背景:鉴于医生在各专业之间的短缺和分布不均,我们旨在评估与医学生职业选择相关的因素,包括背景,人格特质,教育经验,个人利益,生活方式的考虑,和工作要求的意识。
方法:我们对学生进行了多次横断面调查;设计了159个项目的在线问卷,来自六年制医学学位课程三个不同阶段的学生(开始,临床阶段,并在毕业时)被邀请完成调查。数据是在2021年5月至2023年4月之间收集的。
结果:问卷已发送给1406名学生,其中683人回答(49%);481人是女性(70%)。受访者的首选专业是内科,手术,和一般实践,麻醉学,儿科和青少年医学(11-15%),妇产科也受到了关注,6%的人没有决定。特别是,女学生在学习过程中对手术失去了兴趣,转而选择其他选择。一般实践的选择与更多的职业培训有关,以前在专业方面的积极经验,大学入学考试成绩较低。与职业选择相一致的特定(自由选择)专业的临床文员,而最后的实际年份对职业决策没有影响。所有学生都非常希望有规律的工作时间和工作与生活的平衡;然而,选择手术的学生认为这些项目不太重要。愿意在医院环境中工作与选择麻醉和手术高度相关,而农村地区和实践与一般实践相关。较高的同意分数与更多女学生选择儿科和青少年医学有关,而较低的神经质值与麻醉学的选择有关。
结论:结果突出了决策的复杂性,并阐明了有助于选择专业过程的各个方面。通过识别和解决影响因素,我们可以制定有针对性的干预措施和政策,以加强医疗专业的多样性和分布,并旨在实现符合个人和整个人口具体需求的高质量和公平的医疗保健。
BACKGROUND: Given the shortage and unequal distribution of physicians across specialties, we aimed to evaluate factors associated with medical students\' career choices, including background, personality traits, educational experience, personal interests, lifestyle considerations, and the awareness of work requirements.
METHODS: We conducted multiple cross-sectional surveys of students; a 159-item online questionnaire was designed and students from three different stages of the six-year medical degree course (outset, clinical phase, and on graduation) were invited to complete the survey. Data were collected between May 2021 and April 2023.
RESULTS: The questionnaire was sent to 1406 students, of whom 683 replied (49%); 481 respondents were female (70%). The top specialty choices across the respondents were internal medicine, surgery, and general practice, with anaesthesiology, paediatric and adolescent medicine (ranging 11-15%), and obstetrics and gynaecology also receiving interest, with 6% undecided. In particular, female students lost interest in surgery during the course of study in favour of the other options. The choice of general practice was associated with more vocational training, prior positive experiences with the specialty, and lower grades in the university entry examination. Clinical clerkships in a specific (freely chosen) specialty aligned with career choice, while the final practical year did not have an impact on career decision-making. All students highly desired regulated working hours and work-life-balance; however, students choosing surgery rated these items as less important. Willingness to work in a hospital environment was highly associated with choosing anaesthesiology and surgery, whereas rural areas and practices were associated with general practice. Higher scores at agreeableness were associated with choosing paediatric and adolescent medicine by more female students, whereas lower neuroticism values were associated with the choice of anaesthesiology.
CONCLUSIONS: The results highlight the intricate nature of decision-making and shed light on various aspects that contribute to the process of selecting a specialty. By identifying and addressing influencing factors, we can develop targeted interventions and policies to enhance diversity and distribution across medical specialisations and to aim for high-quality and equitable healthcare that matches the specific needs of both individuals and the population as a whole.