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Specialty choice in times of economic crisis: a cross-sectional survey of Spanish medical students

机译:经济危机时期的特殊选择:对西班牙医学生的横断面调查

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摘要

Objective: To investigate the determinants of specialty choice among graduating medical students in Spain, a country that entered into a severe, ongoing economic crisis in 2008.Setting: Since 2008, the percentage of Spanish medical school graduates electing Family and Community Medicine (FCM) has experienced a reversal after more than a decade of decline.Design: A nationwide cross-sectional survey conducted online in April 2011.Participants: We invited all students in their final year before graduation from each of Spain's 27 public and private medical schools to participate.Main outcome measures: Respondents’ preferred specialty in relation to their perceptions of: (1) the probability of obtaining employment; (2) lifestyle and work hours; (3) recognition by patients; (4) prestige among colleagues; (5) opportunity for professional development; (6) annual remuneration and (7) the proportion of the physician's compensation from private practice.Results: 978 medical students (25% of the nationwide population of students in their final year) participated. Perceived job availability had the largest impact on specialty preference. Each 10% increment in the probability of obtaining employment increased the odds of preferring a specialty by 33.7% (95% CI 27.2% to 40.5%). Job availability was four times as important as compensation from private practice in determining specialty choice (95% CI 1.7 to 6.8). We observed considerable heterogeneity in the influence of lifestyle and work hours, with students who preferred such specialties as Cardiovascular Surgery and Obstetrics and Gynaecology valuing longer rather than shorter workdays.Conclusions: In the midst of an ongoing economic crisis, job availability has assumed critical importance as a determinant of specialty preference among Spanish medical students. In view of the shortage of practitioners of FCM, public policies that take advantage of the enhanced perceived job availability of FCM may help steer medical school graduates into this specialty.
机译:目的:调查在2008年陷入严重持续经济危机的西班牙应届医学院学生中选择专业的决定因素。背景:自2008年以来,西班牙医学院毕业生选择家庭和社区医学(FCM)的百分比在经历了十多年的下滑之后经历了逆转。设计:2011年4月在线进行的全国性横断面调查参与者:我们邀请了西班牙27所公立和私立医学院中每所大学毕业的最后一年的所有学生参加主要结果指标:受访者对以下方面的看法而偏爱的专业:(1)获得工作的可能性; (2)生活方式和工作时间; (3)患者的认可; (四)同事间的威信; (5)专业发展的机会; (6)年度报酬和(7)私人执业医师补偿的比例。结果:978名医学生(占当年全国学生的25%)参加了该项目。可以得到的工作机会对专业偏好的影响最大。就业机会每增加10%,偏爱某专业的几率就会增加33.7%(95%CI 27.2%至40.5%)。在确定专业选择时,工作机会的重要性是私人执业的报酬的四倍(95%CI 1.7至6.8)。我们观察到生活方式和工作时间的影响存在很大的异质性,喜欢心血管外科和妇产科等专业的学生认为工作时间更长而不是更短。是西班牙医学生对专业偏爱的决定因素。鉴于FCM从业人员的短缺,利用FCM增强的可感知工作机会的公共政策可能有助于引导医学院毕业生进入该专业。

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