Factors Affecting Medical Students' Choice of Residency: A Preliminary Study

影響醫學生選擇住院醫師訓練科別因素之分析

蘇百弘(Bai-Horng Su) ； 胡哲禎(Je-Jen Hu) ； 陳偉德(Walter Chen) ； 沈戊忠(Wu-Chung Shen) ； 林正介(Cheng-Chieh Lin)

《Mid-Taiwan Journal of Medicine》 10卷4期 (2005/12) Pp. 181-188

https://doi.org/10.6558/MTJM.2005.10(4).3

摘要

目的　本研究在調查分析影響醫學生選擇住院醫師訓練科別及訓練醫院的各項因素，以期增進住院醫師招募效能，以及作為設計全國性研究之參考。
方法　本研究共發出99份問卷，取樣對象包括所有在中國醫藥大學附設醫院實習的六年級及七年級醫學生。問卷分成七大項70個問題，包括基本資料，專業訓練，經濟因素，生活品質與工作量，工作環境，職涯規劃，以及醫院與科別。40個問題使用五分之李克特氏量表（5=非常有關係，4=有關係，3=普通，2=沒關係，1=完全沒關係），其他多30個問題包括單選、複選、排行與填空題。醫學生依所選擇之科別分成primary care組（包括內科，外科，小兒科，婦產科）與non-primary care組，加以比較分析。
結果　經由因素分析，由41個李克特氏量表問題中萃取出五個因素，20個具代表性的問題，並且在信效度檢驗上都達到滿意的標準。工作環境氣氛，生活型態，學術環境，開業機會，與現代性為萃取出的五個因素(accumulative factor loading=72%，Cronbach's α=0.90)。台灣大學附設醫院和內科分別為排名最高的醫院和科別選擇。Primary care組的學生在「將來進修機會」(p=0.03)以及「申請教職機會」(P=0.04)項目上得分較non-primary care組高。
結論　依據研究結果，藉由改善工作氣氛，加強次專科與學術訓練能力，以及減少非醫療相關的工作負擔應可有效增加住院醫師招募能力。就策略面而言，成立職涯規劃中心可以有效提昇醫院形象，並且提供醫院和醫學生、住院醫師間一個溝通管道。

關鍵字

科別選擇 ； 醫療人力 ； 實習醫師及住院醫師 ； 醫學生

並列摘要

Purpose. Recruiting enough residents has become a major issue for hospitals in recent years, especially for traditionally major specialties. To improve recruitment, factors affecting medical students' career choices need to be investigated and analyzed. This study investigated factors affecting medical students' choice of residency programs using a detailed comprehensive questionnaire. The result will be used to improve resident recruitment and for a future nationwide study design.
Methods. A total of 99 questionnaires were distributed to all seventh-year medical students serving as intern doctors in a university hospital in 2004. Seventy questions were categorized into 7 sections, including basic data, professional training, financial factors, life quality and workload, working environment, career planning, and hospital and specialty training. Forty-one questions used a 5 point Likert-type scale (5=strongly agree, 4=agree, 3=neutral, 2=disagree, 1=strongly disagree) and 30 used single choice, multiple choice, ranking, and fill in the blank. Students were grouped into a primary care specialty group (internal medicine, surgery, pediatrics, gynecology and obstetrics) and a non-primary care specialty group; differences between groups were compared. Factor analysis, reliability analysis, student ttest, chi-square test and descriptive statistics were used for statistical analysis.
Results. Five factors containing 20 Likert-type questions were extracted from all 41 Likert-type questions. Working atmosphere, life style, academic environment, private practice and modernity explained 72% of the variance of the survey. National Taiwan University Hospital and internal medicine were ranked highest for hospital and specialty choice, respectively. Students who chose primary care specialties gave more weight to ”chances of further academic advancement” (p=0.03) and ”opportunity to get teaching positions” (p=0.04).
Conclusions. Hospitals can increase their attractiveness by improving the working atmosphere, strengthening academic training, and trying to cut unnecessary work load. The establishment of a career consulting office may improve the general image of the hospital and provide a communication channel between the hospital, medical students and residents.

並列關鍵字

career choice ； health manpower ； internship and residency ； medical student