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Research Article

High prevalence and risk factors of dropout intention among Chinese medical postgraduates

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Article: 2058866 | Received 25 Nov 2021, Accepted 24 Mar 2022, Published online: 31 Mar 2022

References

  • Ahmed H, Carmody JB. On the looming physician shortage and strategic expansion of graduate medical education. Cureus. 2020;12(7):e9216.
  • Rimmer A. Physician shortage worsened by cuts in job ads and lack of trainees, colleges warn. BMJ. 2019;367:l6011.
  • Jolly P, Erikson C, Garrison G. U.S. graduate medical education and physician specialty choice. Acad Med. 2013;88(4):468–11.
  • Streit S, da Costa BR, Christensen S, et al. One in seven Swiss physicians has left patient care - results from a national cohort study from 1980-2009. Swiss Med Wkly. 2019;149:w20116.
  • Salsberg E, Grover A. Physician workforce shortages: implications and issues for academic health centers and policymakers. Acad Med. 2006;81(9):782–787.
  • Wu Q, Zhao L, Ye X-C. Shortage of healthcare professionals in China. BMJ. 2016;354:i4860.
  • Zhao D, Zhang Z. Changes in public trust in physicians: empirical evidence from China. Front Med. 2019;13(4):504–510.
  • Sun T, Wang J, Zhang S, et al. Status, causes and consequences of physicians’ self-perceived professional reputation damage in China: a cross-sectional survey. BMC Health Serv Res. 2021;21(1):344.
  • Sun J, Liu S, Liu Q, et al. Impact of adverse media reporting on public perceptions of the doctor-patient relationship in China: an analysis with propensity score matching method. BMJ Open. 2018;8(8):e022455.
  • Jiang F, Zhou H, Rakofsky J, et al. Intention to leave and associated factors among psychiatric nurses in China: a nationwide cross-sectional study. Int J Nurs Stud. 2019;94:159–165.
  • Yan S, Shen X, Wang R, et al. The prevalence of turnover intention and influencing factors among emergency physicians: a national observation. Hum Resour Health. 2021;19(1):149.
  • Cai CZ, Lin Y, Alias H, et al. Effect of the COVID-19 pandemic on medical student career perceptions: perspectives from medical students in China. Int J Environ Res Public Health. 2021;18(10):5071.
  • Lien SS, Kosik RO, Fan AP, et al. 10-year trends in the production and attrition of Chinese medical graduates: an analysis of nationwide data. Lancet. 2016;388:S11.
  • Gao X, Xu Y. Overwork death among doctors a challenging issue in China. Int J Cardiol. 2019;289:152.
  • Ma Z-S, Wang L, Du G-S, et al. What is the work environment of orthopaedic surgeons in China? Clin Orthop Relat Res. 2014;472(11):3576–3580.
  • Gan Y, Jiang H, Li L, et al. A national survey of turnover intention among general practitioners in China. Int J Health Plann Manage. 2020;35(2):482–493.
  • Zhang P, Gao J. Evaluation of China’s public health system response to COVID-19. J Glob Health. 2021;11:05004.
  • Sun S, Xie Z, Yu K, et al. COVID-19 and healthcare system in China: challenges and progression for a sustainable future. Global Health. 2021;17(1):14.
  • Zhu J, Li W, Chen L. Doctors in China: improving quality through modernisation of residency education. Lancet. 2016;388(10054):1922–1929.
  • Xiao Y, Wu X-H, Huang Y-H, et al. Cultivation of compound ability of postgraduates with medical professional degree: the importance of double tutor system. Postgrad Med J. 2021;2021–139779. https://pmj.bmj.com/content/early/2021/04/08/postgradmedj.
  • Chen Z, Wang L. Reconstruction of a clinician training system in China-A successful “5 + 3” model from Shanghai. Int J Health Plann Manage. 2017;32(3):264–269.
  • Zhang XG. Chinese health statistical yearbook (In Chinese). Peking Union Medical College Press: China; 2019.
  • Xiao Y, Zhu S-Y. China will fully implement the standardised training system for residents in 2020. Postgrad Med J. 2020;96(1141):647–648.
  • Alamri Y, Wilkinson TJ. Attrition among New Zealand medical students completing research degrees: a 20-year analysis. Perspect Med Educ. 2019;8(5):284–288.
  • Maslov Kruzicevic S, Barisic KJ, Banozic A, et al. Predictors of attrition and academic success of medical students: a 30-year retrospective study. PLoS One. 2012;7(6):e39144.
  • Han ER, Chung EK, Oh SA, et al. Medical students’ failure experiences and their related factors. Korean J Med Educ. 2012;24(3):233–240.
  • Andriole DA, Jeffe DB, Hageman HL, et al. Attrition during graduate medical education: medical school perspective. Arch Surg. 2008;143(12):1172–1177. discussion 1177.
  • Wahed F, Latif SA, Mahamud MM, et al. Drop-out and admission cancel rate among the students in a selected medical college. Mymensingh Med J. 2011;20(2):197–200.
  • O’Neill LD, Wallstedt B, Eika B, et al. Factors associated with dropout in medical education: a literature review. Med Educ. 2011;45(5):440–454.
  • Dyrbye LN, Thomas MR, Power DV, et al. Burnout and serious thoughts of dropping out of medical school: a multi-institutional study: academic medicine. Academic Medicine: Journal of the Association of American Medical Colleges. 2010;85(1):94–102.
  • Arulampalam W, Naylor R, Smith J. Factors affecting the probability of first year medical student dropout in the UK: a logistic analysis for the intake cohorts of 1980-92. Med Educ. 2004;38(5):492–503.
  • Ruban PU, Petersen MG, Møller-Madsen B. More than half of the medical students who apply for a dispensation drop out and need focused counselling. Dan Med J. 2013;60(7):A4663.
  • Soh N, Ma C, Lampe L, et al. Depression, financial problems and other reasons for suspending medical studies, and requested support services: findings from a qualitative study. Australas Psychiatry. 2012;20(6):518–523.
  • Andersson C, Johnsson KO, Berglund M, et al. Stress and hazardous alcohol use: associations with early dropout from university. Scand J Public Health. 2009;37(7):713–719.
  • Deng J, Que J, Wu S, et al. Effects of COVID-19 on career and specialty choices among Chinese medical students. Med Educ Online. 2021;26(1):1913785.
  • Cai CZ, Lin Y, Alias H, et al. Effect of the COVID-19 pandemic on medical student career perceptions: perspectives from medical students in China. Int J Environ Res Public Health. 2021;18(10):5071.
  • Xueyuan Z, Luo X, Chenmei X, et al. Analysis of the reasons of medical graduate students’ withdrawal and countermeasures in a university in Beijing (In Chinese). Chinese Journal of Medical Education. 2021;41. 914–918.
  • Zhan H, Zheng C, Zhang X, et al. Chinese college students’ stress and anxiety levels under COVID-19. Front Psychiatry. 2021;12:615390.
  • Shen Y, Meng F, Tan SN, et al. Excessive daytime sleepiness in medical students of hunan province: prevalence, correlates, and its relationship with suicidal behaviors. J Affect Disord. 2019;255:90–95.
  • Yip BHK, Chung RY, Chung VCH, et al. Is Alcohol Use Disorder Identification Test (AUDIT) or its shorter versions more useful to identify risky drinkers in a Chinese population? A diagnostic study. PLoS One. 2015;10(3):e0117721.
  • Zhou Y, Xu J, Rief W. Are comparisons of mental disorders between Chinese and German students possible? An examination of measurement invariance for the PHQ-15, PHQ-9 and GAD-7. BMC Psychiatry. 2020;20(1):480.
  • Dyrbye LN, Satele D, Shanafelt T. Ability of a 9-Item Well-Being index to identify distress and stratify quality of life in US workers. J Occup Environ Med. 2016;58(8):810–817.
  • Ernst J, Jordan KD, Weilenmann S, et al. Burnout, depression and anxiety among Swiss medical students - A network analysis. J Psychiatr Res. 2021;143:196–201.
  • West CP, Dyrbye LN, Satele DV, et al. Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. J Gen Intern Med. 2012;27(11):1445–1452.
  • The publication of Chinese Physicians’ Practice Status White Paper (In Chinese) [Internet]. [cited 2022 Mar 1]. Available from: http://www.cmda.net/rdxw2/11526.jhtml.
  • Guo L, Fan H, Xu Z, et al. Prevalence and changes in depressive symptoms among postgraduate students: A systematic review and meta-analysis from 1980 to 2020. Stress Health. 2021;37(5):835–847. doi:10.1002/smi.3045.
  • Deng J, Zhou F, Hou W, et al. The prevalence of depressive symptoms, anxiety symptoms and sleep disturbance in higher education students during the COVID-19 pandemic: a systematic review and meta-analysis. Psychiatry Res. 2021;301:113863.
  • Zhang K, Lin Z, Peng Y, et al. A longitudinal study on psychological burden of medical students during COVID-19 outbreak and remission period in China. Eur J Psychiatry. 2021;35(4):234–241.
  • Zheng X, Guo Y, Yang H, et al. A cross-sectional study on mental health problems of medical and nonmedical students in shandong during the COVID-19 epidemic recovery period. Front Psychiatry. 2021;12:680202.
  • Li Y, Zhao J, Ma Z, et al. Mental health among college students during the COVID-19 pandemic in China: a 2-Wave longitudinal survey. J Affect Disord. 2021;281:597–604.
  • Qi T, Hu T, Ge -Q-Q, et al. COVID-19 pandemic related long-term chronic stress on the prevalence of depression and anxiety in the general population. BMC Psychiatry. 2021;21(1):380.
  • Jiang D, Chen J, Liu Y, et al. Patterns of mental health problems before and after easing COVID-19 restrictions: evidence from a 105248-subject survey in general population in China. PLoS One. 2021;16(8):e0255251.
  • Zhang Q, Zheng R, Fu Y, et al. Mental health consequences during alerting situations and recovering to a new normal of coronavirus epidemic in 2019: a cross-sectional study based on the affected population. BMC Public Health. 2021;21(1):1499.
  • Th’ng F, Rao KA, Ge L, et al. A one-year longitudinal study: changes in depression and anxiety in frontline emergency department healthcare workers in the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(21):11228.
  • Castaldelli-Maia JM, Marziali ME, Lu Z, et al. Investigating the effect of national government physical distancing measures on depression and anxiety during the COVID-19 pandemic through meta-analysis and meta-regression. Psychol Med. 2021;51(6):881–893.
  • Ren Z, Zhou Y, Liu Y. The psychological burden experienced by Chinese citizens during the COVID-19 outbreak: prevalence and determinants. BMC Public Health. 2020;20(1):1617.
  • Qi T, Hu T, Ge -Q-Q, et al. COVID-19 pandemic related long-term chronic stress on the prevalence of depression and anxiety in the general population. BMC Psychiatry. 2021;21(1):380.
  • Yu Y, Lau MMC, Lau JTF. Working from home and positive/negative experiences due to social distancing as interacting factors of depressive symptoms during the COVID-19 pandemic in a Chinese general population. Soc Psychiatry Psychiatr Epidemiol. 2021. 10.1007/s00127-021-02179-6
  • Ma Z, Zhao J, Li Y, et al. Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China. Epidemiol Psychiatr Sci. 2020;29:e181.
  • Li X, Lv S, Liu L, et al. COVID-19 in Guangdong: immediate perceptions and psychological impact on 304,167 college students. Front Psychol. 2020;11:2024.
  • Moreira de Sousa J, CA M, Telles-Correia D. Anxiety, depression and academic performance: a study amongst Portuguese medical students versus Non-Medical students. Acta Med Port. 2018;31(9):454–462.
  • Dyrbye LN, West CP, Satele D, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. Population Acad Med. 2014;89(3):443–451.
  • de Souza KC, Mendes TB, Gomes THS, et al. Medical students show lower physical activity levels and higher anxiety than physical education students: a cross-sectional study during the COVID-19 pandemic. Front Psychiatry. 2021;12:804967.
  • Noreen A, Iqbal N, Hassan B, et al. Relationship between psychological distress, quality of life and resilience among medical and non-medical students. J Pak Med Assoc. 2021;71(9):2181–2185.
  • Bacchi S, Licinio J. Qualitative literature review of the prevalence of depression in medical students compared to students in non-medical degrees. Acad Psychiatry. 2015;39(3):293–299.
  • Sitarz E, Forma A, Karakuła K, et al. How do polish students manage emotional distress during the COVID-19 lockdown? A web-Based cross-sectional study. J Clin Med. 2021;10(21):4964.
  • Leroy A, Wathelet M, Fovet T, et al. Mental health among medical, healthcare, and other university students during the first COVID-19 lockdown in France. J Affect Disord Rep. 2021; 6: 100260.
  • Xie L, Luo H, Li M, et al. The immediate psychological effects of Coronavirus Disease 2019 on medical and non-medical students in China. Int J Public Health. 2020;65(8):1445–1453.
  • Yeni Elbay R, Yılmaz H, Çifteci K, et al. The Psychological Effects of COVID 19 on Medical and Non-medical University Students. Psychiatr Danub. 2021;33(Suppl 10):126–131.
  • Duan H, Gong M, Zhang Q, et al. Research on sleep status, body mass index, anxiety and depression of college students during the post-pandemic era in Wuhan, China. J Affect Disord. 2022;S0165-0327(22):00019–22.
  • Xiong P, Ming W-K, Zhang C, et al. Factors Influencing mental health among Chinese medical and non-medical students in the early stage of the COVID-19 pandemic. Front Public Health. 2021;9:603331.
  • Mirza AA, Milaat WA, Ramadan IK, et al. Depression, anxiety and stress among medical and non-medical students in Saudi Arabia: an epidemiological comparative cross-sectional study. Neurosciences (Riyadh). 2021;26(2):141–151.
  • Meng N, Liu Z, Wang Y, et al. Beyond Sociodemographic and COVID-19-Related factors: the association between the need for psychological and information support from school and anxiety and depression. Med Sci Monit. 2021;27:e929280.
  • Miao Q, Xie L, Xing B, et al. Emotional states and coping methods in nursing and non-nursing students responding to COVID-19: a cross-sectional study in China. BMJ Open. 2021;11(8):e054007.
  • Chang J, Yuan Y, Wang D. [Mental health status and its influencing factors among college students during the epidemic of COVID-19]. Nan Fang Yi Ke Da Xue Xue Bao. 2020;40(2):171–176.
  • Zhan H, Zheng C, Zhang X, et al. Chinese college students’ stress and anxiety levels under COVID-19. Front Psychiatry. 2021;12:615390.
  • Szczurek K, Furgał N, Szczepanek D, et al. “Medical student syndrome”-a myth or a real disease entity? Cross-Sectional study of medical students of the medical university of silesia in katowice, Poland. Int J Environ Res Public Health. 2021;18(18):9884.
  • Lasheras I, Gracia-García P, Lipnicki DM, et al. Prevalence of anxiety in medical students during the COVID-19 pandemic: a rapid systematic review with meta-analysis. Int J Environ Res Public Health. 2020;17(18):E6603.
  • Bressington DT, Cheung TCC, Lam SC, et al. Association between depression, health beliefs, and face mask use during the COVID-19 pandemic. Front Psychiatry. 2020;11:571179.
  • Xiong P, Ming W-K, Zhang C, et al. Factors influencing mental health among Chinese medical and non-medical students in the early stage of the COVID-19 pandemic. Front Public Health. 2021;9:603331.
  • Nguyen HC, Nguyen MH, Do BN, et al. People with suspected COVID-19 symptoms were more likely depressed and had lower health-related quality of life: the potential benefit of health literacy. J Clin Med. 2020;9(4):E965.
  • Wu Y, Yu W, Wu X, et al. Psychological resilience and positive coping styles among Chinese undergraduate students: a cross-sectional study. BMC Psychol. 2020;8(1):79.
  • Miao Q, Xie L, Xing B, et al. Emotional states and coping methods in nursing and non-nursing students responding to COVID-19: a cross-sectional study in China. BMJ Open. 2021;11(8):e054007.
  • van der Merwe LJ, Botha A, Joubert G. Resilience and coping strategies of undergraduate medical students at the University of the Free State. S Afr J Psychiatr. 2020;26:1471.
  • Versteeg M, Kappe R. Resilience and higher education support as protective factors for student academic stress and depression during covid-19 in the Netherlands. Front Public Health. 2021;9:737223.
  • Kandola A, Ashdown-Franks G, Hendrikse J, et al. Physical activity and depression: towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev. 2019;107:525–539.
  • Steffen J, Schlichtiger J, Brunner S, et al. Health promoting behaviour of medical versus non-medical students during COVID-19 pandemic: results from the COLA cross-sectional study. J Transl Med. 2021;19(1):242.
  • Jackson TN, Pearcy CP, Khorgami Z, et al. The physician attrition crisis: a cross-Sectional survey of the risk factors for reduced job satisfaction among US surgeons. World J Surg. 2018;42(5):1285–1292.
  • Oh S, Kim H. Turnover Intention and Its Related Factors of Employed Doctors in Korea. Int J Environ Res Public Health. 2019;16(14):2509. doi:10.3390/ijerph16142509.
  • Ali Jadoo SA, Aljunid SM, Dastan I, et al. Job satisfaction and turnover intention among Iraqi doctors–a descriptive cross-sectional multicentre study. Hum Resour Health. 2015;13(1):21.
  • Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc. 2005;80(12):1613–1622.
  • Zhang C, Hu L, Ma J, et al. Factors determining intention to leave among physicians in tertiary hospitals in China: a national cross-sectional study. BMJ Open. 2019;9(3):e023756.
  • Jiang F, Zhou H, Rakofsky J, et al. Intention to leave and associated factors among psychiatric nurses in China: a nationwide cross-sectional study. Int J Nurs Stud. 2019;94:159–165.
  • Li H, Zhou X. Medical education reform in China. Postgrad Med J. 2018;94(1118):673–674.
  • Chinese physicians work over 50 hours on average every week. (In Chinese) https://www.cn-healthcare.com/articlewm/20180111/content-1021608.html cited 2021 Oct 17
  • Bureau of Statistics: The average weekly working hours of employed workers in enterprises is 46.5 hours. (In Chinese) https://baijiahao.baidu.com/s?id=1641829421823905577&wfr=spider&for=pc cited 2021 Oct 17
  • Y Z, X F. The relationship between job satisfaction, burnout, and turnover intention among physicians from urban state-owned medical institutions in Hubei, China: a cross-sectional study. BMC health services research [Internet]. 2011 [cited 2021 Jul 5;11]. Available from: https://pubmed.ncbi.nlm.nih.gov/21943042/.
  • Dang WW, Wang Z. A comparative study of physician income disparities in OECD countries and China. (In Chinese) China Health Economics. 2020;39(3):24–30.
  • Yxj W, Li YT. AME survey-003 A2: on the attractiveness of an medicine career in current China with a survey of 7,508 medical professionals and 443 non-medical professionals. Quant Imaging Med Surg. 2016;6(1):84–102.
  • Y-xj W, Lǐ YT. AME survey-003 A1-part 1: in current China, do you regret you joined the medical profession. Quant Imaging Med Surg. 2015;5(5):765–773.
  • Gao B, Dong J. Does the Impact of COVID-19 improve the doctor-Patient relationship in China? Am J Med Sci. 2020;360(3):305–306.
  • Sun T, Wang J, Zhang S, et al. Status, causes and consequences of physicians’ self-perceived professional reputation damage in China: a cross-sectional survey. BMC Health Serv Res. 2021;21(1):344.
  • Puthran R, Zhang MWB, Tam WW, et al. Prevalence of depression amongst medical students: a meta-analysis. Med Educ. 2016;50(4):456–468.
  • Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-Analysis. JAMA. 2016;316(21):2214–2236.