10/29/2013] [Accepted: 12/01/2013] [Indexed: 11/22/2022]
Abstract
Though there are a number of studies investigating the career choices of physicians, there are only few concerning doctors' choices of workplace. A random sample (N=7758) of physicians licensed in Finland during the years 1977-2006 was surveyed. Respondents were asked: "To what extent did the following motives affect your choice of your current workplace?" Respondents were grouped based on several background variables. The groups were used as independent variables in univariate analysis of covariance (ANCOVA). The factors Good workplace, Career and professional development, Non-work related issues, Personal contacts and Salary were formed and used as dependent variables. There were significant differences between groups of physicians, especially in terms of gender, working sector and specialties. The association of Good workplace, Career and professional development, and Non-work related issues with the choice of a workplace significantly decreased with age. Female physicians were more concerned with Career and professional development and Non-work related issues. Since more females are entering the medical profession and there is an ongoing change of generations, health care organizations and policy makers need to develop a new philosophy in order to attract physicians. This will need to include more human-centric management and leadership, better possibilities for continuous professional development, and more personalized working arrangements depending on physician's personal motives.
Collapse
|
81
|
Grigg M, Arora M, Diwan AD. Australian medical students and their choice of surgery as a career: a review. ANZ J Surg 2013; 84:653-5. [PMID: 24103025 DOI: 10.1111/ans.12389] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Surgery is an emotionally, physically and mentally challenging profession, and medical students factor in many variables when choosing surgery as a career choice. The aim of this study is to review the available literature on the factors influencing Australian medical students' choice of surgery as their career. METHOD A search of EMBASE and MEDLINE with the search terms 'medical students' AND 'surgery'; 'medical students' AND 'career pathways'; 'medical students' AND 'career choices' was conducted. Additionally, Google Scholar and the reference list of some articles were canvassed for suitable areas of study. RESULTS Lifestyle factors were the main reason influencing medical student's career choices. A balance between work, family and lifestyle was found to be important, and a surgical career choice was not always compatible with this. In particular, female students placed more importance on family and lifestyle factors when opting for non-surgical careers. Positive exposure and/or experiences in a surgical environment, perceived prestige and perceived financial reward were associated with surgical career choice. CONCLUSIONS There is a need to better understand the factors influencing surgical and non-surgical career choice among Australian medical students, and develop appropriate interventions to promote surgery as a career. This article does not discuss personality traits of people who go into surgery.
Collapse
Affiliation(s)
- Megan Grigg
- Armidale Clinical School, University of New England, Armidale, New South Wales, Australia
| | | | | |
Collapse
|
82
|
Creed P, Buys N, Tilbury C, Crawford M. The relationship between goal orientation and career striving in young adolescents. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2013. [DOI: 10.1111/jasp.12108] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Peter Creed
- School of Applied Psychology; Griffith Health Institute; Griffith University
| | - Nick Buys
- School of Human Services and Social Work; Griffith Health Institute; Griffith University
| | - Clare Tilbury
- School of Human Services and Social Work; Griffith Health Institute; Griffith University
| | - Meegan Crawford
- School of Human Services and Social Work; Griffith Health Institute; Griffith University
| |
Collapse
|
83
|
Mirvis DM. Choosing a medical specialty: the difference between what students want and what society needs. Isr J Health Policy Res 2013; 2:18. [PMID: 23692643 PMCID: PMC3665462 DOI: 10.1186/2045-4015-2-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 05/05/2013] [Indexed: 11/28/2022] Open
Abstract
The choice of a specialty by medical students is a complex one that has significant implications for the future supply of physician manpower. The study by Weissman et al. portrays this choice as reflecting the degree of congruence between a student’s needs and values and his or her perception of the characteristics of the various specialties. The existing shortages in the supply of various specialists in Israel may be interpreted as signifying a lack of alignment of student needs and perceptions. This commentary will extend the implications of this work to include the connection between students’ choices and the physician manpower needs of society, and will focus on primary care physician shortages in the United States as but one example of the implications of these relationships.
Collapse
Affiliation(s)
- David M Mirvis
- Department of Public Health, University of Tennessee, Knoxville, USA.
| |
Collapse
|
84
|
Mena G, Llupià A, Sequera VG, Aldea M. [Specialized health education: medical students' preferences and perceptions]. Med Clin (Barc) 2013. [PMID: 23199832 DOI: 10.1016/j.medcli.2012.09.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Guillermo Mena
- Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic de Barcelona, Universidad de Barcelona (UB), Centro de Investigacion en Salud Internacional de Barcelona (CRESIB), Barcelona, España.
| | | | | | | |
Collapse
|
85
|
Yu TC, Jain A, Chakraborty M, Wilson NC, Hill AG. Factors Influencing Intentions of Female Medical Students to Pursue a Surgical Career. J Am Coll Surg 2012; 215:878-89. [DOI: 10.1016/j.jamcollsurg.2012.08.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Revised: 07/23/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022]
|
86
|
A Multinational Perspective on “Lifestyle” and Other Perceptions of Contemporary Medical Students About General Surgery. Ann Surg 2012; 256:378-86. [DOI: 10.1097/sla.0b013e3182602b9b] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
87
|
Goldacre MJ, Goldacre R, Lambert TW. Doctors who considered but did not pursue specific clinical specialties as careers: questionnaire surveys. J R Soc Med 2012; 105:166-76. [PMID: 22532656 DOI: 10.1258/jrsm.2012.110173] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To report doctors' rejection of specialties as long-term careers and reasons for rejection. DESIGN Postal questionnaires. SETTING United Kingdom. PARTICIPANTS Graduates of 2002, 2005 and 2008 from all UK medical schools, surveyed one year after qualification. MAIN OUTCOME MEASURES Current specialty choice; any choice that had been seriously considered but not pursued (termed 'rejected' choices) with reasons for rejection. RESULTS 2573 of 9155 respondents (28%) had seriously considered but then not pursued a specialty choice. By comparison with positive choices, general practice was under-represented among rejected choices: it was the actual choice of 27% of respondents and the rejected choice of only 6% of those who had rejected a specialty. Consideration of 'job content' was important in not pursuing general practice (cited by 78% of those who considered but rejected a career in general practice), psychiatry (72%), radiology (69%) and pathology (68%). The surgical specialties were the current choice of 20% of respondents and had been considered but rejected by 32% of doctors who rejected a specialty. Issues of work-life balance were the single most common factor, particularly for women, in not pursuing the surgical specialties, emergency medicine, the medical hospital specialties, paediatrics, and obstetrics and gynaecology. Competition for posts, difficult examinations, stressful working conditions, and poor training were mentioned but were mainly minority concerns. CONCLUSIONS There is considerable diversity between doctors in their reasons for finding specialties attractive or unattractive. This underlines the importance of recruitment strategies to medical school that recognize diversity of students' interests and aptitudes.
Collapse
Affiliation(s)
- Michael J Goldacre
- Medical Careers Research Group, Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road Campus, Oxford OX3 7LF, UK
| | | | | |
Collapse
|
88
|
Rogers ME, Creed PA, Searle J. Why are junior doctors deterred from choosing a surgical career? AUST HEALTH REV 2012; 36:191-6. [DOI: 10.1071/ah11999] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 09/21/2011] [Indexed: 11/23/2022]
Abstract
Objective. To identify the reasons why interns would not choose a surgical career. Methods. This qualitative study used semi-structured telephone interviews to explore the future career choices of 41 junior doctors (14 men, 27 women). Doctors were asked to identify specialties they would not take up, and state why this was the case. Results. Thirty (73.2%) of the 41 interns nominated surgery as a specialty they would not choose. Themes relating to reasons for not wanting to pursue a surgical career included the lifestyle associated with surgery (66.7%), the culture within the surgical work environment (53.3%), the lack of interest in performing surgical work (36.7%), and the training requirements associated with surgery (33.3%). Both sexes had similar reasons for not wanting to choose a surgical career; but additionally, women referred to the male domination of surgery, and the difficulty and inflexibility of the training program as deterrents. Conclusions. Efforts are needed to promote interest in surgery as a career especially for women, to improve the surgical work environment so that medical students and junior doctors have exposure to positive role models and surgical placements, and to provide a more flexible approach to surgical training. What is known about the topic? In Australia, there is an anticipated future shortage of surgeons, with acute shortages expected in some locations. Lifestyle issues are reported as the primary contributing factor. What does this paper add? Little is known about Australian junior doctors’ perceptions of surgery as a possible specialty choice. The results of this qualitative study reveal that perceived lack of lifestyle, the culture within the surgical environment, the lack of interest in performing surgery, and concerns relating to the training program were the main disincentives to choosing a surgical career. These results add to the international literature in this area. What are the implications for practitioners? To meet current and future workforce needs, educators need to be aware that positive role models and positive work environments are very important in attracting more medical students and graduates to choosing surgery as a career.
Collapse
|
89
|
|
90
|
Glazer GM, Ruiz-Wibbelsmann JA. Decades of Perceived Mediocrity: Prestige and Radiology. Radiology 2011; 260:311-6. [DOI: 10.1148/radiol.11110596] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
91
|
Kiolbassa K, Miksch A, Hermann K, Loh A, Szecsenyi J, Joos S, Goetz K. Becoming a general practitioner--which factors have most impact on career choice of medical students? BMC FAMILY PRACTICE 2011; 12:25. [PMID: 21549017 PMCID: PMC3112095 DOI: 10.1186/1471-2296-12-25] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 05/09/2011] [Indexed: 11/26/2022]
Abstract
Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany) filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. Results 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance') were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition') for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. Conclusions This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should be made explicit at an early stage at medical school to increase the number of aspirants for general practice.
Collapse
Affiliation(s)
- Kathrin Kiolbassa
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Germany
| | | | | | | | | | | | | |
Collapse
|