preliminary report phoonyathorn phatthanathitikarn, md prawit kittidumrongsuk, md chulalongkorn...
TRANSCRIPT
Factors Influencing orthopedic Resident's Decisions for subspecialty training in
Thailand
ป�จจ�ยท��ม�ผลในการเล�อกเร�ยนต�อแพทย�ประจ�าบ�านต�อยอดของแพทย�ประจ�าบ�านออร�โธป"ด#กส�
Preliminary report
Phoonyathorn Phatthanathitikarn, MD
Prawit Kittidumrongsuk, MD
Chulalongkorn hospital
Introduction There has been much focus on factors
influencing residents’ final subspecialty choice in aboard sufficient future workforce a cultural shift in values and priorities.
Once in a Thailand residency little data on factors influencing residents’ final
subspecialty choice.
Method A cross-sectional survey was developed and
content validated The questionnaire was distributed The study group included 2nd, 3rd and 4th year
orthopedic resident is four institutions
Questionnaire
 ° µ¤� � � � Á¦ºÉ°� ´ ¥ ɤ ¨Ä µ¦Áº° Á¦¥ n°Â¡ ¥r¦³ εoµ n°¥° ° ¡ ¥r¦³ εoµ°°¦rà · · r� � � � � � � � � � � � � � � � � � � � � � � � � � � � ε ÊÂ� � � � : æ� � Ä®oo°¤¼Åªoµ¤ ªµ¤ÁÈ ¦·� � � � � � � Ã¥ µ¦Áº° εÁ¦ºÉ° ®¤µ¥� � � � � � ³Á·¤ 뵀 n° ªnµ Éε® Ūo� � � � � � � � � �
1. o°¤¼ nª » ¨� � � � � 1.1. Á¡« [ ] µ¥� [ ]® ·� � 1.2. °µ¥» ………¸� 1.3. µ ³£µ¡� � [ ] à � [ ] ¤¦ [ ]®¥nµ [ ] ®¤oµ¥ 1.4. ε ª »¦ ɤ� � � � � � [ ]¤ εª� � � .............. [ ]Ťn¤� � 1.5. £¼¤·ÎµÁµ ®ª� � � � ________________________________________(æ ¦³ »� � � ) 1.6. ¡ ¥r«µ ¦rµ µ ´� � � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.7. ¡ ¥r¦³ εoµ� � � � � °°¦rà · · rÊ� � � � � � ¸É� � [ ] 2 [ ] 3 [ ] 4
¡ ¥rÄo»°°¦rà · · rʸÉ� � � � � � � � � � � � [ ] 2 [ ] 3 [ ] 4 [ ] 5 1.8. µ É� � � ¹° ¦¤Ä ´ »� � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.9. o ´ ´� � � � �
1.9.1. [ ] ¦´ µ µ ´� � � � � /¦¡.________________________________________________ (æ ¦³ »� � � ) 1.9.2. [ ] °ºÉÇ� Án¦¡� � .Á°� � � ________________________________________________ (æ ¦³ »� � � ) 1.9.3. [ ] °· ¦³Å¤n¤ o ´ ´� � � � �
2. æ Ä®oÎʵ®´� � � � � ´ ¥ ɤ ¨ n° µ¦ ´ ·Ä ° nµ� � � � � � � � � � � � � � � ®µ nµÁº° ¹° ¦¤Á¡·É¤Á·¤ÁÈ� � � � � � � � � fellow ship ( ε ÊÂ� � � � 1= Ťn ε ´� � , 2= ε ´ o°¥� � � , 3= ε ´ µ ¨µ� � � � � � , 4= ε ´¤µ� � � , 5= ε ´¤µ É »� � � � � )
 ° µ¤� � � � Á¦ºÉ°� ´ ¥ ɤ ¨Ä µ¦Áº° Á¦¥ n°Â¡ ¥r¦³ εoµ n°¥° ° ¡ ¥r¦³ εoµ°°¦rà · · r� � � � � � � � � � � � � � � � � � � � � � � � � � � � ε ÊÂ� � � � : æ� � Ä®oo°¤¼Åªoµ¤ ªµ¤ÁÈ ¦·� � � � � � � Ã¥ µ¦Áº° εÁ¦ºÉ° ®¤µ¥� � � � � � ³Á·¤ 뵀 n° ªnµ Éε® Ūo� � � � � � � � � �
1. o°¤¼ nª » ¨� � � � � 1.1. Á¡« [ ] µ¥� [ ]® ·� � 1.2. °µ¥» ………¸� 1.3. µ ³£µ¡� � [ ] à � [ ] ¤¦ [ ]®¥nµ [ ] ®¤oµ¥ 1.4. εª »¦ ɤ� � � � � � [ ]¤ εª� � � .............. [ ]Ťn¤� � 1.5. £¼¤·ÎµÁµ ®ª� � � � ________________________________________(æ ¦³ »� � � ) 1.6. ¡ ¥r«µ ¦rµ µ ´� � � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.7. ¡ ¥r¦³ εoµ� � � � � °°¦rà · · rÊ� � � � � � ¸É� � [ ] 2 [ ] 3 [ ] 4
¡ ¥rÄo»°°¦rà · · rʸÉ� � � � � � � � � � � � [ ] 2 [ ] 3 [ ] 4 [ ] 5 1.8. µ É� � � ¹° ¦¤Ä ´ »� � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.9. o ´ ´� � � � �
1.9.1. [ ] ¦´ µ µ ´� � � � � /¦¡.________________________________________________ (æ ¦³ »� � � ) 1.9.2. [ ] °ºÉÇ� Án¦¡� � .Á°� � � ________________________________________________ (æ ¦³ »� � � ) 1.9.3. [ ] °· ¦³Å¤n¤ o ´ ´� � � � �
2. æ Ä®oÎʵ®´� � � � � ´ ¥ ɤ ¨ n° µ¦ ´ ·Ä ° nµ� � � � � � � � � � � � � � � ®µ nµÁº° ¹° ¦¤Á¡·É¤Á·¤ÁÈ� � � � � � � � � fellow ship ( ε ÊÂ� � � � 1= Ťn ε ´� � , 2= ε´ o°¥� � � , 3= ε´ µ µ� � � � � � , 4= ε´¤µ� � � , 5= ε ´¤µ É »� � � � � )
´ ¥ ɤ ¨ n° µ¦ ´ ·ÄÁº° ° » µµ� � � � � � � � � � � � � � Ťn ε´� � -----> ε ´� � ¤µ� É »� �1. ¤case emergency o°¥� 1 2 3 4 5
2. ¤ case Éo°� � � nµ´ ° ¨µ º� � � � � � � � � o°¥� 1 2 3 4 5
3. µ¤µ¦ ε®� � � � µ¦µ µ¦ εµ� � � � � � ³ nµ´� � � ÁÈÁª µ� � Åonµ¥� � 1 2 3 4 5
4. ¤Áª µ nª ª¤µ� � � 1 2 3 4 5
5. ¤ ªµ¤� Ä� � Disease/procedure/technique ° ° » µµ Ê� � � � � � ÁÈ¡·Á«¬� � 1 2 3 4 5
6. ¤ ªµ¤� ¦³ ´Ä� � � � µ� � µ¦Åo ¤ � � � ´ µÄ� � � � � field ÊÇ° ÁÈ� � � � � � resident 1 2 3 4 5
7. ¤ ªµ¤ oµµ¥� � � Ä µ¦ ε� � � procedure/technique ( Án¥µ ®¦º°¤ ªµ¤� � � �®µ®µ¥� )
1 2 3 4 5
8. ·ªnµ³ ε� � � � procedure/techniqueÅo� � nµ¥� 宦´ Á°� � � � 1 2 3 4 5
9. ¤¦³¥³Áª µ° µ¦ nµ´� � � � � � (operative time) ÄÂn³� � ¦µ¥ Ê� 1 2 3 4 5
1. o° µ¦� � � learning curve Ä µ¦ εµ� � � � � o°¥� 1 2 3 4 5
2. ¨ µ¦¦´¬µ� � � ¤ ÁÈÅ µ¤ É� � � � � � µ®ª� � � Ūo( ¼onª¥¤ ªµ¤¡¹¡°Ä¤µ¦´¬µÂoª� � � � � � �°µµ¦ ¹Ê¤µÃ° µ ·¡¨µ ¨Â¦ o° o°¥� � � � � � � � � � � � � � � )
1 2 3 4 5
3. ´ ¥� � � » ¤ ·®¦º°� � � � ¨� ¬� ³� ¼o� nª¥Â³ µ ·� � (Ánµ�³� »�£µ¡Â�È�¦�� � � � � � � � �°µ¡² ²� )
1 2 3 4 5
4. ¤ ªµ¤ µ®ª ° ¼onª¥Â³ µ ·� � � � � � � � � � o°¥� 1 2 3 4 5
5. ¤ ªµ¤ oµª®oµÄª·µ¡� � � � � � ¤µ ªnµ� � General orthopedic (¤¦µ¥ÅoÁ¡·É¤Á·� � �ÁºÉ° ε®n¤ ªµ¤ µ¤µ¦ Ä µ¦ ε� � � � � � � � � operation¤µ ¹Ê� � � )
1 2 3 4 5
6. ·ªnµ¤� � ¦µ¥Åo� Ã¥¦ª¤¤µ� � (>150,000 µ� � n°Áº°� � � ) 1 2 3 4 5
7. ·ªnµ� � ¤ ¨ ¦³Ã¥ rµ°o°¤¤µ� � � � � � � ( ¼µ nµ ¦³Á«² ²� � � � � � � ) 1 2 3 4 5
8. ¤ » nµ� � � µ ·Ä³ ªµ¤£µ£¼¤·Ä� � � � � � � � 1 2 3 4 5
9. ¤°´¦µµ¦Ân´ Îɵ� � � � � � � ³ ªµ¤ o° µ¦Â¡ ¥r° » µµoµ ÊÇ ¼Ä° µ� � � � � � � � � � � � � � � �(Án� � ¼onª¥� � Á¥°³®¦º°¤Â¡ ¥roµ Êo°¥� � � � � � )
1 2 3 4 5
10. µ¤µ¦ Áº°� � ÁoµÎµµ®¦º°¥oµ¥� � � � µ Éεµ� � � � � � Åonµ¥� � 1 2 3 4 5
11. ¦¡. Énµ o° µ¦ εµ� � � � � � � � � µÂ¡ ¥roµ Ê°¥¼n� � � � � � � 1 2 3 4 5
12. µ¤µ¦ Áº°� � µ É� � � ¹ ° ¦¤� � Åo� nµ¥� 1 2 3 4 5
13. ¤Ã° µ Åoε� � � ª·¥� 1 2 3 4 5
14. ¤Ã° µ Åo� � °� «¹¬µ®¦º°� � � resident 1 2 3 4 5
15. ¤°µµ¦¥r� fellow ®¦º° ¼o°ºÉ� � Ä®oo°¤¼Ã¥ ¦� � � � ³ 宦º° ´ ª� � � � � � Ä®oÁ¦¥� 1 2 3 4 5
16. ¤Â °¥nµ� � � (role model) µ� � fellow ®¦º°°µµ¦¥r®nª¥ ÊÇ� � � � oµ ¦·¥ ¦¦¤� � � � 1 2 3 4 5
17. ¤Â °¥nµ� � � (role model) µ� � fellow ®¦º°°µµ¦¥r®nª¥ ÊÇ� � � � oµ� � ¦µ¥Åo� 1 2 3 4 5
18. ¤Â °¥nµ� � � (role model) µ� � fellow ®¦º°°µµ¦¥r®nª¥ ÊÇ� � � � oµ� � Á¥¦ ·¥«� �ºÉ°Á ¥� �
1 2 3 4 5
19.  °¥nµ� � � (role model) µ� � fellow ®¦º°°µµ¦¥r®nª¥ ÊÇ� � � � ÄÁ¦ºÉ°� � ¨´¬ ³� �· ¥�
1 2 3 4 5
1. ´ » nµ ·ªnµ³Áº° ¹° ¦¤ n°Ä° » µµÄ� � � � � � � � � � � � � � � � � � (æ� � εÁ¦ºÉ° ®¤µ¥� � � Ä®ª o° Énµ Áº°� � � � � � ) 1.1. µµ Éo° µ¦Á¦¥� � � � � �
1.1.1. [ ]. ŤnÁ¦¥� ®¦º°¥Å¤nÂnÄÃ¥ · ·µÁÈ� � � � � � � � � � � � General Ortho 1.1.2. [ ]. Á¦¥� Ân° µµÃ¦ Á¦¥ ε ´� � � � � � � � � ______________________________(Áº° Á¡¥ ° µµ� � � � )
A.¥Å¤nÅo ·Ä� � � � � � B.Trauma C.Arthroplasty D.Sport E.Hand F.Ped G.Tumor H.Spine 1.2. nµ ·ªnµo°Á ¥� � � � � Ä� µµ� Énµ Áº°� � � � ° ´ É®¹É� � � � � � ®¦º°Å¤nÁ¦¥ n°� � fellow ship º°�
( ε ÊÂ� � � � 1= ŤnÁ®È oª¥� � , 2=Á®È oª¥o°¥� � � , 3=Á®È oª¥ µ ¨µ� � � � � � , 4=Á®È oª¥¤µ� � � , 5= Á®È oª¥¤µ É »� � � � � )
o°Á ¥ ° ° » µµÉnµ Áº°� � � � � � � � � ŤnÁ®È oª¥� � ------>Á®È oª¥ É »� � � �
1. ¦ ª µ¦Äoª· ¦³ εª� � � � � � � � � � ®¦º°case emergency ¤µ� 1 2 3 4 5
2. ¦µ¥ÅoÃ¥¦ª¤ o°¥� � � (< 150,000 µ� � n°Áº°� � � ) 1 2 3 4 5
3. ¤Â¡ ¥rµ oµ ʤµ° ¦µµ¦Ân ¼� � � � � � � � � � � � � � 1 2 3 4 5
4. ®µ µ ÉεµÅo¥µ� � � � � � � � 1 2 3 4 5
5. ¨ µ¦¦´¬µÅ¤nÁÈÅ� � � � � � µ¤� ɵ®ª� � � � (Án¤ ªµ¤¡¹¡°Ä o°¥¤Ã° µ � � � � � � �·¡¨µ ¼Á¡¥ Ân¦¦ÁµÃ¦ Ân¦´¬µÅ¤n®µ¥� � � � � � � � � � � )
1 2 3 4 5
6. ªµ¤ µ®ª n° µ¦¦´¬µ� � � � � � � µ ¼onª¥Â³ µ ·� � � � � � ¼� 1 2 3 4 5
7. o°� � Äo� learning curve ¥µª µ� � 1 2 3 4 5
8. o° °µ«¥°» ¦ rÁ¦ºÉ° ¤º°Â³ » µ¦Ä µ¦¦´¬µ� � � � � � � � � � � � � / nµ ¤µ� � � � 1 2 3 4 5
9. ÁÈ µµÉ¤� � � � ° ¦µ� µ¦¢o° ¦o°� � � ¼� 1 2 3 4 5
10. ªµ¤oµª®oµÄª·µ¡ o°¥� � � � � � � (Ťn¤Á·Á¡·É¤Á·¤Åo¦´ µ¦¥°¤¦´ o°¥� � � � � � � � ) 1 2 3 4 5
1.3. µ ´ Énµ o° µ¦¦´ µ¦ ¹° ¦ ÁÈ¡ ¥r¦³ εoµ n°¥° º°� � � � � � � � � � � � � � � � � � � � � � � � � ________________________(æ ¦³ »� � � ) 1.4. ¦µ¥ÅoÄ° µ Énµ o° µ¦®´ µ¦ ¹° ¦¤� � � � � � � � � � � � � � � � �
[ ] <100,000 µ� � n°Áº°� � � [ ] 1-150,000 µ� � n°Áº°� � � [ ] 1.5-200,000 µ� � n°Áº°� � � [ ] 2-300,000 µ n°Áº°� � � � � [ ] >300,000 µ n°Áº°� � � � �
1.5. ¦µ¥Åo¦µ¥ÅoÄ° µ Énµ o° µ¦Ä¦³¥³¥µª� � � � � � � � � � � � � (æ ¦³ »� � � )__________________________ µ n°Áº°� � � � � 1.6. ¨´¬ ³� � ®nª¥µ Énµ o° µ¦ ε� � � � � � � � � � µ� � (Áº° Á¡¥ o°Á¥ª� � � � )
[ ] ¦¡. ®ª ®¦º°¦¡� � � .«¼¥r° ¦´� � � � [ ] ¦¦.¡ ¥r� µ ¹° ¦¤Â¡ ¥r� � � � � � [ ] ¦¡.Á°� � � ®¦º°®nª¥µÁ°� � � � � � [ ] ÉÄ ÈÅo� � � �
° ° » ÉÄ®oªµ¤¦nª¤¤º°Ä µ¦ °  ° µ¤� � � � � � � � � � � � � � �
Demographic Characteristics of Respondents
n %
Sex Male59
90.77
Female6
9.23
Marital Single55
84.62
Married10
15.38
Address BKK and suburb22
33.85
Other parts in Thailand43
66.15
ScholarshipGovernment scholarship
4163.08
Free training24
36.92
Resident Year 2nd 21
32.31
3rd 23
35.38
4th 21
32.31
N = 112, Response 65 residents (58%)
Subspecialty selected by respondents
Specialty N %
No train/ unsure 3756.9
0%
Arthroplasty 710.8
0%
Spine 710.8
0%
Undecide 57.70
%
Sport 46.20
%
Hand 23.10
%
Trauma 11.50
%
Other 11.50
%
No response 11.50
%
Ped 00.00
%
Tumor 00.00
%
56.90%
10.80%
10.80%
7.70%
6.20%
3.10% 1.50% 1.50%1.50%
No train/ unsure Arthroplasty Spine
Undecide Sport Hand
Trauma Other No response
Year of training
2nd 3rd 4th0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%61.90%
65.20%
42.90%
No train/ Unsure
Factor influence
Mean ค�าเฉล��ย 4.21-5.00 = ส�าค�ญมากท��ส(ด Most importantMean ค�าเฉล��ย 3.41-4.20 = ส�าค�ญมาก Very importantMean ค�าเฉล��ย 2.61-3.40 = ส�าค�ญปานกลางModerate importantMean ค�าเฉล��ย 1.81-2.60 = ส�าค�ญน�อย Little importantMean ค�าเฉล��ย 1.00-1.80 = ไม�ส�าค�ญ No important
Procedure & Technical
Interesting
Impressi
ng
Challenging
Easy
Short
Op-Time
Short
learning Curve1.00
1.80
2.60
3.40
4.20
5.004.40 4.29
3.97 3.85
2.77 2.63
Mean
Income & Pride
¤ ªµ¤ µ®ª ° ¼onª¥Â³ µ ·� � � � � � � � � � o°¥� 1 2 3 4 5
¤ ªµ¤ oµª®oµÄª·µ¡� � � � � � ¤µ ªnµ� � General orthopedic (¤¦µ¥ÅoÁ¡·É¤Á·� � �ÁºÉ° ε®n¤ ªµ¤ µ¤µ¦ Ä µ¦ ε� � � � � � � � � operation¤µ ¹Ê� � � )
1 2 3 4 5
·ªnµ¤� � ¦µ¥Åo� Ã¥¦ª¤¤µ� � (>150,000 µ� � n°Áº°� � � ) 1 2 3 4 5
·ªnµ� � ¤ ¨ ¦³Ã¥ rµ°o°¤¤µ� � � � � � � ( ¼µ nµ ¦³Á«² ²� � � � � � � ) 1 2 3 4 5
¤ » nµ� � � µ ·Ä³ ªµ¤£µ£¼¤·Ä� � � � � � � � 1 2 3 4 5
Income IndirectIncome Pride Progression of life1.00
1.80
2.60
3.40
4.20
5.00
3.262.60
4.153.67
Mean
Mean
Mentor
¤°µµ¦¥r� fellow ®¦º° ¼o°ºÉ� � Ä®oo°¤¼Ã¥ ¦� � � � ³ 宦º° ´ ª� � � � � � Ä®oÁ¦¥� 1 2 3 4 5
¤Â °¥nµ� � � (role model) µ� � fellow ®¦º°°µµ¦¥r®nª¥ ÊÇ� � � � oµ ¦·¥ ¦¦¤� � � � 1 2 3 4 5
¤Â °¥nµ� � � (role model) µ� � fellow ®¦º°°µµ¦¥r®nª¥ ÊÇ� � � � oµ� � ¦µ¥Åo� 1 2 3 4 5
¤Â °¥nµ� � � (role model) µ� � fellow ®¦º°°µµ¦¥r®nª¥ ÊÇ� � � � oµ� � Á¥¦ ·¥«� �ºÉ°Á ¥� �
1 2 3 4 5
 °¥nµ� � � (role model) µ� � fellow ®¦º°°µµ¦¥r®nª¥ ÊÇ� � � � ÄÁ¦ºÉ°� � ¨´¬ ³� �· ¥�
1 2 3 4 5
Invite
by
som
eone
Mor
ale
Inco
me
Reput
atio
n
Chara
cter
istic
1.00
2.60
4.20 3.18 3.602.94 3.45 3.62
Mean
Result Operation & Patient characteristic and Expectation
ResultOp Patient Expectation1.00
1.80
2.60
3.40
4.20
5.00
3.78
2.89 2.77
Mean
 ° µ¤� � � � Á¦ºÉ°� ´ ¥ ɤ ¨Ä µ¦Áº° Á¦¥ n°Â¡ ¥r¦³ εoµ n°¥° ° ¡ ¥r¦³ εoµ°°¦rà · · r� � � � � � � � � � � � � � � � � � � � � � � � � � � � ε ÊÂ� � � � : æ� � Ä®oo°¤¼Åªoµ¤ ªµ¤ÁÈ ¦·� � � � � � � Ã¥ µ¦Áº° εÁ¦ºÉ° ®¤µ¥� � � � � � ³Á·¤ 뵀 n° ªnµ Éε® Ūo� � � � � � � � � �
1. o°¤¼ nª » ¨� � � � � 1.1. Á¡« [ ] µ¥� [ ]® ·� � 1.2. °µ¥» ………¸� 1.3. µ ³£µ¡� � [ ] à � [ ] ¤¦ [ ]®¥nµ [ ] ®¤oµ¥ 1.4. εª »¦ ɤ� � � � � � [ ]¤ εª� � � .............. [ ]Ťn¤� � 1.5. £¼¤·ÎµÁµ ®ª� � � � ________________________________________(æ ¦³ »� � � ) 1.6. ¡ ¥r«µ ¦rµ µ ´� � � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.7. ¡ ¥r¦³ εoµ� � � � � °°¦rà · · rÊ� � � � � � ¸É� � [ ] 2 [ ] 3 [ ] 4
¡ ¥rÄo»°°¦rà · · rʸÉ� � � � � � � � � � � � [ ] 2 [ ] 3 [ ] 4 [ ] 5 1.8. µ É� � � ¹° ¦¤Ä ´ »� � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.9. o ´ ´� � � � �
1.9.1. [ ] ¦´ µ µ ´� � � � � /¦¡.________________________________________________ (æ ¦³ »� � � ) 1.9.2. [ ] °ºÉÇ� Án¦¡� � .Á°� � � ________________________________________________ (æ ¦³ »� � � ) 1.9.3. [ ] °· ¦³Å¤n¤ o ´ ´� � � � �
2. æ Ä®oÎʵ®´� � � � � ´ ¥ ɤ ¨ n° µ¦ ´ ·Ä ° nµ� � � � � � � � � � � � � � � ®µ nµÁº° ¹° ¦¤Á¡·É¤Á·¤ÁÈ� � � � � � � � � fellow ship ( ε ÊÂ� � � � 1= Ťn ε ´� � , 2= ε ´ o°¥� � � , 3= ε ´ µ ¨µ� � � � � � , 4= ε ´¤µ� � � , 5= ε ´¤µ É »� � � � � )
´ ¥ ɤ ¨ n° µ¦ ´ ·ÄÁº° ° » µµ� � � � � � � � � � � � � � Ťn ε´� � -----> ε ´� � ¤µ� É »� �
2. ¨ µ¦¦´¬µ� � � ¤ ÁÈÅ µ¤ É� � � � � � µ®ª� � � Ūo( ¼onª¥¤ ªµ¤¡¹¡°Ä¤µ¦´¬µÂoª� � � � � � �°µµ¦ ¹Ê¤µÃ° µ ·¡ µ ¨Â¦ o° o°¥� � � � � � � � � � � � � � � )
3. ´ ¥� � � » ¤ ·®¦º°� � � � ¨� ¬� ³� ¼o� nª¥Â³ µ ·� � (Ánµ�³� »�£µ¡Â�È�¦�� � � � � � � � �°µ¡² ²� )
4. ¤ ªµ¤ µ®ª ° ¼onª¥Â³ µ ·� � � � � � � � � � o°¥�
Work & Training Place
 ° µ¤� � � � Á¦ºÉ°� ´ ¥ ɤ ¨Ä µ¦Áº° Á¦¥ n°Â¡ ¥r¦³ εoµ n°¥° ° ¡ ¥r¦³ εoµ°°¦rà · · r� � � � � � � � � � � � � � � � � � � � � � � � � � � � ε ÊÂ� � � � : æ� � Ä®oo°¤¼Åªoµ¤ ªµ¤ÁÈ ¦·� � � � � � � Ã¥ µ¦Áº° εÁ¦ºÉ° ®¤µ¥� � � � � � ³Á·¤ 뵀 n° ªnµ Éε® Ūo� � � � � � � � � �
1. o°¤¼ nª » ¨� � � � � 1.1. Á¡« [ ] µ¥� [ ]® ·� � 1.2. °µ¥» ………¸� 1.3. µ ³£µ¡� � [ ] à � [ ] ¤¦ [ ]®¥nµ [ ] ®¤oµ¥ 1.4. εª »¦ ɤ� � � � � � [ ]¤ εª� � � .............. [ ]Ťn¤� � 1.5. £¼¤·ÎµÁµ ®ª� � � � ________________________________________(æ ¦³ »� � � ) 1.6. ¡ ¥r«µ ¦rµ µ ´� � � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.7. ¡ ¥r¦³ εoµ� � � � � °°¦rà · · rÊ� � � � � � ¸É� � [ ] 2 [ ] 3 [ ] 4
¡ ¥rÄo»°°¦rà · · rʸÉ� � � � � � � � � � � � [ ] 2 [ ] 3 [ ] 4 [ ] 5 1.8. µ É� � � ¹° ¦¤Ä ´ »� � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.9. o ´ ´� � � � �
1.9.1. [ ] ¦´ µ µ ´� � � � � /¦¡.________________________________________________ (æ ¦³ »� � � ) 1.9.2. [ ] °ºÉÇ� Án¦¡� � .Á°� � � ________________________________________________ (æ ¦³ »� � � ) 1.9.3. [ ] °· ¦³Å¤n¤ o ´ ´� � � � �
2. æ Ä®oÎʵ®´� � � � � ´ ¥ ɤ ¨ n° µ¦ ´ ·Ä ° nµ� � � � � � � � � � � � � � � ®µ nµÁº° ¹° ¦¤Á¡·É¤Á·¤ÁÈ� � � � � � � � � fellow ship ( ε ÊÂ� � � � 1= Ťn ε ´� � , 2= ε ´ o°¥� � � , 3= ε ´ µ ¨µ� � � � � � , 4= ε ´¤µ� � � , 5= ε ´¤µ É »� � � � � )
´ ¥ ɤ ¨ n° µ¦ ´ ·ÄÁº° ° » µµ� � � � � � � � � � � � � �
9. ¤°´¦µµ¦Ân´ Îɵ� � � � � � � ³ ªµ¤ o° µ¦Â¡ ¥r° » µµoµ ÊÇ ¼Ä° µ� � � � � � � � � � � � � � � �(Án� � ¼onª¥� � Á¥°³®¦º°¤Â¡ ¥roµ Êo°¥� � � � � � )
1 2 3 4 5
10. µ¤µ¦ Áº°� � ÁoµÎµµ®¦º°¥oµ¥� � � � µ Éεµ� � � � � � Åonµ¥� � 1 2 3 4 5
11. ¦¡. Énµ o° µ¦ εµ� � � � � � � � � µÂ¡ ¥roµ Ê°¥¼n� � � � � � � 1 2 3 4 5
12. µ¤µ¦ Áº°� � µ É� � � ¹ ° ¦¤� � Åo� nµ¥� 1 2 3 4 5
13. ¤Ã° µ Åoε� � � ª·¥� 1 2 3 4 5
Competition for job
Work Place Wanted by hospital
Trainning Place
1.00
1.80
2.60
3.40
4.20
5.00
2.953.28 3.45
3.02
Mean
Life schedule control
CaseEmer OpNight HobbyTime1.00
1.80
2.60
3.40
4.20
5.00
2.69 2.66
3.34
 ° µ¤� � � � Á¦ºÉ°� ´ ¥ ɤ ¨Ä µ¦Áº° Á¦¥ n°Â¡ ¥r¦³ εoµ n°¥° ° ¡ ¥r¦³ εoµ°°¦rà · · r� � � � � � � � � � � � � � � � � � � � � � � � � � � � ε ÊÂ� � � � : æ� � Ä®oo°¤¼Åªoµ¤ ªµ¤ÁÈ ¦·� � � � � � � Ã¥ µ¦Áº° εÁ¦ºÉ° ®¤µ¥� � � � � � ³Á·¤ 뵀 n° ªnµ Éε® Ūo� � � � � � � � � �
1. o°¤¼ nª » ¨� � � � � 1.1. Á¡« [ ] µ¥� [ ]® ·� � 1.2. °µ¥» ………¸� 1.3. µ ³£µ¡� � [ ] à � [ ] ¤¦ [ ]®¥nµ [ ] ®¤oµ¥ 1.4. εª »¦ ɤ� � � � � � [ ]¤ εª� � � .............. [ ]Ťn¤� � 1.5. £¼¤·ÎµÁµ ®ª� � � � ________________________________________(æ ¦³ »� � � ) 1.6. ¡ ¥r«µ ¦rµ µ ´� � � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.7. ¡ ¥r¦³ εoµ� � � � � °°¦rà · · rÊ� � � � � � ¸É� � [ ] 2 [ ] 3 [ ] 4
¡ ¥rÄo»°°¦rà · · rʸÉ� � � � � � � � � � � � [ ] 2 [ ] 3 [ ] 4 [ ] 5 1.8. µ É� � � ¹° ¦¤Ä ´ »� � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.9. o ´ ´� � � � �
1.9.1. [ ] ¦´ µ µ ´� � � � � /¦¡.________________________________________________ (æ ¦³ »� � � ) 1.9.2. [ ] °ºÉÇ� Án¦¡� � .Á°� � � ________________________________________________ (æ ¦³ »� � � ) 1.9.3. [ ] °· ¦³Å¤n¤ o ´ ´� � � � �
2. æ Ä®oÎʵ®´� � � � � ´ ¥ ɤ ¨ n° µ¦ ´ ·Ä ° nµ� � � � � � � � � � � � � � � ®µ nµÁº° ¹° ¦¤Á¡·É¤Á·¤ÁÈ� � � � � � � � � fellow ship ( ε ÊÂ� � � � 1= Ťn ε ´� � , 2= ε ´ o°¥� � � , 3= ε ´ µ ¨µ� � � � � � , 4= ε ´¤µ� � � , 5= ε ´¤µ É »� � � � � )
´ ¥ ɤ ¨ n° µ¦ ´ ·ÄÁº° ° » µµ� � � � � � � � � � � � � �¤case emergency o°¥�
¤ case Éo°� � � nµ´ ° ¨µ º� � � � � � � � � o°¥�
 ° µ¤� � � � Á¦ºÉ°� ´ ¥ ɤ ¨Ä µ¦Áº° Á¦¥ n°Â¡ ¥r¦³ εoµ n°¥° ° ¡ ¥r¦³ εoµ°°¦rà · · r� � � � � � � � � � � � � � � � � � � � � � � � � � � � ε ÊÂ� � � � : æ� � Ä®oo°¤¼Åªoµ¤ ªµ¤ÁÈ ¦·� � � � � � � Ã¥ µ¦Áº° εÁ¦ºÉ° ®¤µ¥� � � � � � ³Á·¤ 뵀 n° ªnµ Éε® Ūo� � � � � � � � � �
1. o°¤¼ nª » ¨� � � � � 1.1. Á¡« [ ] µ¥� [ ]® ·� � 1.2. °µ¥» ………¸� 1.3. µ ³£µ¡� � [ ] à � [ ] ¤¦ [ ]®¥nµ [ ] ®¤oµ¥ 1.4. εª »¦ ɤ� � � � � � [ ]¤ εª� � � .............. [ ]Ťn¤� � 1.5. £¼¤·ÎµÁµ ®ª� � � � ________________________________________(æ ¦³ »� � � ) 1.6. ¡ ¥r«µ ¦rµ µ ´� � � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.7. ¡ ¥r¦³ εoµ� � � � � °°¦rà · · rÊ� � � � � � ¸É� � [ ] 2 [ ] 3 [ ] 4
¡ ¥rÄo»°°¦rà · · rʸÉ� � � � � � � � � � � � [ ] 2 [ ] 3 [ ] 4 [ ] 5 1.8. µ É� � � ¹° ¦¤Ä ´ »� � � � � � � � __________________________________________________ (æ ¦³ »� � � ) 1.9. o ´ ´� � � � �
1.9.1. [ ] ¦´ µ µ ´� � � � � /¦¡.________________________________________________ (æ ¦³ »� � � ) 1.9.2. [ ] °ºÉÇ� Án¦¡� � .Á°� � � ________________________________________________ (æ ¦³ »� � � ) 1.9.3. [ ] °· ¦³Å¤n¤ o ´ ´� � � � �
2. æ Ä®oÎʵ®´� � � � � ´ ¥ ɤ ¨ n° µ¦ ´ ·Ä ° nµ� � � � � � � � � � � � � � � ®µ nµÁº° ¹° ¦¤Á¡·É¤Á·¤ÁÈ� � � � � � � � � fellow ship ( ε ÊÂ� � � � 1= Ťn ε ´� � , 2= ε ´ o°¥� � � , 3= ε ´ µ ¨µ� � � � � � , 4= ε ´¤µ� � � , 5= ε ´¤µ É »� � � � � )
µ¤µ¦ ε®� � � � µ¦µ µ¦ εµ� � � � � � ³ nµ´� � � ÁÈÁª µ� � Åonµ¥� �
¤Áª µ nª ª¤µ� � � ¤ ªµ¤� Ä� � Disease/procedure/technique ° ° » µµ Ê� � � � � � ÁÈ¡·Á«¬� �
The type of workplace
50.8
1.6
14.3
33.3Work place type %
Government hospital 50.8
Anywhere 33.3
Medical school 14.3
Private hospital 1.61.1. ¨´¬ ³� � ®nª¥µ Énµ o° µ¦ ε� � � � � � � � � � µ� � (Áº° Á¡¥ o°Á¥ª� � � � )
[ ] ¦¡. ®ª ®¦º°¦¡� � � .«¼¥r° ¦´� � � � [ ] ¦¦.¡ ¥r� µ ¹° ¦¤Â¡ ¥r� � � � � � [ ] ¦¡.Á°� � � ®¦º°®nª¥µÁ°� � � � � � [ ] ÉÄ ÈÅo� � � �
The income
Income (bath/month) n %
<100k 69.37
5
100-150k 2843.7
5
150-200k 1218.7
5
200-300k 8 12.5
>300k 1015.6
25
<100k 100-150k 150-200k 200-300k >300k
0
5
10
15
20
25
30
35
40
45
9.375
43.75
18.75
12.5 15.625
Discussion Arthroplasty and spine are the most
popular subspecialties. The lowest popular specialties are pediatric
and tumor. Procedure & Technic group is the first
concern as other researches. Mentor factor concern are morality,
characteristic and reputation not income. Result of operation is also very important
Discussion In our research is different from others
research about Work Place concern that relatively very important.
Life style control is not affected the decision for choosing subspecialtly but very important for arthroplasty about Hobby time topic is very important
for No training /uncertain group Income topic is just moderate
important in all groups.
Conclusion The majority of residents has no plan for
subspecialize training. Multiple factors influencing subspecialty
training similar to other research are Procedure&Technical and Mentor factor.
Result of the operation is very important differ from other researches
Very important factor
1.00
1.80
2.60
3.40
4.20
5.004.40 4.29
3.97 3.85 3.78 3.674.15
3.45 3.60 3.45 3.62
Relative to low important factor
CaseE
mer
OpNig
ht
Indi
rect
Inco
me
Resea
rchO
pp
Tech
ingO
p1.00
1.80
2.60
3.40
4.20
5.00
2.69 2.66 2.60 2.432.78