The impact of the current medico-legal and regulatory culture in Ireland on the decision of graduate entry medical school students to pursue a career in obstetrics and gynecology

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2024-10-09 DOI:10.1016/j.ejogrb.2024.10.015

Mary-Elizabeth Tumelty , Eimear Spain , Ayesha Cheema , Kaitlyn Cinnamond , Ailish Hannigan , Santosh Sharma , Amanda Cotter

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Abstract

Objectives

Medico-legal and regulatory culture has a significant impact on medical practitioners, including the decision of graduates to enter high-risk specialties. This study explores the impact of the current medico-legal and regulatory culture in Ireland on the decision of graduate entry medical students to enter one high risk specialty, obstetrics and gynecology.

Study Design

We conducted a survey of 146 final-year, graduate-entry medical students pre- and post- a 6-week rotation in obstetrics and gynecology in Ireland. Participants were asked to rate the influence (on a four-point scale) of factors such as fear of being sued, being reported to the regulatory body or criminal prosecution on their decision to pursue a career in obstetrics or gynaecology. Data were matched pre- and post-rotation and McNemar-Bowker’s test was used to test for differences in related data. All analysis was conducted using SPSS for Windows version 25.

Results

The responses of 72 students to both questionnaires could be matched (response rate 49.3%). The majority of participants pre-rotation reported that fear of being sued (74%), fear of being reported to the regulatory body (70%) and fear of criminal prosecution (55%) were factors influencing their decision (somewhat or to a great extent) to pursue a career in obstetrics. There were no significant changes post-rotation. Compared to obstetrics, lower proportions of participants pre-rotation considered fear of being sued (54%), fear of being reported to the regulatory body (50%) and fear of criminal prosecution (40%) as factors influencing their decision to pursue a career in gynecology. There were no significant changes post-rotation.

Conclusions

Medico-legal and regulatory culture is shaping the perceptions of graduate entry medical students of obstetrics and gynecology and influencing their decision to pursue a career in the speciality. Understanding the impact of medico-legal culture on career choices including a high-risk specialty such as obstetrics and gynecology is important from both a policy and reform context, and if the healthcare service is to recruit and retain adequate numbers to ensure the safe provision of healthcare.

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爱尔兰当前的医学法律和监管文化对医学院研究生决定从事妇产科职业的影响

研究目的医学法律和监管文化对从医者有重大影响，包括毕业生进入高风险专业的决定。本研究探讨了爱尔兰当前的医学法律和监管文化对研究生入学医学生决定进入妇产科这一高风险专业的影响。研究设计我们对 146 名研究生入学医学生在爱尔兰妇产科进行 6 周轮转前后的情况进行了调查。我们要求参与者对害怕被起诉、被监管机构举报或被刑事起诉等因素对其决定从事妇产科职业的影响进行评分（4 分制）。数据在轮换前和轮换后进行配对，并使用 McNemar-Bowker 检验来检验相关数据的差异。所有分析均使用 SPSS for Windows 25 版本进行。大多数轮转前的参与者表示，害怕被起诉（74%）、害怕被监管机构举报（70%）和害怕被刑事起诉（55%）是影响他们决定（在一定程度上或很大程度上）从事产科职业的因素。轮转后没有明显变化。与产科相比，轮转前认为 "害怕被起诉（54%）"、"害怕被监管机构举报（50%）" 和 "害怕被刑事起诉（40%）"是影响他们决定从事妇科工作的因素的参与者比例较低。结论医学法律和监管文化正在影响妇产科医科研究生的观念，并影响他们从事该专业的决定。从政策和改革的角度来看，了解医学法律文化对职业选择（包括妇产科这样的高风险专科）的影响是非常重要的，如果医疗保健服务要招聘和留住足够的人才以确保医疗保健服务的安全提供，也是非常重要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.