Čimbenici koji utječu na želju studenata medicine za specijalizacijom iz obiteljske medicine [Factors influencing medical students in their career choice of family medicine]

Ević, Jelena (2015) Čimbenici koji utječu na želju studenata medicine za specijalizacijom iz obiteljske medicine [Factors influencing medical students in their career choice of family medicine]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

The motivation and other factors used by medical students in making their career choices for specific medical specialties have been looked at in a number of studies in the literature. The reasons why medical students choose their careers are complex. Factors include lifestyle preferences, personal fit and workforce factors, including expected income, prestige, job opportunities, longitudinal care and societal need. In many countries, lower interest in family medicine than in other specialties is noticeable. Although most of the students will have to work in primary health care, family medicine does not seem to be an attractive area. Students generally believe that primary health care is not an effective area for personal development. There are ongoing efforts to improve this situation. In Zagreb School of Medicine this research is conducted in order to determine whether social and economic transition, including health care reforms, influences young people motivation to choose medical study and their career choices for medical specializations. The aims of this research were (1) to identify different factors affecting career choice in family medicine, (2) to define differences in career preferences students have at entry to medical school and at the end of study and (3) to explore changes in ten-years period in their career choice of family medicine as a first choice career option. This is retrospective study in the period from academic year 2004./2005. to 2013./2014. and comprised 2490 first-year and 1828 six-year medical students from School of Medicine, University of Zagreb. The pre-validated anonymous questionnaire was administrated to students entering and finishing medical school. The questionnaire included questions on demographic data, opinion about certain specialists in societies and their career choice. Required data were analyzed using descriptive statistics. A logistic regression was performed using career choice (family medicine versus others) as the criterion variable and the factors (social, demographic characteristics and motivation to choose medical study) as predictor variables. Results showed that 2,9% first year medical students and 13% sixth year medical students see themselves as future family medicine specialist. Statistically higher significant differences were found within the categories of gender (females had a higher preferences for family medicine than males), in place of birth (born in rural areas) and parents with lower formal education levels. The first year medical students are less interested to be family practitioners in comparation with those who are at the end of their study. In the last ten years, there is an increasing interest for family medicine among sixth year students. Since School of Medicine has a social responsibility to be accountable for the health care needs, these results could recommend whether to change the admission policies and increase number of students choosing family medicine and/or to modify and reorient medical school curricula towards primary health care.

Abstract in Croatian

Brojna su istraživanja o motivaciji studenata medicine u izboru buduće specijalizacije. Studije ističu složenost čimbenika koji na to utječu, a najčešće se ističu oni vezani uz osobnost, sustav vrijednosti, odrednice životnog stila te položaj liječnika u društvu. Iako će najveći broj liječnika raditi u primarnoj zdravstvenoj zaštiti, želja za izborom tih specijalizacija je mala. Zbog potreba u sustavu zdravstva, u svijetu se nastoji povećati interes za obiteljsku medicina, a moguće je da su socijalne i ekonomske promjene u Hrvatskoj te promjene u sustavu zdravstva utjecale na izbor studija medicine i želju za specijalizacijom mladih. Ciljevi ovog istraživanja bili su: (1) ispitati i utvrditi međuzavisnost čimbenika koji utječu na odabir specijalizacije obiteljske medicine kao buduće profesije, (2) istražiti razlike u namjerama za specijalizacijom iz obiteljske medicine kod studenata na početku i kraju studija te (3) povezati promjene u sustavu zdravstva i njihov utjecaj na izbor specijalizacije iz obiteljske medicine u desetgodišnjem razdoblju. Radi se o retrospektivnoj studiji u desetgodišnjem periodu od akademske godine 2004./05. do 2013./14. koja je obuhvatila 2490 studenata prve godine i 1828 studenata šeste godine Medicinskog fakulteta u Zagrebu. Instrument u istraživanju bio je validirani upitnik koji je obuhvaćao nekoliko skupina pitanja. Uz osobne podatke, studenti su naveli motive svog izbora studija i želju za specijalizacijom te stavove prema pojedinim specijalistima u društvu. Pri istraživanju u potpunosti su korištena etička načela i potpuna tajnost ispitanikovih podataka. Podaci su se analizirati deskriptivnim i kvalitativnim metodama, uz korištenje linearne regresije. Rezultati pokazuju da 2,9% studenata prve godine i 13% studenata završne godine studija želi odabrati specijalizaciju iz obiteljske medicine kao budući poziv. Statistički značajne razlike utvrđene su prema spolu (ispitanice ženskog spola češće žele biti specijalistice obiteljske medicine), mjestu rođenja (želju za obiteljskom medicinom više pokazuju oni koji dolaze s ruralnog područja) te prema formalnoj edukaciji roditelja (ispitanici čini roditelji imaju nižu naobrazbu češće biraju obiteljsku medicinu). U skupini studenata prve godine studija utvrđen je statistički značajan linearni trend porasta onih koji izabiru obiteljsku medicinu. S druge strane, u skupini studenata šeste godine nije utvrđen trend porasta u zadnjih deset godina. Od istraživanja se očekuje da doprinese objašnjenju čimbenika koji utječu na izbor specijalizacije studenata medicine, posebice obiteljske medicine. Kako je uloga Medicinskog fakulteta slijediti potrebe prakse, rezultati mogu biti doprinos odgovoru na pitanje treba li mijenjati izbor pristupnika za studij, i/ili kurikulum studija re-orijentirati prema izvanbolničkoj zaštiti.

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