性別差異在醫學生與醫師人數以及專科別選擇之10年趨勢探討

Gender Difference in the Manpower and Specialty Selection among Medical Students and Physicians: A Ten Year Trend Study from 1998 to 2007

陳韋君(Wei-Chun Chen) ； 璩大成(Da-Chen Chu) ； 陳潤秋(Ran-Chou Chen) ； 張聖原(Sun-Yran Chang)

《Journal of Medical Education》 14卷4期 (2010/12) Pp. 251-261

https://doi.org/10.6145/jme.201012_14(4).0001

摘要

Physician manpower is considered to be an important index when evaluating medical service quality. Furthermore, gender has become an important topic recently. Variations in the gender profile of physicians may influence outcomes in terms of medical services. As a result, concern has focused lately on differences in the distributions of male and female physicians across specialties.
We collected data from the Department of Education, Taiwan, and the National Health Insurance Database, Taiwan, in order to examine the male/female distribution of first year medical students, graduated medical students and new physicians over the years 1998 to 2007. Furthermore, we evaluated the distribution of male and female physicians in terms of their first selected specialty. The study was separated into two 5-year periods and this split was used to estimate the differences in specialty selection between the two periods, which were analyzed statistically using a trend-test. In addition, a chi-square test was used to compare the changes in selected specialties between the two periods.
The number of the first year medical students, graduated students, and physicians in terms of manpower increased significantly over the decade, and this growth was more apparent for females than for males (p＜0.001). In general, the top three preferred choices in terms of specialty were internal medicine, surgery, and pediatrics for male physicians and pediatrics, internal medicine, and family medicine for female physicians. When specialty preference over the two study periods is considered, emergency medicine, nuclear medicine, and radiology showed significant growth (p＜0.05), while ophthalmology, ENT, and obstetrics/ gynecology showed a significant decline (p＜0.05), when the first five year period was compared with the second five year period.
Medical education needs to focus greater effort on gender specific training in the various specialties. Personalized and advanced courses specifically targeting medical students and physicians of different genders should be arranged in order to improve post-graduate physician development and the quality of patient care.

關鍵字

性別 ； 醫師人數 ； 醫師專科 ； 醫學教育

並列摘要

Physician manpower is considered to be an important index when evaluating medical service quality. Furthermore, gender has become an important topic recently. Variations in the gender profile of physicians may influence outcomes in terms of medical services. As a result, concern has focused lately on differences in the distributions of male and female physicians across specialties.
We collected data from the Department of Education, Taiwan, and the National Health Insurance Database, Taiwan, in order to examine the male/female distribution of first year medical students, graduated medical students and new physicians over the years 1998 to 2007. Furthermore, we evaluated the distribution of male and female physicians in terms of their first selected specialty. The study was separated into two 5-year periods and this split was used to estimate the differences in specialty selection between the two periods, which were analyzed statistically using a trend-test. In addition, a chi-square test was used to compare the changes in selected specialties between the two periods.
The number of the first year medical students, graduated students, and physicians in terms of manpower increased significantly over the decade, and this growth was more apparent for females than for males (p＜0.001). In general, the top three preferred choices in terms of specialty were internal medicine, surgery, and pediatrics for male physicians and pediatrics, internal medicine, and family medicine for female physicians. When specialty preference over the two study periods is considered, emergency medicine, nuclear medicine, and radiology showed significant growth (p＜0.05), while ophthalmology, ENT, and obstetrics/ gynecology showed a significant decline (p＜0.05), when the first five year period was compared with the second five year period.
Medical education needs to focus greater effort on gender specific training in the various specialties. Personalized and advanced courses specifically targeting medical students and physicians of different genders should be arranged in order to improve post-graduate physician development and the quality of patient care.

並列關鍵字

gender ； physician ； specialty ； medical education

參考文獻

Liu, T.C.、Chen, C.S.、Cheng, Y.C.(2004)。Medical specialty choice under National Health Insurance。Journal of Healthcare Management。5，473-494。

Kao, M.Y.、Chen, H.J.、Lue, B.H.(2009)。Medical students' attitudes toward patient-centered care。J Med Ethic。13，275-286。

Wedsite of Taiwan Medical Association. Available at: [http://www.tma.tw/]

Website of Department of Health, Executive Yuan,Taiwan (R.O.C.). Available at: [http://www.doh.gov.tw/cht2006/index_populace.aspx]

Website of Association of American Medical College (AAMC). Available at: [http://www.aamc.org/data/facts/enrollmentgraduate/table31-women-count.htm]