專業人才職涯選擇模式–整合期望理論與多準則決策的架構

Abstract

近幾年台灣各大教學醫院面臨外科、婦產科與麻醉科等科別住院醫師招募不足的現象，醫學系學生是各科醫師人力的主要來源，醫學院畢業後的選科行為，會直接影響各科的人力配置。本研究目的有：1. 以期望理論為主要架構結合多準則決策建構醫學系學生專科選擇模型。2. 應用本研究建構的專科選擇模型探討醫學系高年級學生專科選擇偏好因素及專科志願排序。3. 瞭解專科選擇因素對專科選擇的影響。4. 模型實證研究結果可做為其他產業之專業人員職業選擇參考與應用。

本研究整合期望理論與多準則決策所架構的三階層專科選擇模型，包括三個構面、十四項準則及十個選擇專科的醫學系學生。研究結果顯示，在第一層的三項評量構面中，權重（因素價值）最高的為個人喜好及工作成就（0.460）；第二為專科特性（0.291）；第三為專科訓練過程（0.249）。在第二層的14項評量準則中，以個人智慧或能力喜好權重最高（0.197），工作職位升遷機會第二（0.107），第三為完成訓練後生活型態（0.094）。第三層的專科選擇偏好值排序中前四名是內科（72.40）、外科（72.20）、婦產科（65.67）、與小兒科（64.11）。本研究調查醫學系學生主觀專科選擇，發現人數最多的前四名為內科、外科、小兒科、特殊專科。兩項研究結果與目前各教學醫院住院醫師申請最熱門的專科為皮膚科，外科住院醫師招募不足的現況存在極大落差。經由訪談執業專科醫師與醫學系學生發現新生代醫師重視個人生活品質，當正式面對生涯選擇時，在理想與現實間，會考慮現實面選擇壓力小、生活品質較佳的科別。瞭解目前醫學系學生專科選擇偏好可藉由誘因設計，如：提供完整良好的專科培育環境，讓年輕醫師可以發揮自己的興趣與專才; 維持未來升遷管道的暢通及合理的薪酬制度，吸引醫學系學生投入人力缺乏的科別，改善目前國內專科醫師分佈不均的現象。

本研究模型架構係以醫學系學生專科選擇為探討對象，其他產業可參考架構人才選擇模式，惟建議使用時需考量產業特性做修正。

Medical centers in Taiwan have found it difficult to recruit sufficient residents in the fields of surgery and gynecology/obstetrics over the last few years. The specialties that recruit insufficient residents currently will encounter a shortage of manpower in the future. In this research the Expectancy Theory and the Multiple Criteria Decision Making Method were employed to construct a 3-tier model for forecasting one’s professional selection. The first tier assessed three aspects and the second tier assessed fourteen criteria, targeting the “factors considered when selecting specialty”, ten specialties for selected were on the third tier. The purposes of this decision model are to explore senior medical students’ choices of specialties, to identify the relative weight among these determinants, to survey the objective ranking of choices of specialties and to be a reference for other industries to structure their personnel selecting model. On the first tier, the aspect of “personal preferences/work achievement” had the highest weight of 0.460, followed by “specialty characteristics” with 0.291 and the “specialty training process” with 0.249. Of the 14 criteria on the second tier, “personal intelligence/ability /preference” had the highest weight of 0.197, which was followed by “career opportunities” with 0.107 and “lifestyle after completion of training” with 0.094. Of the 10 specialties on the third tier, Internal Medicine got the highest performance value with 72.40, which was followed by Surgery with 72.20, Obstetrics and Gynecology with 65.67 and Pediatrics with 64.11. The top four ranking specialties were Internal, Surgery, Pediatrics and others. There existed a great discrepancy between of medical students and the current residency application status of the teaching hospitals. The new generation of medical doctors highly values the quality of lives. When faced with the ultimate career decision, they would choose the specialties that are less stressful and support better quality of life. An understanding of the present specialty preferences of the medical students can help us remedy the existing uneven distribution of specialists. By devising incentives such as a well-developed specialty training environment so that the young medical doctors can live up to their interests and talents, and have chances for further promotion we can entice medical students to go into the specialties that are currently lacking in manpower.The structure of the model generated in this study can be a reference for other industries to structure their personnel selecting model. However, it is advisable to modify the model according to the characteristics of the specific industry.