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Kurahara D, Hamamura FD, Ifuku C, Chen JJ, Liu CA, Seamon EM, Miwa CS, Maestas B, Oba R, Patel SJ, Shiramizu B. Medical School Location and Sex Affect the In-State Retention of Pediatric Residency Program Graduates in Hawai'i. Hawaii J Health Soc Welf 2020; 79:240-245. [PMID: 32789294 PMCID: PMC7417638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The objective of this study was to assess the impact of medical school, sex, career choice, and location of practice of one pediatric residency program on physician workforce. This is a retrospective study of all categorical pediatric graduates of a residency program located in Honolulu, Hawai'i from 1968 to 2015. Information on medical school training, sex, career choice (general pediatrics or specialty), and location of practice were studied by examining data into five 10-year graduation periods. The program graduated 319 residents over nearly a 50-year timespan. Of these, 181 (56.7%) residents remained in Hawai'i to practice (adjusted odds ratio [OR] = 7.46, 95% confidence interval [CI]: 3.61-15.43). There were 125 (39.1%) graduates who relocated to the continental US with the majority moving to the West (55.2%), while other graduates moved to the South, Midwest, and Northeast (25.6%, 13.6%, and 5.6%, respectively). The remaining 13 (4.1%) graduates moved internationally. Female residents steadily increased over time (P < .001), with females significantly choosing general pediatrics (OR = 3.05, 95% CI: 1.91-4.89). In the time periods with the highest percentage of University of Hawai'i medical school graduates, there was an increased percentage of graduates staying in Hawai'i. This study examined the regional and national impact of a small residency program. The results indicated that trends in gender and the impact of medical school location were important in establishing a pediatrician workforce for local communities. Support of both medical school and residency education should be considered when assessing future workforce needs.
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Affiliation(s)
- David Kurahara
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | - Faith D. Hamamura
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | - Christine Ifuku
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | | | - Chloe A. Liu
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | - Elisabeth M. Seamon
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | - Chloe S. Miwa
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | - Brienna Maestas
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | - Ria Oba
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | - Shilpa J. Patel
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
| | - Bruce Shiramizu
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI (DK, FDH, CI, CAL, EMS, CSM, BM, RO, SJP, BS)
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Wong SM, Kamaka M, Carpenter DAL, Seamon EM. A Review of the Literature on Native Hawaiian End-of-Life Care: Implications for Research and Practice. Hawaii J Health Soc Welf 2019; 78:41-44. [PMID: 31930201 PMCID: PMC6949468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The need for cultural understanding is particularly important in end-of-life (EOL) care planning as the use of EOL care in minority populations is disproportionately lower than those who identify as Caucasian. Data regarding the use of EOL care services by Native Hawaiians in Hawai'i and the United States is limited but expected to be similarly disproportionate as other minorities. In a population with a lower life expectancy and higher prevalence of deaths related to chronic diseases such as cardiovascular disease, diabetes, and obesity, as compared to the state of Hawai'i as a whole, our objective was to review the current literature to understand the usage and perceptions of EOL care planning in the Native Hawaiian population. We searched ten electronic databases and after additional screening, seven articles were relevant to our research purpose. We concluded that limited data exists regarding EOL care use specifically in Native Hawaiians. The available literature highlighted the importance of understanding family and religion influences, educating staff on culturally appropriate EOL care communication, and the need for more research on the topic. The paucity of data in EOL care and decision-making in Native Hawaiians is concerning and it is evident this topic needs more study. From national statistics it looks as though this is another health disparate area that needs to be addressed and is especially relevant when considering the rapid increase in seniors in our population.
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Affiliation(s)
- Shelley M. Wong
- John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI
| | - Martina Kamaka
- John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI
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