METHODS: We emailed a 10-question survey to individuals pursuing urology in the United States and collected demographic data, education and training backgrounds, and preferences for proposed integrated residency programs and abbreviated transplant fellowships. We stratified respondents based on transplant interest (yes/no); we made comparisons by using t-tests for continuous variables and Fisher exact tests for categorical variables. We used multivariable logistic regression to identify factors associated with interest in transplant surgery.
RESULTS: Of 104 respondents, 98 were included in the final analysis, with 47% indicating a current or prior interest in transplantation. Male respondents were 3.7 times more likely than female respondents to be interested (odds ratio = 4.675; 95% CI, 1.411-15.495; P = .012). Participants aged <30 years were 93% less likely than older participants to be interested in transplantation (odds ratio = 0.071; 95% CI, 0.006-0.779; P = .03). International medical graduates reported higher enthusiasm for transplantation compared with US-trained counterparts (89% vs 42%), with a trend toward significance (P = .06). Nearly all (93%, 43/46) who expressed interest endorsed having an integrated training pathway. Only 70% (32/46) supported an abbreviated fellowship (<24 mo). Lifestyle concerns and insufficient exposure during residency were the most frequently cited reasons for lack of interest.
CONCLUSIONS: Compared with male and older urology trainees, female and younger urology trainees were less inclined to pursue transplant surgery. Nonetheless, urologists represent an untapped pool of transplant surgeons. Proposing an integrated training program for urologists and increasing exposure to transplantation during urology residency represent potential strategies to decrease transplant surgeon shortages.
方法:我们通过电子邮件向在美国从事泌尿外科工作的个人进行了10个问题的调查,并收集了人口统计数据,教育和培训背景,以及对拟议的综合居留计划和缩写的移植研究金的偏好。我们根据移植兴趣(是/否)对受访者进行了分层;我们通过对连续变量使用t检验和对分类变量使用Fisher精确检验进行了比较。我们使用多变量逻辑回归来确定与对移植手术的兴趣相关的因素。
结果:在104名受访者中,98个被纳入最终分析,47%的人表示目前或先前对移植感兴趣。男性受访者感兴趣的可能性是女性受访者的3.7倍(比值比=4.675;95%CI,1.411-15.495;P=0.012)。年龄<30岁的参与者对移植感兴趣的可能性比年龄较大的参与者低93%(比值比=0.071;95%CI,0.006-0.779;P=0.03)。与受过美国培训的同行相比,国际医学毕业生对移植的热情更高(89%对42%)。具有显著性趋势(P=.06)。几乎所有(93%,43/46)表示有兴趣的人赞同拥有综合培训途径。只有70%(32/46)支持缩写的研究金(<24个月)。生活方式的担忧和居住期间的暴露不足是缺乏兴趣的最常见原因。
结论:与男性和老年泌尿外科学员相比,女性和年轻的泌尿科学员不太倾向于进行移植手术。尽管如此,泌尿科医生代表了未开发的移植外科医生。为泌尿科医师提出综合培训计划,并在泌尿科住院期间增加对移植的接触,是减少移植外科医生短缺的潜在策略。