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Lin PL, Huang JP, Fujii T, Cho EH, Huang MC. A survey of specialty choice among obstetrics and gynecology residents in Japan, Korea, and Taiwan. J Obstet Gynaecol Res 2022; 48:1968-1977. [PMID: 35474372 DOI: 10.1111/jog.15274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/17/2022] [Indexed: 11/29/2022]
Abstract
AIM The percentage of medicine graduates opting for residency in obstetrics and gynecology (OB/GYN) has been decreasing in developed countries, including in Taiwan, Japan, and Korea. This multicountry study surveyed the OB/GYN residents affiliated with the Taiwan Association of Obstetrics and Gynecology (TAOG), the Japanese Society of Obstetrics and Gynecology (JSOG), and the Korean Society of Obstetrics and Gynecology (KSOG) to evaluate the factors affecting the choice of pursing OB/GYN. METHODS A 17-item questionnaire surveying the factors influencing the choice of pursuing a major medical specialty was translated into Japanese, Korean, and Chinese and administered to postgraduate OB/GYN residents between July 1, 2020, and August 31, 2020. Data on the participants' sex, age, and level of residency were collected. Responses were compared between countries and sexes. RESULTS Residents of all three countries chose OB/GYN based on personal interest, and a sense of accomplishment in saving people's life. Other positive factors include improved quality of life; higher salaries; and more opportunity for new techniques, research, and promotion. The negative factors included medical litigations, longer work hours, and unsafe working environments. Korean residents had lower ratings in several items, including "support from family," "safety of working environment," and "effectiveness of the alternative dispute resolution system," which, unlike Japan and Taiwan, is not a no-fault compensation system for childbirth accidents. CONCLUSIONS The study findings can guide strategy making, such as decreasing workload and yet maintain training quality, to increase the number of medical students pursuing OB/GYN residency.
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Affiliation(s)
- Ping-Lun Lin
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tatsuya Fujii
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eun H Cho
- Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, Ewha Womans University, Seoul, South Korea
| | - Ming-Chao Huang
- Department of Obstetrics and Gynecology, HsinChu MacKay Memorial Hospital, HsinChu, Taiwan.,Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
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Tsai CH, Hsieh CH, Huang JP, Lin PL, Kuo TC, Huang MC. A survey of career-decision factors for obstetrics and gynecology residents in Taiwan. Taiwan J Obstet Gynecol 2021; 60:628-633. [PMID: 34247799 DOI: 10.1016/j.tjog.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE The recruitment of obstetrics and gynecology residents has been challenging in Taiwan since 2000. There are a lots factors influencing applying, including career interest and prospects, lifestyle, salary, litigation, stress level, time demands of specialty work and gender consideration. The purpose of this study was to evaluate the factors influencing the career choice of current OB/GYN residents and identify the important factors influencing recruitment. MATERIALS AND METHODS A cross-sectional questionnaire of career-decision factors was sent to all 280 residents during December, 2019. Total 16 factors were rated on a 5-point Likert and were ranking by their average score on the scale. Gender of residents was analyzed for their association with the scores by a two-sample test and two-tailed t test. RESULTS 91 (32.5%) residents responded and 61 were female and 30 were male. The top influencing factor was being interested in clinical expertise with an average score of 4.32. The second factor was having a great sense of accomplishment in saving people with an average score of 3.82, followed by it being easier to become a medical practitioner at 3.77. The lowest scoring factor was fewer hours of work, with an average score of 1.77 and a safer working environment with a score of 2.33 was the second lowest factor. Female residents agreed that it was easier to get specialist certification with a score of 3.0. This score was significantly higher than male doctors at 2.63 with p value of 0.017. CONCLUSION Career interest and prospects were key influencing factors for applying OB/GYN residents. Minimizing the influence of detracting factors like heavy workload and medical litigation was also effective. Enrolling new residents is key to maintaining adequate staffing in specialties in healthcare. Establishing a safer work environment and determining the optimal workload will be the next reforms in the future.
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Affiliation(s)
- Chin-Han Tsai
- Department of Obstetrics and Gynecology, HsinChu MacKay Memorial Hospital, HsinChu, Taiwan
| | - Ching-Hung Hsieh
- Department of Obstetrics and Gynecology, Lee Women's Hospital, Taichung, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ping-Lun Lin
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Tsung-Cheng Kuo
- Department of Obstetrics and Gynecology, Kuo General Hospital, Tainan, Taiwan
| | - Ming-Chao Huang
- Department of Obstetrics and Gynecology, HsinChu MacKay Memorial Hospital, HsinChu, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
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Chang RE, Yu TH, Shih CL. The number and composition of work hours for attending physicians in Taiwan. Sci Rep 2020; 10:14934. [PMID: 32913272 PMCID: PMC7483534 DOI: 10.1038/s41598-020-71873-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 08/10/2020] [Indexed: 11/09/2022] Open
Abstract
Long work hours among physicians is a worldwide issue in the healthcare arena. Previous studies have largely focused on the work hours of resident physicians rather than those of attending physicians. The purpose of this study was to investigate total work hours and the composition of those work hours for attending physicians across different hospital settings and across different medical specialties through a nationwide survey. This included examining differences in physician workload and its composition with respect to different hospital characteristics, and grouping medical specialties according to the work similarities. A cross-sectional self-reported nationwide survey was conducted from June to September of 2018, and the two questionnaires were distributed to all accredited hospitals in Taiwan. The number of physician work hours in different types of duty shifts were answered by medical specialty in each surveyed hospital. Each medical specialty in a hospital filled only one response for its attending physicians. The findings reveal that the average total work hours per week of an attending physician is around 69.1 h, but the total work hours and their composition of different duty shifts varied among hospital accreditation levels, geographic locations, emergency care responsibilities, and medical specialties. Because of the variance in the number and composition of attending physicians' work hours, adjusting physician work hours to a reasonable level will be a major challenge for health authority and hospital managers.
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Affiliation(s)
- Ray-E Chang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Institute of Health Policy and Management, National Taiwan University, Room 639, No 17, Hsu-Chow Road, Taipei, 100, Taiwan.
| | - Tsung-Hsien Yu
- Department of Health Care Management, National Taipei University of Nursing and Science, Taipei, Taiwan
| | - Chung-Liang Shih
- Department of Medical Affairs, Ministry of Health and Welfare, Taipei, Taiwan
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Lee FY, Yang YY, Huang CC, Huang LJ, Chang CC, Liang JF, Huang SS, Lee WS, Lu DY, Chuang CL, Yang LY, Huang HC, Shulruf B, Chen CH, Kao SY. Sustained effects of faculty leadership development modules for clinical instructors of core competences education in Taiwan: a four-year explanatory case study. BMC MEDICAL EDUCATION 2020; 20:155. [PMID: 32414406 PMCID: PMC7226719 DOI: 10.1186/s12909-020-02065-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 05/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The Accreditation Council for Graduate Medical Education (ACGME) core competencies (CC) in general medicine-based primary care are essential for junior medical trainees. In this country, a regular faculty development (FD) program aimed at training faculty in instructing (teaching and assessing) these CC had operated. However, leadership was not emphasized. In a new intervention module, the roles and associated responsibilities of clinical instructors to conduct, design, and lead CC-based education were emphasis. AIMS This follow-up explanatory case study compares the effectiveness of intervention module with that of the previous regular module. METHODS The regular group (n = 28) comprised clinical instructors who participated in the FD module during the 2013-2014 year while the intervention group (n = 28) was composed of 2015-2016 participants. Prior to the formal (hands-on) training, participants in the intervention group were asked to study the online materials of the regular module. These participants then received a 30-h hands-on training in conducting, designing, and leading skills. Finally, they prepared a 10-h reflective end-of-module presentation of their real-world practices. RESULTS Following the training, a higher degree improvement in participants self-reported familiarity with CC education, self-confidence in their ability to deliver CC education and sustained involve CC education were noted among the intervention FD group, compared with the regular FD group. In the intervention group, senior academicians (associate and full professor) are more substantially involved in designing and leading CC-based courses than junior academicians (lecturers and assistant professors). Among non-teaching award winners of in the intervention FD group, the follow-up degree of sustained involvement in delivering, designing and leading CC-based courses was significantly higher than that of the regular group. CONCLUSIONS Our study demonstrated that leadership training in the intervention FD modules substantially motivated clinical instructors to become leaders in CC education.
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Affiliation(s)
- Fa-Yauh Lee
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University, Taipei, Taiwan
| | - Ying-Ying Yang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan.
- Division of Clinical Skills Training Center, Taipei Veteran General Hospital , Taipei, Taiwan.
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
- Department of Medicine, Taipei Veteran General Hospital , Taipei, Taiwan.
| | - Chia-Chang Huang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Division of Clinical Skills Training Center, Taipei Veteran General Hospital , Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ling-Ju Huang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Chih Chang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jen-Feng Liang
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veteran General Hospital , Taipei, Taiwan
| | - Shiau-Shian Huang
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Bali Psychiatric Center, Ministry of Health and Welfare, Bali, Taiwan
| | - Wei-Shin Lee
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Dai-Yin Lu
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chiao-Lin Chuang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ling-Yu Yang
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veteran General Hospital , Taipei, Taiwan
| | - Hui-Chun Huang
- Division of General Medicine, Taipei Veteran General Hospital, Taipei, Taiwan
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Boaz Shulruf
- New South Wales Sydney University, Sydney, Australia
| | - Chen-Huan Chen
- Faculty of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veteran General Hospital , Taipei, Taiwan
| | - Shou-Yen Kao
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- National Yang-Ming University, Taipei, Taiwan
- Department of Medical Education, Taipei Veteran General Hospital , Taipei, Taiwan
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