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Medical electives: exploring the determinants of placement and access variables between 2010 and 2016 at the University of Auckland

机译：医学选修科目：探索奥克兰大学2010年至2016年间安置和获取变量的决定因素

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Medical electives undertaken during sixth year at medical school provide an opportunity for students to work in an overseas or New Zealand health facility to gain exposure to a health system outside their training facility. Previous work suggests that the elective experience can be profound, exposing global health inequities, or influencing future career decisions. This study assessed patterns within elective choice by students’ socio demographic and programme entry characteristics. A retrospective analysis of student elective records from 2010 to 2016 was undertaken using a Kaupapa Māori research framework, an approach which prioritises positive benefits for Māori (and Pacific) participants and communities. A descriptive analysis of routinely collected de-identified aggregate secondary data included demographic variables (gender, age group, ethnicity, secondary school decile, year and route of entry), and elective site. Route of entry (into medical school) is via general, MAPAS (Māori and Pacific Admissions Scheme) and RRS (Regional and Rural Scheme). Multivariable logistic regression analysis determined the odd ratios for predictors of going overseas for elective and electives taking place in a “High” (HIC) compared to “Low- and middle-income countries” (LMIC). Of the 1101 students who undertook an elective (2010–2016) the majority undertook their elective overseas; the majority spent their elective within a high-income country. Age (younger), route of entry (general) and high school decile (high) were associated with going overseas for an elective. Within the MAPAS cohort, Pacific students were more likely (than Māori) were to go overseas for their elective; Māori students were more likely to spend their elective in a HIC. The medical elective holds an important, pivotal opportunity for medical students to expand their clinical, professional and cultural competency. Our results suggest that targeted support may be necessary to ensure equitable access, particularly for MAPAS students the benefit of an overseas elective.
机译：在医学院六年级期间进行的医学选修课为学生提供了在海外或新西兰卫生机构工作的机会，使他们有机会接触其培训机构以外的卫生系统。先前的工作表明，选修经历可能是深刻的，暴露了全球健康不平等现象，或影响未来的职业决策。这项研究根据学生的社会人口统计和课程入学特点评估了选修模式内的模式。使用KaupapaMāori研究框架对2010年至2016年的学生选修成绩进行了回顾性分析，该方法优先考虑了对毛利人（和太平洋地区）参与者和社区的积极利益。对常规收集的未识别的汇总二手数据的描述性分析包括人口统计学变量（性别，年龄段，种族，中学十等分，入学年份和途径）和选修地点。入学途径（进入医学院）是通过MAPAS（毛利和太平洋地区入学计划）和RRS（地区和农村计划）进行的。多变量逻辑回归分析确定了在高收入国家（HIC）与低收入和中等收入国家（LMIC）相比，选修和选修课程出国预测因子的奇数比。在接受选修的1101名学生中（2010-2016年），大多数在海外选修。大多数人在高收入国家/地区内选修。年龄（年轻人），入学途径（一般）和高中分数（高）与出国选修课程有关。在MAPAS队列中，太平洋学生（比毛利人）更有可能出国选修;毛利人的学生更有可能在HIC上选修课。医学选修课程为医学​​生扩展临床，专业和文化能力提供了重要的关键机会。我们的结果表明，可能需要有针对性的支持以确保公平获得入学机会，特别是对于MAPAS学生而言，受益于海外选修课。

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