Gender-Related Attrition in a General Surgery Training Program

This study describes how graduates of the University of Washington Family Medicine Residency Network who practice in rural locations differ from their urban counterparts in demographic characteristics, practice organization, practice content and scope of services, and satisfaction. Five hundred and three civilian medical graduates who completed their residencies between 1973 and 1990 responded to a 27-item questionnaire sent in 1992 (84% response rate). Graduates practicing outside the United States in a specialty other than family medicine or for fewer than 20 hours per week in direct patient care were excluded from the main study, leaving 116 rural and 278 urban graduates in the study. Thirty percent of graduates reported practicing in rural counties at the time of the survey. Rural graduates were more likely to be in private and solo practices than urban graduates. Rural graduates spent more time in patient care and on call, performed a broader range of procedures, and were more likely to practice obstetrics than urban graduates. Fewer graduates in rural practice were women. A greater proportion of rural graduates had been defendants in medical malpractice suits.



The more independent and isolated private and solo practice settings of rural graduates require more practice management skills and support. Rural graduates' broader scope of practice requires training in a full range of procedures and inpatient care, as well as ambulatory care. Rural communities and hospitals also need to develop more flexible practice opportunities, including salaried and part-time positions, to facilitate recruitment and retention of physicians, especially women.

Two decades of experience in the University of Washington Family Medicine Residency Network: practice differences between graduates in rural and urban locations.

This paper reports the results of a national survey of perceptions of practice and career satisfaction among the first cohorts of residency-trained family physicians The findings indicate that a large majority of the respondents (n = 876), most of whom had been in practice for only three years or less at the time of the survey in 1979, were well satisfied with their careers and work in general as well as with their residency training, practice arrangements and facilities, colleague relationships, and hospital privileges Several sources of relative dissatisfaction and difficulty were reported by the physicians, however, including practice time pressures, the necessity of treating emotional problems beyond their training, financial costs associated with operating their practice, paperwork, and perceived interference of external regulations and/or agencies in the physician-patient relationship

Practice and career satisfaction among residency trained family physicians: a national survey.

Introduction In 2005, competency based training was introduced into the curriculum of the postgraduate training of Dutch medical residents. The role as manager is one of the seven competencies and, compared to the other roles, it is presently thought to receive little attention during training. The goal of this study was to investigate medical residents’ understanding of this competency and how they perceive their role as manager. Methods In October 2009, 506 residents from different specialties in four teaching hospitals were invited via email to participate in the study. A 29-item Likert scale questionnaire was designed to investigate residents perceived healthcare management skills and knowledge in four management areas. Results 177 of 506 residents (35%) responded to the survey. More than half of the residents (106/177, 60%) did not feel confident in their (contract) negotiating skills and 56% (98/175) stated that they lacked sufficient knowledge of how the Dutch healthcare system is financed and organised. The residents were most confident in their ability to handle feedback (151/177, 85%), medical information data registration (168/173, 97%), and how to allocate healthcare resources based on evidence based principles (143/173, 83%). Conclusion These results demonstrate that residents in the Netherlands perceive their knowledge and skills in certain essential medical management concepts to be inadequate. The results suggest that a course in medical management should be considered as a mandatory part of the curricula of residency training programmes.

https://pmj.bmj.com/content/postgradmedj/early/2011/06/20/pgmj.2010.110254.full.pdf

How Dutch medical residents perceive their competency as manager in the revised postgraduate medical curriculum

Resident attrition: is gender a factor?

Graduate follow-up in the University of Washington family practice residency network.

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Graduate follow-up in the University of Washington family practice residency network.