Medical school ranking and medical student vocational identity

The NERSH Questionnaire and Pool of Data from 12 Countries: Development and Description

Modern healthcare research has only in recent years investigated the impact of health care workers' religious and other values on medical practice, interaction with patients, and ethically complex decision making. So far, only limited international data exist on the way such values vary across different countries. We therefore established the NERSH International Collaboration on Values in Medicine with datasets on physician religious characteristics and values based on the same questionnaire. The present article provides (a) an overview of the development of the original and optimized questionnaire, (b) an overview of the content of the NERSH data pool at this stage and (c) a brief review of insights gained from articles published with the questionnaire. The pool at this stage consists of data from 17 studies from research units in 12 different countries representing six continents with responses from more than 6000 health professionals. The joint data pool suggests that there are large differences in religious and other moral values across nations and cultures, and that these values contribute to the observed differences in health professionals' clinical practices-across nations and cultures!

The Professional Identity and Career Attitude of Chinese Medical Students During the COVID-19 Pandemic: A Cross-Sectional Survey in China

BACKGROUND

Although professional identity is a strong predictor of career choice, only a few studies have reported on medical students' career attitude during a public health emergency. This study investigates the changes in medical students' professional identity and career attitude during the COVID-19 pandemic, evaluates their mental health and social support system under stress, and explores the relationship between their career attitude and other factors.

METHODS

An online survey of 6,226 Chinese medical students was conducted to collect information on demographics, professional identity, and career attitude. The collected data were assessed using the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Social Support Rating Scale.

RESULTS

The results revealed that most (80.8%) of the participants did not change their career attitude and the professional identity of most participants strengthened, and they preferred to participate on the frontline during the COVID-19 pandemic. The prevalence of depression and anxiety among medical students was 22.86% and 35.43%. Low social support, depressive symptoms, male gender, and higher grades were factors that negatively affected career attitude.

CONCLUSIONS

After the outbreak of the pandemic, it was necessary to conduct diversified professional identity research to support medical students, especially those with low social support and depressive symptoms.

Religious Characteristics of Physicians Who Care for Underserved Populations or Work in Religiously Oriented Practices

OBJECTIVES

This study examined the relation between physicians' religious characteristics and working for medically underserved populations or in religiously oriented practices.

METHODS

Secondary data analysis of 2009-2010 national survey of 896 primary care physicians (PCPs) and 312 psychiatrists. Predictors included physicians' religious characteristics.

RESULTS

Adjusted response rates among eligible physicians were 63% (896 of 1427) for PCPs and 64% (312 of 487) for psychiatrists. Overall, 41.3% of US PCPs and 53.2% of US psychiatrists reported working with medically underserved populations. A smaller percentage reported working in religiously oriented practices. Physicians who rated religion as most important in their lives were more likely to report working for medically underserved populations (52.5% most important vs 36.7% not important, P = 0.02) or report working in religiously oriented practices (23.9% most important vs 6.8% not important, P < 0.01).

CONCLUSIONS

Religious physicians may be serving in medically underserved areas or religiously oriented practices as a way to integrate their professional and personal identities.

The Association Between a Sense of Calling and Physician Well-Being: A National Study of Primary Care Physicians and Psychiatrists

OBJECTIVE

This study assesses the association between calling and physician well-being, clinical commitment, and burnout.

METHODS

In 2009-2010, a survey was mailed to 1504 primary care physicians (PCPs) and 512 psychiatrists drawn from the American Medical Association Physician Masterfile. The primary independent variable was a single-item measure that assessed physicians' level of calling. Main outcomes were markers of physician well-being (career satisfaction and morale), clinical commitment (intentions to reduce time spent in direct patient care, leave practice in a few years), and experiences of burnout.

RESULTS

Adjusted response rates were 63 % (896/1427) for PCPs and 64 % (312/487) for psychiatrists. Forty-two percent of US PCPs and psychiatrists agree strongly that their practice of medicine is a calling. Physicians with a high sense of calling were less likely than those with low to report regret in choosing medicine as a career (18 vs. 38 %; odds ratio 0.3; 95 % confidence interval, 0.2-0.5), wanting to go into a different clinical specialty (28 vs. 49 %; OR 0.4; 95 % CI, 0.2-0.6), or wanting to leave the practice of medicine in the next few years (14 vs. 25 %, OR 0.4; 95 % CI 0.2-0.7). Physicians with a high sense of calling were less likely to report burnout (17 vs. 31 % low calling, OR 0.4; 95 % CI 0.3 to 0.7).

CONCLUSIONS

Physicians who reported that medicine was a calling may be experiencing higher levels of career satisfaction, more durable clinical commitments, and resilience from burnout. Though physicians may differ on their understanding of the concept of calling in medicine, this study highlights an important factor that should be investigated further when assessing long-term workforce retention in the fields of primary care and psychiatry.

Institution-Specific Factors Associated With Family Medicine Residency Match Rates

Phenomenon: Existing research provides little specific evidence regarding the association between public and private medical school curricular settings and the proportion of medical students matching into family medicine careers. Institutional differences have been inadequately investigated, as students who match into family medicine are often consolidated into the umbrella of primary care along with those matching in internal medicine and pediatrics. However, understanding medical school contexts in relation to career choice is critical toward designing targeted strategies to address the projected shortage of family physicians. This study examines factors associated with family medicine residency match rates and the extent to which such factors differ across medical school settings.

APPROACH

We combined data from a survey of 123 departments of family medicine with graduate placement rates reported to the American Academy of Family Physicians over a 2-year period. Chi-square/Fisher's Exact texts, t tests, and linear regression analyses were used to identify factors significantly associated with average match rate percentages.

FINDINGS

The resulting data set included 85% of the U.S. medical schools with Departments of Family Medicine that reported 2011 and 2012 residency match rates in family medicine. Match rates in family medicine were higher among graduates of public than private medical schools-11% versus 7%, respectively, t(92) = 4.00, p < .001. Using a linear regression model and controlling for institutional type, the results indicated 2% higher match rates among schools with smaller annual clerkship enrollments (p  = .03), 3% higher match rates among schools with clerkships lasting more than 3 to 4 weeks (p  = .003), 3% higher match rates at schools with at least 1 family medicine faculty member in a senior leadership role (p  = .04), and 8% lower match rates at private medical schools offering community medicine electives (p < .001, R(2) = .48), F(6, 64) = 9.95, p < .001. Three additional factors were less strongly related and varied by institutional type-informal mentoring, ambulatory primary care learning experiences, and institutional research focus. Insights: Educational opportunities associated with higher match rates in family medicine differ across private and public medical schools. Future research is needed to identify the qualitative aspects of educational programming that contribute to differences in match rates across institutional contexts. Results of this study should prove useful in mitigating physician shortages, particularly in primary care fields such as family medicine.