Postresidency Practice Setting and Clinical Care Features According to 3 Versus 4 Years of Training in Family Medicine: A Length of Training Pilot Study.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
M. P. Eiff, Annie Ericson, Dang H. Dinh, Steele Valenzuela, C. Conry, Alan B. Douglass, W. P. Dickinson, Stephanie E. Rosener, Patricia A. Carney
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Abstract

BACKGROUND AND OBJECTIVES Factors associated with physician practice choice include residency location, training experiences, and financial incentives. How length of training affects practice setting and clinical care features postgraduation is unknown. METHODS In this Length of Training Pilot (LoTP) study, we surveyed 366 graduates of 3-year (3YR) and 434 graduates of 4-year (4YR) programs 1 year after completion of training between 2013 and 2021. Variables assessed included reasons for practice setting choice, practice type, location, practice and community size, specialty mix, and clinical care delivery features (eg, integrated behavioral health, risk stratified care management). We compared different length of training models using χ2 or Fisher's exact tests for categorical variables and independent samples, and t test (unequal variances) for continuous variables. RESULTS Response rates ranged from 50% to 88% for 3YR graduates and 68% to 95% for 4YR graduates. Scope of practice was a predominant reason for graduates choosing their eventual practice, and salary was a less likely reason for those completing 4 years versus 3 years of training (scope, 72% vs 55%, P=.001; salary, 15% vs 22%, P=.028). Community size, practice size, practice type, specialty mix, and practice in a federally designated underserved site did not differ between the two groups. We found no differences in patient-centered medical home features when comparing the practices of 3YR to 4YR graduates. CONCLUSIONS Training length did not affect practice setting or practice features for graduates of LoTP programs. Future LoTP analyses will examine how length of training affects scope of practice and clinical preparedness, which may elucidate other elements associated with practice choice.
全科医学 3 年与 4 年培训后的实习环境和临床护理特点:培训期限试点研究。
背景和目标与医生选择执业相关的因素包括住院医师培训地点、培训经历和经济激励。在这项培训时长试点(LoTP)研究中,我们调查了 366 名 3 年制(3YR)毕业生和 434 名 4 年制(4YR)毕业生在 2013 年至 2021 年期间完成培训 1 年后的情况。评估的变量包括选择执业地点的原因、执业类型、地点、执业和社区规模、专科组合以及临床医疗服务特点(如综合行为健康、风险分层护理管理)。我们使用χ2 或费雪精确检验对分类变量和独立样本进行了比较,并使用 t 检验(不等方差)对连续变量进行了比较。结果 3 年制毕业生的回复率在 50% 到 88% 之间,4 年制毕业生的回复率在 68% 到 95% 之间。执业范围是毕业生选择最终执业单位的主要原因,而对于完成 4 年培训和 3 年培训的毕业生来说,工资是较少的原因(执业范围,72% 对 55%,P=.001;工资,15% 对 22%,P=.028)。社区规模、执业规模、执业类型、专科组合以及在联邦指定的服务不足地区执业在两组之间没有差异。我们发现,在比较 3 年制和 4 年制毕业生的执业情况时,以患者为中心的医疗之家特征并无差异。未来的 LoTP 分析将研究培训时间如何影响实践范围和临床准备,这可能会阐明与实践选择相关的其他因素。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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