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首页> 外文期刊>Family medicine >Determinants of the 5-Year Retention and Rural Location of Family Physicians: Results from the Iowa Family Medicine Training Network
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Determinants of the 5-Year Retention and Rural Location of Family Physicians: Results from the Iowa Family Medicine Training Network

机译：家庭医生五年保留期和农村地区的决定因素：爱荷华州家庭医学培训网络的结果

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摘要

States are seeking ways to retain primary care physicians trained within their borders. We analyzed the 5-year retention and rural Iowa location decisions for 1,645 graduates of the Iowa Family Medicine Training Network (IFMTN)—eight residency programs (in seven different cities) that are affiliated with the Carver College of Medicine (University of Iowa). Methods: Data from 1977-2014 includes 98.5% of active graduates. Location in Iowa 5 years after graduation was the dependent variable in a binary logistic regression. A second model used rural location in Iowa as the dependent variable. Independent variables included graduation year cohort, IMG status, sex, undergraduate medical training in Iowa, medical degree, and residency location. Results: Undergraduate medical training in Iowa was strongly related to retention. Compared to graduates of the AMC residency, graduates of six of the seven community-based programs were significantly more likely to be practicing in Iowa. While the overall proportion of graduates practicing in rural Iowa was high (47.3%), women and IMGs were significantly less likely to practice in rural areas. Graduates of the Mason City program were significantly more likely to practice in a rural area after graduation. Conclusions: The experience of the IFMTN suggests that educating family physicians in community-based programs contributes significantly to in-state retention even 5 years after graduation. While all programs contribute to the rural FM workforce in Iowa, the residency program located in a rural community (Mason City) has a disproportionately positive impact.
机译：各国正在寻找方法来保留在其境内接受培训的初级保健医生。我们分析了爱荷华州家庭医学培训网络（IFMTN）的1,645名毕业生的5年保留和爱荷华州乡村位置的决策-与卡佛医学院（爱荷华大学）相关的八个居住计划（在七个不同的城市）。方法：1977-2014年的数据包括98.5％的活跃毕业生。毕业后5年在爱荷华州的位置是二元logistic回归中的因变量。第二种模型使用爱荷华州的农村地区作为因变量。自变量包括毕业年份队列，IMG身份，性别，爱荷华州的大学医学培训，医学学位和居住地点。结果：爱荷华州的大学医学培训与保留率密切相关。与AMC驻地毕业生相比，七个以社区为基础的计划中有六个计划的毕业生在爱荷华州实习的可能性更大。虽然在爱荷华州农村实习的毕业生比例很高（47.3％），但是妇女和IMG在农村地区实习的可能性大大降低。梅森城计划的毕业生毕业后更有可能在农村地区实习。结论：IFMTN的经验表明，即使在毕业后的5年内，在社区项目中对家庭医生进行教育也会大大促进州内留任。尽管所有计划都为爱荷华州的农村FM劳动力做出了贡献，但位于农村社区（梅森城）的居住计划却产生了不成比例的积极影响。

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