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November 2007
Feature Story
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| The Hervey Allen Oak that stands at the southwest corner of Colcock Hall has witnessed many things over the last 200 years. Today, four generations of health professionals, Dr. Ken Holden (Silent Generation), Dr. Bernie Maria (Baby Boomer), Dr. Michelle Hudspeth (Generation X), and MD/PhD student Amena Smith (Generation Y) stand under the Porter Oak to discuss the professional values of future pediatricians. |
What do new pediatricians value?
Recent study shows emerging pediatricians want to be of service without engaging in research
A new study, the results of which have just been published in the Journal of Pediatrics, surveyed nearly 3,500 medical school graduates and found that while future pediatricians - particularly females - ranked caring for others at the top, they put research, academic and teaching pursuits at the bottom.
Titled "What do future (female) pediatricians value?," the article polled recent medical school graduates registered with the Careers in Medicine website, an online career planning program operated by the Association of American Medical Colleges (AAMC). Only participants in residency two years or less were included.
First author and MD/PhD student Amena Smith, who is enrolled in MUSC's Medical Scientist Training Program, says the first concern was the shortage of academic pediatric neurologists and other pediatric sub-specialists. "We wanted to know why there was a deficit. And we hoped to determine how to address it."
Using a 35-value inventory called Physician Values in Practice Scale (PVIPS), the survey measured six values that help identify what's most important and satisfying about being a physician: prestige - being recognized by others as a top physician; service -caring for others regardless of financial gains or other rewards; autonomy - the importance of freedom, independence and control over clinical decision making; lifestyle -having a predictable and stable work schedule, management - supervising and having responsibility for others; and scholarly pursuits -engaging in clinical or basic research, academic medicine and teaching.
It found that pediatric students scored much higher than others on service, placing it above autonomy, management and prestige.
"Regrettably, across all specialties, scholarship has lower value, and in people choosing pediatrics, scholarship was the lowest," notes Dr. Bernie Maria, the senior author and principal investigator of the ongoing study.
What this indicates, explains Smith, is that pediatricians entering the field are very interested in caring for people, but are not as interested in research. "And that is problematic for institutes like the DCRI, and ultimately for the advancement of children's medical care."
"We're making important discoveries in science, yet if we don't create proper incentives, we may not have the medical professionals to carry this work forward," adds Dr. Maria. "We won't be able to make optimal use of this information without new generations of academicians."
The survey also looked at differences between the sexes, finding significant differences between men and women on all professional values except management issues in practice.
Among the findings: women in both the pediatrics group and the "all other" group valued service to a greater extent than their male counterparts, and both placed significantly lower emphasis on the value of scholarly pursuits. Overall, men in both groups valued autonomy, prestige and scholarly pursuits, while women placed higher value on lifestyle and service.
Second year MUSC medical student and co-investigator Robbie Hendry, agrees with the findings. "My classmates seem more focused on recognition and prestige," he offers.
He believes part of the problem is they're not familiar with academic medicine. "They don't understand the benefits of it, that it offers opportunities to be effective participants in a patient's quality of life. The rewards are more related to direct patient contact and to being part of a rewarding care team."
There were also differences between future female and male pediatricians. Of 350 participants, 27 percent were men and 73 percent were women. "Pediatrics is the first specialty with a female majority," explains Dr. Maria, "Nationwide, over 80 percent of interns are women, and these numbers reflect that."
"Since scholarly pursuits are less appealing overall and particularly among women, who make up the majority of the pediatric field, pediatrics really stands to lose in the research world," notes Smith.
This survey was a first step, she continues. The next is to determine the differences between generations, find out how to acknowledge them and foster career development for the next generation.
"The strategy is for current mentors in the field to link the scholarly aspect more closely to the highly valued autonomy, lifestyle, and service, to make it more attractive," concludes Smith. "That's where the appeal of translational research comes in."
The questions are: What does my generation think is important, what do our mentors/teachers think is important and how can they be linked? How can the previous generation of predominantly male pediatricians make academics exciting, and show new, primarily female investigators how to marry the two interests so their careers are fulfilling?"
Stay tuned: In their next paper, the authors will report values differences by generation and findings from focus groups of Generation Y students (born 1980-) that probe the dichotomy between prestige and scholarly pursuits.
This is the first time there's been data that addresses these issues, notes Dr. Maria. "It's a snapshot that shows us that people in their 40s to 60s are mentoring young physicians in their 20s and 30s who have very different priorities. To attract more of the new generation to medicine, to pediatrics, to academics - to move the field forward - we need to pay attention more than ever to generational and individual differences."
He hopes Generation Y pediatricians will see that one of the best ways to serve many children is to move the field forward with novel treatments through translational research.
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