八年制医学博士的“弃医”选择——基于自我主导力理论的研究

The Choice of “Abandoning Doctor Career” by Eight-year Medical Doctors: Study Based on “Self-Authorship Theory”

八年制医学教育作为医学精英教育,在我国医学教育体系中备受关注。基于某院校的统计信息资料及该院校八年制医学博士毕业生的访谈数据,考察了八年制医学博士的"弃医"选择。研究发现,"弃医"的个体在选择"读医"上大多服从外部规则,自我主导性相对不足;八年制医学生在"弃医"前基本形成了未来从医的观念,并具备了初步的从医信念;选择"弃医"均发生在八年制医学教育的二级学科阶段,且个体均形成了"弃医"的内部信念;"弃医"的选择是多种因素相互作用的结果,主要因素来自于临床学习阶段所经历的内外部环境,"弃医"是环境压制下个体主导选择的结果。建议:采取合适的机制及政策引导对医学感兴趣、适合学医的学生报考;加强学生进入临床阶段学习时的学业及心理支持服务;聆听医学生的声音,合理制定相关政策;提高媒体素养,倡导科学合理的医学传播环境。

Eight-year Medical Education, has attracted special attention in China’s medical education system.Eight-year medical doctors are regarded as the medical elites. Based on the statistical information of a university and interview data from eight-year medical doctor graduates, this paper investigates the choice of"abandoning doctor career"by eight-year medical doctors. The study found that most of the"abandoning medicine"individuals obeyed the"external rules"in"choosing medical education period", while the self-dominated"medical education"was relatively rare;eight-year medical students basically formed the concept of future medical career before"abandoning doctor career", and had a preliminary medical belief;the choice of"abandoning doctor career"occurred in the phase of "Secondary Discipline" in Eight-year Medical Education, and they have all formed the internal belief of"abandoning doctor career". The choice of"abandoning doctor career"is a result of the interaction of many factors, but the most important factor comes from the internal and external environment experienced in the clinical learning stage, and"abandoning doctor career"is the result of the individual’s dominant choice under the oppression of environment. It is suggested that appropriate mechanisms and policies should be adopted to guide students who are interested in medicine and suitable to study medicine;strengthen the academic and psychological support services for students when they enter the clinical stage;listen to the voice of medical students to formulate relevant policies;improve media literacy and advocate a scientific and reasonable medical communication environment.