Gender Difference and Specialty Preference in Medical Career Choice

Chang-Woo Lee 한국의학교육학회 2013 Korean journal of medical education Vol.25 No.1

Purpose: We are entering a new era of medicine in which an equal number of men and women are becoming doctors. Many factors combine in complex and poorly understood ways to influence a medical student’s career and choice of specialty. This study investigated the preferences of medical students with regard to specialty and examined differences between genders. Methods: We administered a survey to medical students at the end of their third- or fourth-year clinical clerkships. In addition to demographic data and specialty choice, medical students selected factors that were importance to their choice of specialty. Results: One hundred forty-one medical students completed the survey (81 males, 57%). For medical students who had chosen a specialty, the most common specialty was internal medicine (20.5%). Significant gender differences were observed in choosing orthopedic surgery and family medicine—17 male students chose orthopedic surgery (10.5%) versus 3.3% of female students (p=0.02), and 11 females (9.2%) were drawn toward family medicine compared with 4 male students (2.5%). More female medical students chose lower workloads (19.9%) and low-risk work (14%) than male students (p<0.05). Lifestyle and income have become more important to medical students regarding their choice of specialty. Conclusion: There were significant gender differences concerning the choice of medical specialty. Controllable lifestyle remains an important factor for female medical students who are choosing a specialty. We must begin to make meaningful and thoughtful changes in medical center policies that affect a balance between work and home.

Development of a Modified Korean East Asian Student Stress Inventory by Comparing Stress Levels in Medical Students with Those in Non-Medical Students

신희곤,강석훈,임선혜,양정희,채성욱 대한가정의학회 2016 Korean Journal of Family Medicine Vol.37 No.1

Background: Medical students are usually under more stress than that experienced by non-medical students. Stress testing tools for Korean medical students have not been sufficiently studied. Thus, we adapted and modified the East Asian Student Stress Inventory (EASSI), a stress testing tool for Korean students studying abroad, and verified its usefulness as a stress test in Korean university students. We also compared and analyzed stress levels between medical and non-medical students. Methods: A questionnaire survey was conducted on medical and non-medical students of a national university, and the responses of 224 students were analyzed for this study. Factor analysis and reliability testing were performed based on data collected for 25 adapted EASSI questions and those on the Korean version of the Global Assessment of Recent Stress Scale (GARSS). A correlation analysis was performed between the 13 modified EASSI questions and the GARSS, and validity of the modified EASSI was verified by directly comparing stress levels between the two student groups. Results: The 13 questions adapted for the EASSI were called the modified EASSI and classified into four factors through a factor analysis and reliability testing. The Pearson’s correlation analysis revealed a significant correlation between the modified EASSI and the Korean version of the GARSS, suggesting a complementary strategy of using both tests. Conclusion: The validity and reliability of the EASSI were verified. The modified Korean EASSI could be a useful stress test for Korean medical students. Our results show that medical students were under more stress than that of non-medical students. Thus, these results could be helpful for managing stress in medical students.

Gender Difference and Specialty Preference in Medical Career Choice

이창우 한국의학교육학회 2013 Korean journal of medical education Vol.25 No.1

Purpose: We are entering a new era of medicine in which an equal number of men and women are becoming doctors. Many factors combine in complex and poorly understood ways to influence a medical student’s career and choice of specialty. This study investigated the preferences of medical students with regard to specialty and examined differences between genders. Methods: We administered a survey to medical students at the end of their third- or fourth-year clinical clerkships. In addition to demographic data and specialty choice, medical students selected factors that were importance to their choice of specialty. Results: One hundred forty-one medical students completed the survey (81 males, 57%). For medical students who had chosen a specialty, the most common specialty was internal medicine (20.5%). Significant gender differences were observed in choosing orthopedic surgery and family medicine—17 male students chose orthopedic surgery (10.5%) versus 3.3% of female students (p =0.02), and 11 females (9.2%) were drawn toward family medicine compared with 4 male students (2.5%). More female medical students chose lower workloads (19.9%) and low-risk work (14%) than male students (p<0.05). Lifestyle and income have become more important to medical students regarding their choice of specialty. Conclusion: There were significant gender differences concerning the choice of medical specialty. Controllable lifestyle remains an important factor for female medical students who are choosing a specialty. We must begin to make meaningful and thoughtful changes in medical center policies that affect a balance between work and home.

의학전문대학원생과 의과대학생의 전문 과목 선택에 영향을 미치는 요인 비교

이지혜,김건일,박귀화,윤소정 한국의학교육학회 2009 Korean journal of medical education Vol.21 No.4

Purpose: This study was conducted to compare the specialty preference and factors that affect choices of medical specialties between medical college students and graduate medical school students. Methods: A self-administered questionnaire was conducted in 563 medical students, and 482 (graduates: 199, undergraduates: 283) responded (response rate, 85.61%). The students completed a brief survey, which included 39 items that sampled their demographic data, career choice, and factors that influenced their choice. Results: Most students in medical college and graduate medical school preferred clinical medicine. Graduate medical school students preferred internal medicine, pediatrics, and family medicine. In contrast, medical college students preferred neurology, family medicine, and psychiatry. Important factors that affected the selection of specialties were seniors' advice, advice of other students, clerkship experiences, and specialty experiences. Conclusion: This result shows that there are differences in the factors that affect the selection of medical specialties between medical college students and graduate medical school students. But, the opportunity to explore future careers and to consult their choice of specialty, in accordance with the needs and characteristics of individual students, must be provided for all medical students.

의학을 전공하는 학생의 의료행위의 법적 문제

배현아 한국의료법학회 2017 한국의료법학회지 Vol.25 No.2

의학을 전공하는 학교의 학생들은 의료법에 의해 의료인이 아님에도 불구하고 지도교수나 의료인의 지도·감독 하에 의료행위를 할 수 있도록 예외적으로 허용되어 있다. 관련하여 최근 대법원은 대학병원을 의료기관이자 의사를 양성하는 교육기관으로 일반병원과 구분하여 학생들의 임상실습 및 참관이 교육과정의 일부로 정해져 있고 환자의 입장에서도 이를 당연히 예상할 수 있다고 보고 환자의 명시적인 동의가 없더라도 묵시적인 동의가 있는 것으로 보아 반대의사가 명시적으로 표명되지 않는 한 학생들의 참관이 허용되지만, 대학병원이 아닌 일반병원의 경우에는 일반원칙에 따라 산모의 명시적인 동의가 있는 경우에 한하여 학생들의 참관이 허용된다고 판시하였다. 의과대학생의 의료행위는 지도교수나 다른 의료인의 지도·감독과 같이 적법한 의료행위로서의 요건을 갖추어야 한다. 뿐만 아니라 학생들 스스로도 해당 행위에 내재되어 있는 위험성, 해당 의료행위에 참여하는 것에 대하여 환자의 자기결정권 보장에 기인한 명시적 동의 필요성, 민감정보에 해당하는 환자의 의료정보 보호에 대하여 인식하고 있어야 한다. 동시에 환자에게 행해지는 의료행위의 내용과 특수성을 고려할 때 실습에 임하는 자세와 태도 역시 중요하며 대상 환자에게 자신의 신분에 대하여 정확하게 알리고 그에 대하여 설명하고 동의를 구하는 과정이 필요하다. 그래야만 의과대학생의 의료행위로 인한 환자의 자기결정권 침해, 환자에게 발생한 나쁜 결과로 인한 손해의 발생이나 상해로 인한 형사 책임 발생과 같은 법적 문제를 예방할 수 있을 것이다. 무엇보다 이후 의사가 된 후 환자에게 최선의 진료를 제공할 수 있는 능력(competence)을 기르기 위하여 의학 교육의 과정 중에 예외적으로 허용된 의과대학생의 의료행위에 대하여 의사가 되려는 자로서의 전문가 윤리를 우선적으로 확보하는 것이 더욱 중요하겠다. Medical Service Act allows medical students to engage in medical practice, under the supervision of advisory professors or medical personnel, despite not being licensed medical personnel themselves. As both medical institutions and educational institutions for the training of doctors, teaching hospitals are differentiated from general hospitals. Clinical practice and observation are mandated parts of a medical student’s curriculum. Considering that patients of teaching hospitals can easily predict this type of student involvement, there is a presumption of implied consent even in the absence of a patient’s explicit consent. Thus, medical student involvement is permitted so long as the patient does not expressly indicate a contrary preference. However, this presumption does not apply to general hospitals, where the explicit consent of patients is necessary in order to permit medical student observation. The mandatory supervision of an advisor or other medical personnel is not the only requirement for medical students to legitimately engage in medical practice. Students themselves must also be aware of the risks inherent in the relevant actions; understand the necessity of the patient’s explicit consent regarding relevant actions, arising from protection of their self-determination rights; and be perceptive to protection of patient information that qualifies as sensitive information. Equally important is that medical students take on an appropriate attitude with regard to the content and specifics of the practices enacted on the patient, and that the student properly informs the patient of their status as a medical student, explaining this and acquiring the patient’s consent for observation. Only through these means can prosecution or other legal issues regarding damage or injury be prevented, in case of negative consequences to the patient or violation of patients’ self-determination rights due to students engaging in medical practice. Above all, it is important to prioritize the establishment of professionalism, through exceptions that permit the involvement of medical students in medical practice as part of their curriculum, in order to develop the competence to provide the best quality care once those students become doctors.

의료오류(Medical Error) 공개에 대한 의학전문대학원생과 인턴의 인식 및 태도 비교

이수현,신영혜,김성수 한국의학교육학회 2012 Korean journal of medical education Vol.24 No.3

Purpose:The purpose of this study was to compare attitudes toward disclosing medical errors between medical students and interns. Methods:The questionnaires were administrated to 164 medical students and interns. The questionnaires consist of 3 major concepts: knowledge, attitudes toward disclosure of medical error, barriers to the disclosure of medical error. Results:Interns (56.1%) took medical errors less seriously than medical students (74.8%). Medical students (75.6%) believed that patients would want to be informed of any kind of medical errors while Interns (46.3%) thought so. Medical students (83.1%) considered that serious medical errors should be disclosed to patients. On the contrary, only 46.3% of interns believed so. Medical students (16.3%) and interns (19.5%) believed disclosing medical error would increase patients trust in doctors. Both medical students and interns pointed out worries about malpractice suits as the biggest barrier to disclosing medical error. Conclusion:The attitudes toward disclosing medical error between medical students and interns were significantly different in many aspects. Interns show more negative attitudes about disclosing medical errors than medical students. And they also take medical errors less seriously than medical students. In particular, the attitudes of the subjects in this study were greatly different from the results of a previous patients' attitudes study. These perspectives differences could work against achieving patient-centered care which is the upmost priority in the current trends in health care. The efforts to bridge these perspective gaps between patients and doctors should start from medical school by teaching medical students the importance of the disclosing medical errors.

의과대학생의 의학교육 및 의료에 대한 의식 조사

박정한(Jung Han Park),김경환(Kyung Hwan Kim),전혜리(Hae Ri Jun),이주영(Ju Young Lee) 한국의학교육학회 1999 Korean journal of medical education Vol.11 No.2

1983년에 전국 규모의 의대생들에 대한 의식 및 가치관 조사를 실시한 이래 그동안 의대 수와 학생정원이 약 2배 증가하였고 사회․경제적 여건도 많이 변하였으므로 의대생들의 의식과 가치관이 어떻게 변하였는지 알아보기 위하여 이 조사를 다시 실시하였다. 1997년 11월 당시 전국의 40개 의대가운데 의학과 4학년까지 재학생이 있는 32개 대학의 의학과 재학생 전원을 모집단으로 하여 각 학년별 학생명부의 출석번호를 이용하여 10명에 1명씩 계통표본추출을 하고, 각 학년의 출석번호 끝번을 추가한 표본을 대상으로 설문조사를 하였다. 설문지는 1983년에 사용한 것을 근간으로 하여 최근 의료환경 변화에 대한 내용과 의대생들의 의학 및 직업관 형성에 관련된 문항을 추가하여 개발하였다. 조사는1997년 12월에서 1998년 1월 사이에 각 대학마다 사전에 위촉된 1명의 조사담당 교수가 조사대상자들에게 설문지를 배부하여 기입하게 하였다. 총 재학생 11,987명중에 설문 조사대상으로 뽑힌 1,386명가운데 1,233명 (89.0%)이 응답하였는데 응답자중 학년 미상 11명과 응답이 부실한 1명을 제외한 1,221명을 최종 분석대상으로 하였다. 몇 가지 특성을 중심으로 모집단과 조사표본을 비교해 본결과 표본의 대표성에는 별 문제가 없었다. 조사내용을 3부분으로 나누어 보고하였는데 1부에서는 조사방법과 조사대상자의 특성 및 응답자들의 의학교육에 대한 태도와 의학에 대한 본인의 적성에 관해 기술하였다. 응답자중 남자가 75.7 %를 차지하였다. 고졸 즉시 의대에 입학한 학생의 비율은 서울지역이 45.8 %, 서울 이외지역은 53.4 %이었다. 본인의 정치적 성향이 보수적이라는 사람이 서울지역은 43.9 %, 서울 이외 지역은 33.0 %로 지방 학생들이 진보적이라는 응답률이 더 높았다. 종교를 가진 사람이 57.2 %이었는데, 기독교가 31.0 %, 가톨릭 15.2 %, 불교 9.5 % 순이었다. 아버지의 교육수준이 대학 또는 그 이상인 사람이 59.8 %로 일반 국민의 교육수준보다 높았다. 아버지의 직업분포도 전문직 21.2%, 회사원 17.2%,공무원 13.1 %, 관리직 11.8 %, 의료인 8.7%로 화이트칼라가 지배적이었다. 의대진학 결정과정에 영향을 미친 사람이 있었다는 사람이 53.7 %이었는데, 이들중 부모가 62.1%를 차지하였다. 의대진학을 권유한 이유중 사회․경제적 측면이 33.5%로 가장 높은 비율을 차지하였다. 의학공부의 재미있는 측면은 생명현상을 배우는것 (47.2 %)과 인간을 배울 수 있다 (44.3%)는 것이었고, 재미없는 측면은 암기식 공부라는 것(39.7%)과 공부 분량이 너무 많다 (34.1%)는 것이었다. 만약 고교 3학년에 되돌아가 다시 대학을 선택할 경우 여전히 의대를 선택하겠다는 사람은 50.3 %이었으나, 지금 전과가 가능하다면 전과하겠다는 사람은 6.0 %에 불과하였다. 의학 공부에 자신의 적성이 맞다는 사람은 64.9%이었고, 이 비율은 학년이 올라갈수록 증가하였다. 장차 자기 아들을 의대에 보내겠다는 사람은 남학생중 36.6%, 여학생중 26.7%였고, 딸을 의대에 보내겠다는 사람은 각각 33.6%, 27.7%이었다. Since the first survey done in 1983, this is the second national sample survey of medical students about their perception and evaluation on medical study, career plan, and medical care system. One out of every 10 students plus one in each class were systematically sampled from each grade year of 32 medical schools in Korea that had students from freshman to senior in November 1997. A questionnaire was developed by adding items related with recent changes in medical care environment and with viewpoint on medicine and physician as an occupation to the questionnaire used in 1983. The questionnaire was administered at each school under the supervision of designated collaborator of the same school in December 1997 through January 1998. A total of 1,386 students were sampled from a total of 11,987 medical students and 1,233 students(89.0%) filled out the questionnaire. Twelve students were excluded from the analysis because of incomplete response and the final analysis was done for 1,221 students. A few demographic characteristics of the sample were compared with those of the study population to check the representativeness of the sample and found no skew. The contents of the study were divided into three parts and the first part describes the study methods, demographic and other characteristics of the sample, students viewpoint on medical education, and students aptitude for medicine Male students accounted for 75.7% of the sample. The proportion of students who entered medical school right after graduating from a high school was 45.8% in Seoul and 53.4% in other than Seoul area. The students who classified their own political inclination conservative were 43.9% in Seoul and 33.0% in other than Seoul and the percentage of students with progressive inclination was higher in out of Seoul than Seoul area. The proportion of students who have a religion was 57.2%; Christian 31.0%, Catholic 15.2%, and Buddhist 9.5%. The educational level of fathers of students was far higher than the level of general population, e.g. 59.8% had college or higher education. Occupation of fathers was mainly white-collar worker; professional worker 21.2%, company employee 17.2%, government official 13.1%, manager 11.8%, and medical professional 8.7%. In the decision-making process to enter the medical school, 53.7% of the students were influenced by someone else and 62.1% of them were parents. Socio-economic factor was the most common reason for recommending medical school and it accounted 33.5% of the reasons. Medical students enjoy learning life phenomenon(47.2%) and human being(44.3%) in medical study but most disturbing factors are memory work(39.7%) and too much to study(34.1%). If students were given another chance to choose a college as a senior student in high school, 50.3% of them said that they would choose medical school. Only 6% of students have intention to change their major subject of study if they are allowed to change now. The proportion of students who consider their scholastic aptitude is compatible with medical study was 64.9% and such proportion increased with grade. The percentage of students who are going to recommend medical school to their own son in the future was 36.6% for male and 26.7% for female students and to their own daughter 33.6% and 27.7%, respectively.

의과대학/의학전문대학원 학생들의 학습에 대한 신념

박재현,Park, Jaehyun 연세대학교 의과대학 2012 의학교육논단 Vol.14 No.2

Learning in medical school is usually regarded as a very specialized type of learning compared to that of other academic disciplines. Medical students might have general beliefs about their own learning. Beliefs about learning have a critical effect on learning behavior. There are several factors that affect medical students' learning behavior: epistemological beliefs, learning styles, learning strategies, and learning beliefs. Several studies have addressed epistemological beliefs, learning styles, and learning strategies in medical education. There are, however, few studies that have reported on medical students' beliefs about learning. The purpose of this study was to determine what learning beliefs medical students have, what the causes of these beliefs are, and how medical educators teach students who have such beliefs. In this study, the five learning beliefs are assumed and we considered how these beliefs can affect students' learning behaviors. They include: 1) medical students are expected to learn a large amount of information in a short time. 2) memorization is more important than understanding to survive in medical schools. 3) learning is a competition and work is independent, rather than collaborative. 4) reading textbooks is a heavy burden in medical education. 5) the most effective teaching and learning method is the lecture. These learning beliefs might be the results of various hidden curricula, shared experiences of the former and the present students as a group, and personal experience. Some learning beliefs may negatively affect students' learning. In conclusion, the implications of medical students' learning beliefs are significant and indicate that students and educators can benefit from opportunities that make students' beliefs about learning more conscious.

의과대학생의 의학 전문직업성 수준에 대한 학생과 교수의 인식 차이

허예라 한국의학교육학회 2008 Korean journal of medical education Vol.20 No.3

Purpose: The implementation of medical professionalism education and evaluation is a recent trend in medical education. Although many studies on this subject have been performed, they have focused specifically on the level of medical student professionalism the perception gaps between medical students and professors on this topic are unresolved. This study attempts to determine whether such gaps exist. Methods: Three hundred ninety fourth-year medical students and 250 professors who were randomly selected from 41 medical schools were asked to complete a survey on the level of the professionalism of medical students. Using the 31 core professionalism elements that are required for Korean medical students, students self-assessed their level of professionalism, and the professors evaluated the professionalism level of medical students who were graduating. Results: Of the 31 core elements, significant perception gaps were found in 28 elements. The three domains into which the 31 core elements were divided-professional knowledge, professional skills, and professional attitude-all contained perception gaps, and professors’ ratings generally were higher than those of the students, a noteworthy observation Conclusion: Medical professors need to encourage their students in elevating their professionalism, and what the faculty think they have taught regarding professionalism may not be fully assimilated by students. Further research is necessary to investigate why such gaps exist.

의대생과 일반대생의 삶의 질과 영향 요인에 대한 비교 연구

박범석,박귀화 사단법인 인문사회과학기술융합학회 2017 예술인문사회융합멀티미디어논문지 Vol.7 No.9

The purpose of this study was to investigate the difference of stress, stress coping, social support, self-esteem and quality of life(QOL) between medical and non medical students and analyzed the factors that affected their QOL. A subjects were 609 medical students and 396 non medical students. The data was analyzed by χ2, T-test, multiple variable regression analysis method. As a result, the scores of physical(p<0.001), social relationship(p<0.05), and environment(p<0.05) domain was significantly higher in non medical students than in medical students. Medical students scored higher on stress(p<0.05), while non medical students scored higher on stress coping(p<0.05). There were not significant differences in self-esteem by two group(p>0.05). Medical students showed higher scores of faculty support than non medical students(p<0.05). By regression alaysis, stress(β=-0.320) and active coping of stress(β=0.144) affected the QOL of medical students, while self-esteem(β=0.373) and stress(β=-0.184) affected the QOL medical students. We hope that this study will contribute to the development of program to improve the quality of life of undergraduate students. 본 연구에서는 의대생과 일반대생을 대상으로 스트레스, 스트레스 대처, 사회적 지지, 자아 존중감과 삶의 질의 차이를 분석하고, 삶의 질에 영향을 미치는 요인을 비교하였다. 연구대상은 의대생이 609명, 일반대생이 396명이었다. 분석방법은 χ2, T-test, 중다회귀분석을 사용하였다. 그 결과, 일반대생이 의대생에 비해 신체적 건강(p<0.001), 사회적 관계(p<0.05), 환경(p<0.05) 영역에 대한 삶의 질이 높았다. 스트레스는 의대생이 일반대생에 비해 유의미하게 높았으며(p<0.05), 스트레스 대처는 일반대생이 의대생에 비해 유의미하게 높았다(p<0.05). 자아 존중감에서는 의대생과 일반대생이 유의미한 차이가 없었다(p>0.05). 사회적 지지는 교수 지지에서만 의대생이 일반대생에 비해 높게 인식하였다(p<0.05). 의대생은 스트레스(β=-0.320)와 적극적 대처(β=0.144)가 일반대생은 자아 존중감(β=0.373)과 스트레스(β=-0.184)가 삶의 질에 영향을 미치는 요인이었다. 본 연구가 학생의 특성에 따른 차별화된 학생지원 프로그램을 개발하고 제공하는데 기초자료로 활용될 수 있기를 기대한다.