目的:这项研究检查了个体,教育,以及预测牙医攻读研究生牙科(PGD)培训的政策因素。
方法:来自2017年美国牙科协会Masterfile的个人牙医记录与博士前培训属性和州级牙科政策因素相关联。广义逻辑模型,针对个人进行调整,教育,和政策因素,用于预测:(1)参加任何PGD计划,和(2)主要(即,先进的一般实践,儿科,或牙科公共卫生,根据卫生资源和服务管理局[HRSA])与专科护理。
结果:大多数新的PGD住院医师(77%)都在初级保健。女性占初级保健槽的56%;男性占专业槽的62%。预测PGD初级保健培训的个体特征包括黑人,西班牙裔,亚洲人,或其他种族;男性或老年人减少了几率。预测PGD初级保健培训的博士前学校特征包括拥有博士前HRSA资助,与学术医学中心的隶属关系,成为一所历史悠久的黑人学院/大学;成为一所私立学校或在一个小的都会区降低了几率。在政策层面,参加PGD初级保健培训的最强预测因素是您目前所在州的住院医师要求以及每个住院医师的联邦研究生医学教育(GME)投资.
结论:根据牙医的种族/民族/性别,进行PGD训练是可变的。对博士前牙科教育和GME的联邦投资可以推动股权,因为它们大大增加了牙医继续接受PGD培训的几率,国家执照要求也是如此。
OBJECTIVE: This study examines the individual, educational, and policy factors that predict dentists pursuing postgraduate dental (PGD) training.
METHODS: Individual dentist records from the 2017 American Dental Association Masterfile were linked with pre-doctoral training attributes and state-level dental policy factors. Generalized logistic models, adjusted for individual, educational, and policy factors, were used to predict: (1) attending any PGD program, and (2) primary (i.e., advanced general practice, pediatrics, or dental public health, per the Health Resources and Services Administration [HRSA]) versus specialty care.
RESULTS: The majority of new PGD residency slots (77%) were in primary care. Women held 56% of primary care slots; men held 62% of specialty slots. Individual characteristics that predicted PGD primary care training included being Black, Hispanic, Asian, or other race; being male or older age reduced the odds. Pre-doctoral school characteristics that predicted PGD primary care training included having a pre-doctoral HRSA grant, affiliation with an academic medical center, and being a historically Black college/university; being a private school or in a small metro area lowered the odds. At the policy level, the strongest predictors of attending PGD primary care training are a residency requirement in the state you currently practice in and federal graduate medical education (GME) investment per residency slot.
CONCLUSIONS: Pursuing PGD training is variable based on the race/ethnicity/gender of the dentist. Federal investments in pre-doctoral dental education and GME can drive equity, as they significantly increase the odds that dentists will go on to PGD training, as do state licensure requirements.