A大附設醫院畢業後一般醫學訓練學員申請住院醫師考量因素調查

A Study of Factors Affecting Post-Graduate Year Trainees' Preference on A Hospital of Choice for Residency

目的：希望藉有系統的初探問卷調查以了解A大附設醫院畢業後一般醫學訓練(Post-graduate Year, PGY) 學員選擇專科訓練醫院考量面向，作為醫院後續招募住院醫師參考。方法：以七分法自陳式問卷為調查工具，讓A大附設醫院49位PGY學員利用網路線上填卷後進行相關統計分析。結果：回收有效問卷35份回收比率71.4%，男女比率60：40。其中以在『A大附設醫院實習』為類別，進行獨立樣本 t 檢定『我對該院有歸屬感』『我是選擇專科不選醫院』，兩題達95%雙尾統計顯著。利用因素分析萃取4個因素面向，分別命題『主觀感受的臨床學習環境』『臨床工作負擔合理』『夥伴關係』『個人志向』。另外使用邏輯式迴歸發現當選科不選院每增一分，學員選擇專科的機率會增加5.32倍，隱含學員的高度專科情節。結論：在傳統師徒模式的醫生養成過程雖然重視人情與倫理，然而在PGY受訓期間讓學員從臨床醫療團隊學習與工作中，認識醫院、體驗良好的人際關係，這中介調節出的歸屬感，會讓獨立自主性強的PGY學員選擇留下接受專科住院醫師訓練。

Objectives: The main purpose of this study was to conduct an initial probe into the factors affecting Post-graduate Year (PGY) trainees from ＂A University Hospital＂ when applying their hospital of choice for residency, and to gain a better insight on applicant's decision making process in a systemically manner to improve our resident recruitment program based on the finding of this study. Method: 49 applicants were asked to fill out a web-based seven-point Likert scale self-report questionnaires after their interview. The surveys were then collected and analyzed. Results: Out of 49 questionnaires, 35 were deemed effective (71.4%) with a male to female ratio 60:40. The independent t-test among the ＂A University Hospital＂ graduates, ＂a sense of belonging to my hospital＂ and ＂personal preference on subjects of choice over hospital of choice＂ were revealed as significant factors in two-tail t-test (confidence level ＞ 95%), and ＂A University Hospital＂ graduates had significantly higher sense of belonging than graduates from other schools. Using factor analysis, we isolated four dimensions, ＂subjective feeling of clinical learning environment＂, ＂acceptable clinical work loading＂, ＂interpersonal relationships＂ and ＂personal aspiration＂. The logistic regression analysis showed PGY trainees are 5.32 times more likely to choose ＂A University Hospital＂ with every point increase in their ＂sense of belonging＂. Conclusions: Although the traditional style of apprenticeship training focused more on interpersonal relationship and work ethic, the team-approach style of training built up more sense of belonging in the PGY trainees, especially when the trainees worked together in clinical environment. In this environment, the trainees formed tight bonds between peers, and these bonds between peers then being generalized by the trainees as sense of belonging to ＂A University Hospital＂ and became an important part of the organization. Thus, the trainees were more willing to stay for residency at the same hospital.