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新医科背景下临床医学专业八年制学生毕业后发展研究

Career Development of Graduates of 8-Year Clinical Medicine Programs in the Context of the New Medical Education Initiative

  • 摘要:
    目的  探讨当前八年制医学教育的成效与问题,结合新医科要求,提出八年制医学教学改革初步建议与思考。
    方法  采用自制问卷对全国近10年毕业的680名八年制毕业生职业发展状况进行调研,采用多元线性回归分析影响八年制毕业生职业发展的核心因素;并在其中选取30名毕业生开展访谈。
    结果  本研究收回有效问卷676分,回收率为99.41%,研究对象中女性占比57.40%(388/676)略高于男性,二级学科选择中占比最高的是外科学,占35.21%(238/676),其次为内科学,占16.12%(109/676)。毕业生的自评岗位胜任力情况中56.12%(348/620)认为比较胜任,0.65%(4/620)认为完全不能胜任。从就业基本情况看,91.72%(620/676)的毕业生按时毕业、88.61%(599/676)的毕业生按时获得学位证书、91.72%(620/676)的毕业生从事医疗行业,其中97.9%(607/620)在三级医院工作;从毕业生发展情况看,至毕业第十年中级职称及以上人员占89.13%(41/46);工作满意度评价中,比较满意及以上占67.30%( 455/676);从学术成就看,到毕业第十年学生发表论文数中位数为6篇,其中在SCI收录期刊发表论文的中位数为5篇。毕业时长及毕业后发表论文的数量与其职称晋升有较强的关联(P<0.05);毕业生访谈结果揭示,83.33%(25/30)希望加强科研能力培养,60%(18/30)希望加交叉学科能力培养。
    结论  八年制医毕业生成材率高、就业好,自我认同度高,职业发展顺畅,但毕业生专业选择过于集中;在校教育的时间限制和毕业生希望强化科研能力培养的需求存在矛盾,毕业生交叉学科能力有待进一步加强等问题,需要政府、学校、医疗机构协同解决。

     

    Abstract:
    Objective  To evaluate the outcomes and challenges of China's 8-year clinical medicine programs and to discuss preliminary suggestions and reflections on the reform of 8-year clinical medicine programs in line with the requirements of the New Medical Education Initiative.
    Methods A nationwide survey was conducted to cover 680 graduates of 8-year clinical medicine programs. All participants graduated from 8-year programs in the past decade. Participants responded to a questionnaire on their career development. Multiple linear regression analysis was performed to identify the core factors affecting the career development of 8-year program graduates. In addition, 30 participants were selected to participate in an intensive interview.
    Results  A total of 676 valid responses were collected in this study, yielding a response rate of 99.41%. Among the participants, females slightly outnumbered males, accounting for 57.40% (388/676). In terms of subspecialty choices, surgery was the most popular, accounting for 35.21% (238/676), followed by internal medicine, which accounted for 16.12% (109/676). Self-assessed job competency ratings showed that 56.12% (348/620) felt competent, while 0.65% (4/620) reported being completely incompetent. In terms of employment status, 91.72% (620/676) of the participants completed their studies on time, 88.61% (599/676) were awarded diplomas as scheduled, and 91.72% (620/676) entered the healthcare industry, with 97.9% (607/620) working in tertiary-care hospitals. Regarding career development, by the tenth year after graduation, 89.13% (41/46) attained mid-level or senior professional titles. In terms of job satisfaction, 67.30% (455/676) reported moderate or higher levels of job satisfaction. In terms of academic achievements, the median number of papers published by the participants between graduation and the tenth year after graduation was 6, with a median of 5 papers published in journals included in the Science Citation Index (SCI). The quantity of publications and the length of time after graduation significantly correlated with professional advancement (P < 0.05). According to the interview results, 83.33% (25/30) of the participants suggested that research training should be increased and 60% (18/30) stated that interdisciplinary skills development should be prioritized.
    Conclusion A high proportion of graduates from 8-year clinical medical programs become highly competent professionals with good employment prospects, strong self-efficacy, and favorable career trajectories. However, the participants are disproportionately concentrated in certain subspecialties. Furthermore, other issues, such as the conflict between curricular time constraints and the graduates' desire to strengthen research training, as well as insufficient interdisciplinary preparation, require collaborative solutions from the government, universities, and medical institutions.

     

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