To investigate to what extent a physician's place of graduation is associated with the physician choosing a career as a general practitioner (GP), and identify factors in the curriculum that could predict a general practice career.
Cross-sectional study based on the membership database of the Norwegian Medical Association.
Physicians working in Norway who graduated from four domestic medical schools, five other countries, and three groups of countries. Physicians were categorized according to their main professional activity as GPs, hospital physicians, and researchers.
A total of 2836 medical physicians who were working in Norway during 2010 and graduated from medical school between 2002 and 2005.
Percentage and odds ratio for subjects working as a GP in Norway during 2010. Descriptive data for pre-graduate general practice education in Norwegian medical schools were also analysed.
Compared with the University of Oslo, there was a significantly higher proportion of GPs among physicians who had graduated from Denmark (OR 2.9, 95% CI 1.9-4.5), Poland (OR 2.0, 95% CI 1.4-2.9), Sweden (OR 1.8, 95% CI 1.0-3.1), and Trondheim (Norway) (OR 1.5, 95% CI 1.1-2.0). Across the four Norwegian medical schools, there were significant associations between choosing a general practice career and the sum of pre-graduate educational hours regarding general practice, general practice preceptorship, and the number of GP teachers.
The physician's place of graduation appears to be associated with career choice. The universities' total contribution in pre-graduate general practice education may be associated with future GP career choice.
Cites: Health Trends. 1981 Feb;13(1):17-2010252178
Cites: Med Educ. 2003 Sep;37(9):809-1412950945
Cites: Med Educ. 1993 May;27(3):250-38336575
Cites: Acad Med. 1995 Jul;70(7):620-417612128
Cites: Tidsskr Nor Laegeforen. 1999 Aug 20;119(19):2858-6410494211
Cites: Med J Aust. 2005 Sep 19;183(6):295-30016167868
Cites: Scand J Prim Health Care. 2006 Jun;24(2):65-616690551
Cites: Scand J Prim Health Care. 2006 Dec;24(4):193-517118856
Cites: Med Teach. 2006 Dec;28(8):734-4117594587
Cites: Med J Aust. 2007 Jul 16;187(2):124-817635100
Cites: Tidsskr Nor Laegeforen. 2008 Aug 28;128(16):1833-718787594
Cites: Aust Fam Physician. 2009 May;38(5):341-419458806
Cites: Acad Med. 2000 Mar;75(3):278-8210724318
Cites: Health Econ. 2003 Jan;12(1):67-7312483762
Cites: J Health Econ. 1990 Nov;9(3):335-5710107850
Contradictory results have been reported regarding most delivery parameters as risk factors for urinary incontinence. We investigated the association between the incidence of urinary incontinence six months postpartum and single obstetric risk factors as well as combinations of risk factors.
This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health during 1998-2008. This substudy was based on 7561 primiparous women who were continent before and during pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and six months postpartum. Data were linked to the Medical Birth Registry of Norway. Single and combined delivery- and neonatal parameters were analyzed by logistic regression analyses.
Birthweight was associated with significantly higher risk of urinary incontinence six months postpartum [3541-4180 g: odds ratio (OR) 1.4, 95% confidence interval (CI) 1.2-1.6; >4180 g: OR 1.6, 95% CI 1.2-2.0]. Fetal presentation, obstetric anal sphincter injuries, episiotomy and epidural analgesia were not significantly associated with increased risk of urinary incontinence. The following combinations of risk factors among women delivering by spontaneous vaginal delivery increased the risk of urinary incontinence six months postpartum; birthweight =3540 g and =36 cm head circumference; birthweight =3540 g and forceps, birthweight =3540 g and episiotomy; and =36 cm head circumference and episiotomy.
Some combinations of delivery parameters and neonatal parameters seem to act together and may increase the risk of incidence of urinary incontinence six months postpartum in a synergetic way.
Weight gain during pregnancy may contribute to increased urinary incontinence (UI) during and after pregnancy, but scientific support is lacking. The effect of weight loss on UI postpartum is unclear. From 1999 to 2006, investigators in the Norwegian Mother and Child Cohort Study recruited pregnant women during pregnancy. This study was based on 12,679 primiparous women who were continent before pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and 6 months postpartum. Weight gain greater than the 50th percentile during weeks 0-15 of pregnancy was weakly associated with higher incidence of UI at week 30 compared with weight gain less than or equal to the 50th percentile. Weight gain greater than the 50th percentile during pregnancy was not associated with increased prevalence of UI 6 months postpartum. For each kilogram of weight loss from delivery to 6 months postpartum among women who were incontinent during pregnancy, the relative risk for UI decreased 2.1% (relative risk = 0.98, 95% confidence interval: 0.97, 0.99). Weight gain during pregnancy does not seem to be a risk factor for increased incidence or prevalence of UI during pregnancy or postpartum. However, weight loss postpartum may be important for avoiding incontinence and regaining continence 6 months postpartum.