[Longitudinal evaluation of female and male medical residents' career satisfaction]

[Actual Duration of Postgraduate Training of Medical Residents in Germany: Results of the KarMed Study Ten Years After Physician Licensure]

BACKGROUND

Professional qualification as a doctor of medicine includes completion of medical studies and residency. Data on the real duration of residency are currently not assessed systematically in Germany.

OBJECTIVES

Our study aimed to analyze data on the real length of residency under consideration of area of expertise (specialization), part-time working, grades after school and medical studies, gender, and parenthood of the physicians in residency.

MATERIAL AND METHODS

The KarMed Study's database consists of annual postal surveys throughout the entire residency of medical students, beginning with their "Practical Year" in 2008/2009 until 2019. The study analyzed data six and ten years within this residency period.

RESULTS

The majority of the residents was capable of finishing their residency within the minimal time. One significant effect on actual duration of residency was the subject choice. One-third of the female residents had not yet finished their residency after ten years. Partenhood had a significant effect on female residents, but not on male residents. A regression analysis showed (R²corr=0.03, p<0.001) that the duration of residency was associated with the grade received after studying (β=0.30). Male residents were more satisfied with the overall residency then female residents.

DISCUSSION

Structural improvement in postgraduate training needs to be adjusted in terms of parental status. Prospective studies should take the selection process of universities into account and examine its association with the time required to complete residency.

Postgraduate medical training in Germany: A narrative review

The structure and content of the training phase following completion of medical school, referred to in most countries as postgraduate medical training, varies between countries. The purpose of this article is to give national and international readers an overview of the organisation and structure of postgraduate medical training in Germany. The content and duration of postgraduate training in Germany are stipulated by state medical boards, officially termed associations (Landesärztekammer). In a periodically updated decree, the federal German medical association (Bundesärztekammer) provides a template for postgraduate medical training structure (Musterweiterbildungsordnung), which is adapted by the state medical associations. Admission to postgraduate medical training in Germany takes place by way of open, free-market selection. Based on the traditional assumption that junior doctors acquire all necessary clinical skills "on the job", formal education in the form of seminars, lectures, or preorganised, detailed rotation plans through various specialties or wards is largely absent. Requirements for postgraduate medical training focus on the fulfilment of broad categories of rotations rather than specific content or gaining competencies. With few exceptions, no structured educational programs with curricular learning objectives exist. Limited funding impedes program development and expansion. Junior doctors bear the primary organisational responsibility in their training, which often results in extended training times and dissatisfaction. Structured training programs which prioritise skill-building and formal education are needed to support junior doctors and ensure their competence in primary and specialty care.

[The Impact of Parenthood, Support, and Short-Term Contracts on Work-Family Conflict of Female and Male Residents' Career]

BACKGROUND

Work factors and work-family interference play an important role in physicians leaving clinical practice.

OBJECTIVES

The purpose of this study was to examine residents' work-family conflict and family-work conflict in association with parental status, perceived support, and short-term contracts.

MATERIAL AND METHODS

Data acquisition was carried out within the multi-centric and prospective "KarMed" study in Germany at the end of the postgraduate training in 2016 (N=433). The Work-Family Conflict and Family-Work Conflict scales were used. Further independent variables were gender, parental status, short-term contracts, and perceived support from partner. Results Female physicians with children interrupted postgraduate training five times more often then female physicians without children and 18 times more often than male physicians with children. Female as well as male physicians with children showed greater family-work conflicts, and female physicians without children scored higher on work-family conflict. Male physicians did not show significant results on work-family conflict. Neither short-term contracts nor perceived support from the partner had a significant influence on work-family or family work conflict.

CONCLUSIONS

There is a need to reduce work-family conflicts and their associated factors in female resident physicians.

[Analysis of career and life satisfaction of women residents with children during their postgraduate training compared to male colleagues: A longitudinal analysis as part of the KarMed study]

OBJECTIVE

Former results of the KarMed study revealed a significant decrease in the career satisfaction of female physicians with children in the course of their postgraduate training compared to male physicians with children. Yet, female physicians with children showed the highest scores on satisfaction with life at the fourth year of postgraduate training. The present study evaluates whether the different courses of career satisfaction and life satisfaction of female physicians compared to male physicians are caused by parental status.

METHODS

Data were collected in the course of the KarMed study (2008-2016). A cross-lagged panel design was used to analyze data from T2 to T5.

RESULTS

The results indicate an inverse association of career satisfaction with life satisfaction. Women physicians with a low level of career satisfaction were more likely to have children than those with a higher career satisfaction. Furthermore, we found a causal effect of parental status on career satisfaction in male physicians. For female physicians, yet not for male physicians, life satisfaction predicts the parental status.

CONCLUSIONS

The structural improvement in postgraduate training needs to be adjusted in terms of parental status. Prospective studies should take medical leave during pregnancy as well as parental leave of male medical residents into account.