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Profile of health professionals who completed a master’s, doctoral, or post-doctoral degree in one Brazilian pediatric program

Abstract

OBJECTIVE:

This study aimed to determine the personal and professional characteristics, and the physical, psychiatric/psychological, and professional issues that exist among master’s-, doctoral-, and post-doctoral-level health professionals.

METHODS:

A cross-sectional, online, self-reported survey of 452 postgraduates who completed master’s, doctoral, or post-doctoral degrees in one graduate program in pediatrics in São Paulo, Brazil, was conducted.

RESULTS:

The response rate was 47% (211/453). The majority of participants were women (78%) and physicians (74%), and the median age was 47 years (28-71). Master’s, doctoral, and post-doctoral degrees were reported by 73%, 53%, and 3%, respectively. High workload (>40 hours/week) occurred in 59%, and 45% earned ≥15 minimum wages/month. At least one participation in scientific meeting in the past year was reported by 91%, and 79% had published their research. Thirty-nine percent served as a member of a faculty of an institution of higher learning. The data were analyzed by two age groups: participants aged ≤48 years (group 1) and participants aged >48 years (group 2). The median rating of overall satisfaction with the profession in the past year [8 (0-10) vs. 9 (1-10), p=0.0113]; workload >40 hours/week (53% vs. 68%, p=0.034); and ≥15 minimum wages/month (37% vs. 56%, p=0.0083) were significantly lower in group 1. Further analysis by gender revealed that the median rating of overall satisfaction with the profession in the past year [8 (0-10) vs. 9 (3-10), p=0.0015], workload >40 hours/week (53% vs. 83%, p=0.0002), and ≥15 minimum wages/month (37% vs. 74%, p=0.0001) were significantly lower in women compared with men. The median rating of overall satisfaction with the mentorship supervision provided was significantly higher among the women 10 (5-10) vs. 10 (2-10), p=0.0324].

CONCLUSIONS:

The majority of master’s-, doctoral-, and post-doctoral-level health professionals were women and physicians, and had published their thesis. Younger postgraduates and women reported low salaries, less likelihood of working >40 hours/week, and less overall satisfaction with their profession. Further longitudinal and qualitative studies are warranted to assess career trajectories after graduation.

Master’s Degree; Doctoral Degree; Post-Doctoral Degree; Salary; Faculty


INTRODUCTION

Contemporary teaching methods, humanistic approaches to patient care, and early exposure to scientific research are common in undergraduate, fellowship, residency, and postgraduate programs (11. Escobar AM, Grisi SJ. 21st century well-child care. Rev Assoc Med Bras. 2016;62(6):479-81. https://doi.org/10.1590/1806-9282.62.06.479.
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2. Almeida MF, Guinsburg R, Costa JO, Anchieta LM, Freire LM; Pesquisadores do Programa de Reanimação Neonatal da Sociedade Brasileira de Pediatria. [Teaching neonatal resuscitation at public hospitals in Brazilian state capitals]. J Pediatr. 2005;81(3):233-9. https://doi.org/10.2223/JPED.1344.
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3. Wuillaume SM, Batista NA. [The preceptor in medical residencies in Pediatrics: main attributes]. J Pediatr. 2000;76(5):333-8. https://doi.org/10.2223/JPED.156.
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4. Feigerlova E, Oussalah A, Fournier JP, Antonelli A, Hadjadj S, Marechaud R, et al. Predictors of High Motivation Score for Performing Research Initiation Fellowship, Master 1, Research Master 2, and PhD Curricula During Medical Studies: A Strobe-Compliant Article. Medicine. 2016;95(5):e2633. https://doi.org/10.1097/MD.0000000000002633.
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5. Alveno RA, Miranda CV, Passone CG, Waetge AR, Hojo ES, Farhat SCL, et al. Pediatric chronic patients at outpatient clinics: a study in a Latin American University Hospital. J Pediatr. 2018;94(5):539-45. https://doi.org/10.1016/j.jped.2017.07.014.
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6. Ramos GF, Ribeiro VP, Mercadante MP, Ribeiro MP, Delgado AF, Farhat SCL, et al. Mortality in adolescents and young adults with chronic diseases during 16 years: a study in a Latin American tertiary hospital. J Pediatr. 2019;95(6):667-73. https://doi.org/10.1016/j.jped.2018.06.006.
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7. Silva CA, Aikawa NE, Bonfa E. Vaccinations in juvenile chronic inflammatory diseases: an update. Nat Rev Rheumatol. 2013;9(9):532-43. https://doi.org/10.1038/nrrheum.2013.95.
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8. Sneha LM, Ravindran M, Kumar R, Venkatraman P, Scott J, Kannan L. Indian Pediatric Postgraduate's Perspective on Future Career Intentions. Indian J Pediatr. 2017;84(3):183-7. https://doi.org/10.1007/s12098-016-2268-y.
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-99. Ahn J, Watt CD, Man LX, Greeley SA, Shea JA. Educating future leaders of medical research: analysis of student opinions and goals from the MD-PhD SAGE (Student’s Attitudes, Goals, and Education) survey. Acad Med. 2007;82(7):633-45. https://doi.org/10.1097/ACM.0b013e318065b907.
https://doi.org/10.1097/ACM.0b013e318065...
). The career development of health professionals after completion of undergraduate and residency training varies around the world (99. Ahn J, Watt CD, Man LX, Greeley SA, Shea JA. Educating future leaders of medical research: analysis of student opinions and goals from the MD-PhD SAGE (Student’s Attitudes, Goals, and Education) survey. Acad Med. 2007;82(7):633-45. https://doi.org/10.1097/ACM.0b013e318065b907.
https://doi.org/10.1097/ACM.0b013e318065...

10. Watt CD, Greeley SA, Shea JA, Ahn J. Educational views and attitudes, and career goals of MD-PhD students at the University of Pennsylvania School of Medicine. Acad Med. 2005;80(2):193-8. https://doi.org/10.1097/00001888-200502000-00019.
https://doi.org/10.1097/00001888-2005020...

11. Skinnider MA, Twa DDW, Squair JW, Rosenblum ND, Lukac CD; Canadian MD/PhD Program Investigation Group. Predictors of sustained research involvement among MD/PhD programme graduates. Med Educ. 2018;52(5):536-45. https://doi.org/10.1111/medu.13513.
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12. Andriole DA, Jeffe DB. Predictors of full-time faculty appointment among MD-PhD program graduates: a national cohort study. Med Educ Online. 2016;21:30941. https://doi.org/10.3402/meo.v21.30941.
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13. Twa DDW, Skinnider MA, Squair JW, Lukac CD; Canadian MD/PhD Program Investigation Group. Cross-sectional-derived determinants of satisfaction with physician-scientist training among Canadian MD/PhD graduates. PLoS One. 2017;12(9):e0185218. https://doi.org/10.1371/journal.pone.0185218.
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-1414. Skinnider MA, Squair JW, Twa DDW, Ji JX, Kuzyk A, Wang X, et al. Characteristics and outcomes of Canadian MD/PhD program graduates: a cross-sectional survey. CMAJ Open. 2017;5(2):E308-E314. https://doi.org/10.9778/cmajo.20160152.
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).

In Brazil, the University of São Paulo is a major producer of highly qualified members of the workforce for teaching, research, and science and technology. The university is responsible for educating a significant portion of the country’s master’s, doctoral, and post-doctoral students (1515. Meckien R. University of São Paulo. Institute of Advanced Studies of the University of São Paulo. 2014. Available from: http://www.iea.usp.br/en/iea/about-iea/usp/university-of-sao-paulo.
http://www.iea.usp.br/en/iea/about-iea/u...
). The Pediatric Department at the university has a master’s/doctoral and post-doctoral program, which is responsible for epidemiological, translational, and clinical research in children and adolescent health, focusing on primary, secondary, and tertiary care; subspecialties; and transplantation. The program includes professors and students and involves physicians and non-physicians (e.g., physiotherapists, dietitians, nurses, physical educators, biomedicals, and dentists).

Previous research has shown that personal, professional, and educational characteristics, ratings of overall satisfaction, physical/psychological stress, and professional issues after undergraduate, fellowship, and residency training are different around the world (55. Alveno RA, Miranda CV, Passone CG, Waetge AR, Hojo ES, Farhat SCL, et al. Pediatric chronic patients at outpatient clinics: a study in a Latin American University Hospital. J Pediatr. 2018;94(5):539-45. https://doi.org/10.1016/j.jped.2017.07.014.
https://doi.org/10.1016/j.jped.2017.07.0...
,66. Ramos GF, Ribeiro VP, Mercadante MP, Ribeiro MP, Delgado AF, Farhat SCL, et al. Mortality in adolescents and young adults with chronic diseases during 16 years: a study in a Latin American tertiary hospital. J Pediatr. 2019;95(6):667-73. https://doi.org/10.1016/j.jped.2018.06.006.
https://doi.org/10.1016/j.jped.2018.06.0...
,1616. Fnais N, Soobiah C, Chen MH, Lillie E, Perrier L, Tashkhandi M, et al. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med. 2014;89(5):817-27. https://doi.org/10.1097/ACM.0000000000000200.
https://doi.org/10.1097/ACM.000000000000...

17. Tartas M, Walkiewicz M, Majkowicz M, Budzinski W. Psychological factors determining success in a medical career: a 10-year longitudinal study. Med Teach. 2011;33(3):e163-72. https://doi.org/10.3109/0142159X.2011.544795.
https://doi.org/10.3109/0142159X.2011.54...
-1818. de Andrade AP, Amaro E Jr, Farhat SC, Schvartsman C. Higher burnout scores in paediatric residents are associated with increased brain activity during attentional functional magnetic resonance imaging task. Acta Paediatr. 2016;105(6):705-13. https://doi.org/10.1111/apa.13371.
https://doi.org/10.1111/apa.13371...
). However, to the best of our knowledge, simultaneous analysis of these data has not been carried out among health professionals in Latin America, after master’s, doctoral, and post-doctoral degree completion.

Thus, the objective of the present study was to evaluate postgraduate reports regarding demographic characteristics, overall satisfaction, salary, teaching, publishing, patient care profiles, and main physical, psychiatric/psychological and professional issues related to clinical practice. Additionally, personal, professional, and educational characteristics and issues were compared by age and gender.

METHODS

A cross-sectional, online, self-reported survey of 452 individuals who had successfully completed a master’s, doctoral, or post-doctoral degree in a pediatric postgraduate program at a university in São Paulo, Brazil, was conducted to collect data on demographic, professional, and educational characteristics and physical, psychiatric/psychological, and professional issues among postgraduate health professionals. In this postgraduate program, 3 years are required to complete the master’s degree, and up to 4 years are required to complete the doctoral degree. The program focuses on epidemiological, translational, and clinical research in pediatric primary, secondary, and tertiary care; subspecialties; and transplantation.

The survey was carried out using Research Electronic Data Capture (REDCap; Vanderbilt University, Nashville, TN, USA), which is a safe Web application for developing research databases that can also be used for building, managing, and accessing electronic surveys. Between January and February 2019, all health professionals that had completed their master’s, doctoral, or post-doctoral degree in the pediatric postgraduate program between 1995 and 2018 were invited to participate in the survey. The ethics committee of the university hospital approved this study (CAAE: 93564518.5.0000.0068).

Invitations to participate in the anonymous, self-reported survey were distributed by email. The survey included 22 questions on demographic, professional, and educational characteristics, and physical, psychiatric/psychological, and professional issues. The formats of the questions were multiple choice, dichotomous (yes/no), or horizontal visual analog scale. The questions referred to events during and after degree completion. Estimated time to complete the questionnaire was approximately 15 minutes.

The topics of the 22 items were as follows:

  1. Demographic and educational data (current age; gender; ethnicity; marital status; nationality; number of children; city; state; country; year of undergraduate completion; major course; years since completion of master’s, doctoral, or post-doctoral degree; master’s, doctoral, or post-doctoral mentorship; and profession and specialty after undergraduate completion).

  2. Master’s, doctoral, or post-doctoral degrees.

  3. Overall satisfaction with the written research project and its submission to the Ethics Committee, measured with a horizontal visual analog scale (0=“no satisfaction at all” and 10=“complete overall satisfaction”).

  4. Overall satisfaction with the process of writing the scientific manuscript, measured with a horizontal visual analog scale (0=“no satisfaction at all” and 10=“complete overall satisfaction”).

  5. Overall satisfaction with the process of submitting the manuscript to a scientific journal, measured with a horizontal visual analog scale (0=“no satisfaction at all” and 10=“complete overall satisfaction”).

  6. Overall satisfaction with the mentorship supervision provided, measured with a horizontal visual analog scale (0=“no satisfaction at all” and 10=“complete overall satisfaction”).

  7. Overall satisfaction with your profession in the past year, measured with a horizontal visual analog scale (0=“no satisfaction at all” and 10=“complete overall satisfaction”).

  8. Overall satisfaction with the postgraduate program, measured with a horizontal visual analog scale (0=“no satisfaction at all” and 10=“complete overall satisfaction”).

  9. Professional practice setting in the past year (public service, private service, pediatric primary care, pediatric infirmary, pediatric emergency room, pediatric intensive care, neonate care, pediatrician private practice, public or private university, pharmaceutical industry, medical procedure, radiology service, laboratory exam, non-governmental organization, community service, elementary school/high school, and administrative service).

  10. Workload in hours/week in the past year (≤20 hours, 20-40 hours, 40-60 hours, and >60 hours).

  11. Number of pediatric patients weekly (≤50 patients, 50-100 patients, 100-200 patients, >200 patients, and no patient supervision).

  12. Patient health insurance issues availability among your patients in the past year (public health insurance, private insurance, and/or other).

  13. Salary in the past year (<15 minimum wages/month and ≥15 minimum wages/month).

  14. Ages of patients seen in the past year (neonate, <10 years, 10-20 years, 20-60 years, >60 years).

  15. Patient care profiles for the past year (emergency room, infirmary, pediatric intensive care, primary care, newborn, growth and development monitoring, chronic disease management, psychiatric/psychological management, contraception and gynecological counseling, licit and illicit drug use, sexually transmitted infections and pregnancy counseling, physical/psychological violence assessment, and no patient supervision).

  16. Number of scientific meeting participations in the past year.

  17. Scholarship during the master’s, doctoral, or post-doctoral degree program (yes/no).

  18. Published papers during or after the master’s, doctoral, or post-doctoral degree program (yes/no).

  19. Translational, epidemiological, or clinical research contribution after the master’s, doctoral or post-doctoral program (yes/no).

  20. Faculty service (yes/no).

  21. Current participation in a master’s, doctoral, or post-doctoral degree program as a mentor (yes/no).

  22. Self-reported physical and professional issues related to clinical practice in the past year (long working hours, poor social life, sedentarism, overall decrease in health-related quality of life, disruption in family life, harassment, obsessive-compulsive symptoms, low salary, legal issues, workplace violence, stress induced by chief/professor, and stress induced by patient health insurance issues).

The respondents were divided into two age groups according to the mean of current age (aged ≤48 years [group 1] and aged >48 years [group 2]) and by gender.

Statistical analysis

The Statistical Package for the Social Sciences version 13.0 (SPSS Inc, Chicago, IL, USA) was used in the analysis of the data. Results for the continuous variables were reported as median (minimum-maximum values) or mean±standard deviation, and compared by Mann-Whitney test and Student’s t-test, respectively. The results for categorical variables were reported as frequency (percentage) and compared by Fisher’s exact test or Pearson chi-square test, as appropriate. Pearson or Spearman rank correlation coefficients were employed for correlations between overall satisfaction, current age, and year of degree completion. A p-value less than 0.05 was considered statistically significant.

RESULTS

The survey response rate was 53% (239/453). Incomplete data were observed among 6% (27/453) of potential respondents and 0.2% (1/453) declined participation in the study. Therefore, 47% (211/453) of potential respondents completed the questionnaire and were evaluated.

The proportion of women among those who completed the questionnaire (n=211) was equal to that among those who did not participate (n=214) ([164/211 (78%) vs. 167/214 (78%), p=1.000].

Table 1 shows the data on the demographic characteristics, region of Brazil, postgraduate degree, current profession, overall satisfaction rate, location of practice, workload in hours/week, number of patients/week, salary, and patient health insurance issues reported by 211 master’s-, doctoral-, and post-doctoral health professionals. The majority of the postgraduates were women (78%), and the mean age was 47.61±10.4 years. Eighty-two percent lived in Southeastern Brazil, and 74% worked as physicians. Master’s degrees were reported by 73%, doctoral degrees by 53%, and post-doctoral degrees by 3%. The majority of postgraduates (65%) had worked as public service professionals within the past year, followed by those who worked as private practice pediatricians (50%), and those who worked as public/private university professors (20%). Approximately one half of postgraduates earned ≥15 minimum wages/month (Table 1).

Table 1
Demographic data, region of Brazil, postgraduate degree, current profession, ratings of satisfaction, professional practice setting, workload in hours/week, number of patients/week, salary and patient health insurance issues reported by master’s-, doctoral-, or post-doctoral-level health professionals.

Participation in at least one scientific meeting was reported by almost 91% of postgraduates. Seventy-nine percent reported having published research papers in health science, and 39% were faculty members at an institution of higher learning. The most prominent physical, psychiatric/psychological, and professional issues (>40%) were physical inactivity and long working hours (Table 2).

Table 2
Age groups of patients, patient care profiles, scholarship during graduate school, number of scientific meeting participations, published research papers, translational/epidemiological/clinical research, faculty service, and main issues related to clinical practice reported by master’s-, doctoral-, or post-doctoral-level health professionals.

The data on the participants were also analyzed by age. Two age groups were used in the analysis: participants aged ≤48 years (group 1, n=120) and participants aged >48 years (group 2, n=91). The median age [40 (28-48) vs. 58 (49-71) years, p<0.0001], years since master’s, doctoral, or post-doctoral degree [5 (1-22) vs. 15 (1-45) years, p<0.0001], and number of children [1 (0-3) vs. 2 (0-4), p=0.0006] were significantly lower in group 1 compared with group 2. The median rating of overall satisfaction with one’s profession in the past year [8 (0-10) vs. 9 (1-10), p=0.0113] was also significantly lower in group 1 compared with group 2. Significantly fewer participants in group 1 worked for >40 hours/week (53% vs. 68%, p=0.034) and earned ≥15 minimum wages/month (37% vs. 56%, p=0.0083) compared with those in group 2 (Table 3).

Table 3
Demographic data, ratings of satisfaction, workload, patients/week, salary, scientific meeting participation, published research paper, faculty service and main issues related to profession according to years of clinical practice in two groups of master’s-, doctoral-, or post-doctoral-level health professionals: group 1 (≤48 year) and group 2 (>48 year).

An analysis of the data by gender revealed that the median rating of overall satisfaction with the mentorship supervision provided was significantly higher among women compared with men [10 (5-10) vs. 10 (2-10), p=0.0324]. In contrast, the median rating of overall satisfaction with one’s profession in the past year was significantly lower in women compared with men [8 (0-10) vs. 9 (3-10), p=0.0015], and women were significantly less likely to have a workload >40 hours/week (53% vs. 83%, p=0.0002), earn ≥15 minimum wages/month (37% vs. 74%, p=0.0001), and work long hours (38% vs. 55%, p=0.045), and were significantly more likely to be paid a low salary (35% vs. 19%, p=0.0496) (Table 4).

Table 4
Demographic data, ratings of satisfaction, workload, patients/week, salary, scientific meeting participation, published research paper, faculty service, and main issues related to profession according to years of clinical practice in two groups of master’s-, doctoral-, or post-doctoral-level health professionals: women and men.

Spearman rank correlations revealed that current age was positively correlated with overall satisfaction with one’s profession in the past year (r=0.168, p=0.015), and years since completion of master’s, doctoral, or post-doctoral degree also was positively correlated with overall satisfaction with one’s profession in the past year (r=0.160, p=0.019). No other correlation was observed among current age, years since completion of master’s, doctoral, or post-doctoral degree, and overall satisfaction rating (written research project/scientific manuscript, submitting the paper, mentorship supervision, profession in the past year, postgraduate program, p>0.05).

DISCUSSION

To our knowledge, this was the first study to explore the profile of postgraduate professionals from a Latin American postgraduate program in children and adolescent health.

The strength of the present study was the simultaneous analysis of personal, professional, and educational characteristics, and physical, psychiatric/psychological, and professional issues. The inclusion of measurements of six overall satisfaction rates, linked to the postgraduate program, scientific research and publishing, and current satisfaction with one’s profession also allowed a better understanding of the quality of the program and the current impact of the program on the professional lives of its graduates. The self-report and anonymous survey allowed confidentiality of data.

The main goal of our Pediatric Postgraduate Program is career development of the faculty and researchers in the area of child and adolescent health, accompanied by great innovation. This program focuses mainly on studies dedicated to epidemiologic and patient-oriented research from the fetal period to adolescence, involving socio-economic, cultural, and biological problems. In our university, master’s and/or doctoral degrees are usually pursued after an undergraduate degree has been obtained for a non-physician career and after completion of a residency for physician careers.

The majority of our postgraduates live in Southeastern, Brazil, which is the richest region of the country; this region generates approximately 60% of the Brazilian gross domestic product. Forty percent of the postgraduates in the present study serve on a faculty at an institution of higher education and have careers that are research- and teaching-oriented with a true academic trajectory. However, the majority of postgraduates work as health professionals in both private and public services (dual practice), which is common in Brazil (1919. Miotto BA, Guilloux AGA, Cassenote AJF, Mainardi GM, Russo G, Scheffer MC. Physician's sociodemographic profile and distribution across public and private health care: an insight into physicians' dual practice in Brazil. BMC Health Serv Res. 2018;18(1):299. https://doi.org/10.1186/s12913-018-3076-z.
https://doi.org/10.1186/s12913-018-3076-...
), and do not focus their careers on academia. The results are different in other countries in terms of the physician-scientists model. The mentor program includes both basic sciences and clinical integration research, thus promoting student development as physician-scientists who are engaged in translational research (1313. Twa DDW, Skinnider MA, Squair JW, Lukac CD; Canadian MD/PhD Program Investigation Group. Cross-sectional-derived determinants of satisfaction with physician-scientist training among Canadian MD/PhD graduates. PLoS One. 2017;12(9):e0185218. https://doi.org/10.1371/journal.pone.0185218.
https://doi.org/10.1371/journal.pone.018...
,2020. Jeffe DB, Andriole DA, Wathington HD, Tai RH. Educational outcomes for students enrolled in MD-PhD programs at medical school matriculation, 1995-2000: a national cohort study. Acad Med. 2014;89(1):84-93. https://doi.org/10.1097/ACM.0000000000000071.
https://doi.org/10.1097/ACM.000000000000...
).

In the present study, physician was the profession most reported, and the vast majority of professionals were women, in agreement with past research that has observed increased numbers of women in medical schools and residency programs around the world (2121. Wang LC, Mittal AG, Puttmann K, Janzen N, Palmer LS, Yerkes EB, et al. The changing gender landscape of pediatric urology fellowship: results from a survey of fellows and recent graduates. J Pediatr Urol. 2019;15(1):51-7. https://doi.org/10.1016/j.jpurol.2018.09.001.
https://doi.org/10.1016/j.jpurol.2018.09...
,2222. Scheffer MC, Guilloux AG, Poz MR, Schraiber LB. Reasons for choosing the profession and profile of newly qualified physicians in Brazil. Rev Assoc Med Bras. 2016;62(9):853-61. https://doi.org/10.1590/1806-9282.62.09.853.
https://doi.org/10.1590/1806-9282.62.09....
23. Tremolada M, Schiavo S, Tison T, Sormano E, De Silvestro G, Marson P, et al. Stress, burnout, and job satisfaction in 470 health professionals in 98 apheresis units in Italy: A SIdEM collaborative study. J Clin Apher. 2015;30(5):297-304. https://doi.org/10.1002/jca.21379.
https://doi.org/10.1002/jca.21379...
). The result of the present study was different from that of research on MD/PhD programs in Canada and the United States, which found that men were the predominant gender (99. Ahn J, Watt CD, Man LX, Greeley SA, Shea JA. Educating future leaders of medical research: analysis of student opinions and goals from the MD-PhD SAGE (Student’s Attitudes, Goals, and Education) survey. Acad Med. 2007;82(7):633-45. https://doi.org/10.1097/ACM.0b013e318065b907.
https://doi.org/10.1097/ACM.0b013e318065...
,1010. Watt CD, Greeley SA, Shea JA, Ahn J. Educational views and attitudes, and career goals of MD-PhD students at the University of Pennsylvania School of Medicine. Acad Med. 2005;80(2):193-8. https://doi.org/10.1097/00001888-200502000-00019.
https://doi.org/10.1097/00001888-2005020...
,1313. Twa DDW, Skinnider MA, Squair JW, Lukac CD; Canadian MD/PhD Program Investigation Group. Cross-sectional-derived determinants of satisfaction with physician-scientist training among Canadian MD/PhD graduates. PLoS One. 2017;12(9):e0185218. https://doi.org/10.1371/journal.pone.0185218.
https://doi.org/10.1371/journal.pone.018...
,2020. Jeffe DB, Andriole DA, Wathington HD, Tai RH. Educational outcomes for students enrolled in MD-PhD programs at medical school matriculation, 1995-2000: a national cohort study. Acad Med. 2014;89(1):84-93. https://doi.org/10.1097/ACM.0000000000000071.
https://doi.org/10.1097/ACM.000000000000...
).

Analysis of the data from the postgraduate program evaluation measurements, including the five ratings of overall satisfaction, indicated that the overall rating was good, because the median rating was above 8. Almost 80% of postgraduates reported that their thesis was published, reinforcing the efficiency of our program. Overall satisfaction with one’s profession in the past year was low in young health professionals after degree completion. This low enthusiasm is possibly related to high workload and low salaries. In contrast, MD-PhD students of one medical school reported optimism for their future, with up 80% of the respondents describing excellent job opportunities for physician-scientists (1010. Watt CD, Greeley SA, Shea JA, Ahn J. Educational views and attitudes, and career goals of MD-PhD students at the University of Pennsylvania School of Medicine. Acad Med. 2005;80(2):193-8. https://doi.org/10.1097/00001888-200502000-00019.
https://doi.org/10.1097/00001888-2005020...
).

The overall satisfaction with one’s profession in the past year was also low in women, who reported low salaries and workload. Interestingly, overall satisfaction with mentorship supervision was high among women, probably due to engagement, proactiveness, commitment, and a fairly good relationship with their mentor.

It is worth noting that continuing education after degree completion was found to be an important factor. The majority of participants reported attending professional conferences regularly. In fact, this population has a notable interest in scientific knowledge (11. Escobar AM, Grisi SJ. 21st century well-child care. Rev Assoc Med Bras. 2016;62(6):479-81. https://doi.org/10.1590/1806-9282.62.06.479.
https://doi.org/10.1590/1806-9282.62.06....
).

There were problems related to clinical practice among the postgraduates, involving sedentarism, long work hours, and poor social life that may decrease health-related quality of life. Additionally, these health professionals may be at risk for anxiety, depression, and burnout. Future studies that clarify these issues are warranted (16-1816. Fnais N, Soobiah C, Chen MH, Lillie E, Perrier L, Tashkhandi M, et al. Harassment and discrimination in medical training: a systematic review and meta-analysis. Acad Med. 2014;89(5):817-27. https://doi.org/10.1097/ACM.0000000000000200.
https://doi.org/10.1097/ACM.000000000000...
,). Furthermore, improvements in health professionals’ training and preventive programs, targeted at enhancing overall satisfaction, and psychological/psychiatric issues diagnosis should be implemented.

This study had several limitations. One limitation was the moderate response rate (47%) to the online, self-reported survey. The long length of the questionnaire, and electronic address problems might have been reasons for dropout. The cross-sectional study design and the absence of validated tools to evaluate physiological/psychiatric issues were also limitations.

In conclusion, the quality of the postgraduate program was found to be reasonable. The program’s postgraduate professionals were primarily women and physicians, and had published their thesis. Young postgraduates and women reported low salaries, low workloads, and less overall satisfaction with their profession. Further longitudinal and qualitative studies are needed to assess career trajectories after graduate degree completion.

ACKNOWLEDGMENTS

The authors would like to express their gratitude to all the postgraduates who answered the online survey and would also like to thank Dr. Ulysses Doria Filho for support in the analysis of the data. This study was supported by grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq 303422/2015-7 to CAS), Fundação de Amparo è Pesquisa do Estado de São Paulo (FAPESP 2015/03756-4 to CAS), and Núcleo de Apoio è Pesquisa “Saúde da Criança e do Adolescente” da USP (NAP-CriAd) to MCS and CAS.

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Publication Dates

  • Publication in this collection
    17 Apr 2020
  • Date of issue
    2020

History

  • Received
    10 June 2019
  • Accepted
    27 Aug 2019
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