Senior house officer withdrawals from hospital posts: a questionnaire survey.
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OBJECTIVES: To assess the nature and number of unexpected withdrawal by senior house officers (SHOs) after acceptance of a hospital post at interview, and to investigate the reasons and possible solutions. DESIGN: Postal questionnaire based study. SUBJECTS: Medical staffing departments, accident and emergency (A&E) consultants, and withdrawing SHOs in England. MAIN OUTCOME MEASURES: Unexpected withdrawals by hospital specialty, three year trend in A&E departments, notice and reasons given, and action taken. RESULTS: 39% of medical staffing departments reported unexpected withdrawals in a broad spectrum of specialties for February 1998. In the specialty of A&E medicine this occurred in 34% of departments. Overall 72% of A&E departments had experienced this problem over a three year period, and the trend is increasing. The majority of A&E consultants (70%) took no action, and there was a lack of consensus among all respondents on the appropriate course of action to prevent this escalating problem. CONCLUSIONS: Unexpected SHO withdrawal is a substantial issue in hospital medicine and has been increasing in A&E medicine. Measures to prevent this national problem are urgently needed. (+info)
Impact of NHS Direct on other services: the characteristics and origins of its nurses.
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OBJECTIVE: To characterise the NHS Direct nurse workforce and estimate the impact of NHS Direct on the staffing of other NHS nursing specialties. METHOD: A postal survey of NHS Direct nurses in all 17 NHS Direct call centres operating in June 2000. RESULTS: The response rate was 74% (682 of 920). In the three months immediately before joining NHS Direct, 20% (134 of 682, 95% confidence intervals 17% to 23%) of respondents had not been working in the NHS. Of the 540 who came from NHS nursing posts, one fifth had come from an accident and emergency department or minor injury unit (110 of 540), and one in seven from practice nursing (75 of 540). One in ten (65 of 681) nurses said that previous illness, injury, or disability had been an important reason for deciding to join NHS Direct. Sixty two per cent (404 of 649) of nurses felt their job satisfaction and work environment had improved since joining NHS Direct. CONCLUSION: The NHS Direct nurse workforce currently constitutes a small proportion (about 0.5%) of all qualified nurses in the NHS, although it recruits relatively experienced and well qualified nurses more heavily from some specialties, such as accident and emergency nursing, than others. However, its overall impact on staffing in any one specialty is likely to be small. NHS Direct has succeeded in providing employment for some nurses who might otherwise be unable to continue in nursing because of disability. (+info)
The new middle level health workers training in the Amhara regional state of Ethiopia: students' perspective.
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BACKGROUND: Following health sector reform, Ethiopia started training new categories of health workers. This study addresses students' perspectives regarding their training and career plans. METHODS: A cross sectional questionnaire was administered to 145 students in the three schools of the Amhara regional state of Ethiopia. RESULTS: The majority of students were male (62%) and originally from urban areas (76%). Job search was the most common reason for enrolling in the training for almost half (48%) of the respondents, followed by a desire to help the sick (46%). Once trained, the majority (98%) of graduates preferred to serve in the government sector and in rural health institutions (84%). Females were more willing to work in rural settings [chi2 (df 1)= 7.37; P = 0.007]. The majority (98%) of students felt the training period should be extended. 12% of graduates lacked confidence in their competencies after completing the training. A substantial proportion of the respondents (29%) did not feel the social science courses (Anthropology, Ecology and Psychology) were useful. CONCLUSIONS: This study demonstrates that mid-level health professional students are highly motivated, wish to address the health needs of rural communities, and are interested in professional development. However, students do not feel the training programs are fully addressing their needs. The students found that the duration of the training, the time for theory and practice, the availability of teaching materials, the course contents and their teachers were inadequate. This study suggests that the current training programs have serious inadequacies that need to be addressed. (+info)
Gender differences in first-year dental students' motivation to attend dental school.
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Women's role in the field of dentistry has historically been limited to the dental auxiliary fields, rather than that of D.D.S. or D.M.D. Today, women are nearly 38 percent of U.S. dental school students and 14 percent of active practitioners. The slow(er) influx of women into dentistry has been little studied by dental educators. During the 2000-01 academic year, we conducted a survey of first-year dental students at a sample of publicly funded U.S. dental schools. The purpose of the survey was to assess gender differences in motives for pursuing a dental career. The data show that male dental students rate self-employment and business-related motives as more important, while female dental students rate people-oriented motives more highly. Factor analysis revealed four distinct clusters of motives for pursuing a dental career: a financial motive, a business-oriented motive, a people-oriented or caring motive, and a flexibility motive. Women scored significantly higher than men on the caring factor, whereas the reverse was true on the business factor. Male and female students rated financial and flexibility motives equally. The implications of the results for attracting students to the profession of dentistry are discussed. (+info)
Dentists in general and community practice: a Scottish survey.
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OBJECTIVES: To identify the available workforce in general dental practice and to describe the job satisfaction, career and retirement plans of dentists in general and community practice. DESIGN: A postal cross-sectional survey. SETTING: Primary care dentists practising in Scotland in 2000. MATERIALS AND METHODS: Semi-structured questionnaires were sent to all primary care dentists identified from the Scottish Dental Practice Division as being in practice in Scotland. RESULTS: The response rate was 70% (1,335 GDPs and 187 CDPs). Although most dentists in both the GDS and CDS stated that they enjoyed their work, 35% of GDPs would not now choose dentistry as a career. Eighty-three per cent of the GDPs' time was spent on clinical work, of which 5% was not NHS-funded. Daily demotivation was reported by 70%, most commonly citing the job itself and the NHS 'treadmill'. Two-thirds of CDPs were women, as were half of GDPs aged less than 30. Only 35% of CDPs planned early retirement but 80% of them felt underused. Two-thirds of GDPs planned to retire in their mid-50s, and a further quarter planned to work part-time. Of the former, only a quarter agreed that nothing would induce them to work beyond this time. CONCLUSION: Conditions of work within primary care dentistry require modification to retain the current workforce and accommodate the increasing proportion of women. Part-time employment packages may encourage older practitioners to work for longer, and allow younger practitioners to fulfil family or personal commitments. (+info)
A qualitative study of the experiences of one group of African Americans in pursuit of a career in academic medicine.
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Recent reports demonstrate that medical school enrollment of minority students has continuously declined over the past several years and underrepresented minorities (URMs) continue to account for a disproportionately low percentage (less than 4%) of full-time academic faculty at medical schools in the United States. This article reports on a qualitative research project to examine the sociocultural experiences that influenced one group of minority physicians pursuing an academic medical career. Nine African American faculty, one resident, and one fellow from a Southern medical school of 574 full-time clinical and basic faculty completed 25 open-ended questions on a structured, qualitative interview plus background demographics. These nine faculty represented 82% (N = 11) of the total number of African American clinical and basic scientist faculty on campus at the end of the 1999 academic year. The narrative interviews describe key decision points, environmental and economic influences, and cultural experiences that affected faculty career choices and illustrate the real-life experiences of current minority faculty and scientists. These narratives contain significant messages for addressing policy on school campuses to improve the opportunities and likelihood of increasing the proportion of minority physicians and scientists. (+info)
Reasons for student debt during medical education: a Michigan study.
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The authors address the need for a better understanding of the reasons for greater indebtedness among today's osteopathic medical students. In May 2000, a survey was mailed to all 219 osteopathic interns at participating institutions in Michigan. The self-administered survey contained 19 questions designed to gather basic financial information, demographic characteristics, and subjective perceptions of student debt loads from participating interns. One hundred seventy completed surveys were returned, for a response rate of 78%. The authors attempted to focus on demographic predictors of debt and found that although there is no indication that such predictors have a significant effect on a student's total debt load, financial support from the student's family remains the single most important factor in predicting low levels of student debt. The authors suggest that the higher debt rate of students entering specialty fields may reflect the fact that students incur these debts with the knowledge that those debts will be more easily repaid once the student has begun to practice medicine. (+info)
PGD training and its impact on general dentist practice patterns.
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This study compares the practice patterns of general dentists with and without formal advanced training in AGED or GPR programs. The UCLA School of Dentistry surveyed a random selection of dentists from graduating years 1989, 1993, and 1997 as part of a Health Resources Services Administration (HRSA)-supported evaluation of the impact of federal funding on postgraduate general dentistry (PGD) programs. Using a sample drawn by the American Dental Association (ADA), 6,725 dentists were surveyed about their practice, advanced training, patients served, and services provided. Of the 2,029 dentists (30 percent) who responded, 49 percent were practicing dentists with no formal advanced training in general dentistry or one of the eight ADA specialties; 7 percent had Advanced Education in General Dentistry (AEGD) experience; 20 percent trained in a General Practice Residency (GPR); and 24 percent were specialists. Additionally, 7 percent of respondents had PGD training and a clinical specialty. GPR-trained dentists were significantly more likely to be on a hospital staff and to treat medically compromised patients even after ten years of practice. PGD dentists were less likely to seek specialty training. Major reasons for seeking PGD training were increasing treatment speed, learning to treat medically compromised patients, and wanting hospital experience. Primary reasons for not selecting training were starting a practice and having a great practice opportunity. Our conclusion is that PGD training has an enduring impact on practice patterns and improves access to dental care for underserved populations. (+info)