Factors affecting the choice of medical specialties in Turkiye: an analysis based on cross-sectional survey of medical graduates.

BACKGROUND: Modern healthcare systems require the right mix of medical specialties for effective provision of high-quality services. Despite increased availability of general physicians and specialists, Türkiye lags behind high-income countries in terms of availability of specialists. The purpose of the study is to identify several specific factors that affect the choice of medical specialization. METHODS: All 350 medical school graduates in a specialty examination preparation bootcamp were requested to participate in the survey and 333 completed the self-administered questionnaire. The survey asked questions about factors affecting choice of medical specialty by medical graduates. RESULTS: The empirical results indicate that surgical specialties, compared to other broad medical specializations, are selected because of its higher income-earning potential and social prestige. The likelihood of selecting surgical specialties is negatively affected by rigorousness of the training program, high work-load, risk of malpractice lawsuits and risk of workplace violence. Male participants were 2.8 times more likely to select surgery specialty compared to basic medical science. Basic medical science areas were selected at a higher rate by female graduates and graduates with high level of academic performance in medical schools. CONCLUSIONS: It is critically important to improve trust and inter-personal communications between the patients and physicians in all specialties to lower the likelihood of malpractice lawsuits and workplace violence. Policy-makers may adopt policies to affect income earning potential and social prestige of targeted specializations to improve their supply.

Effect of accreditation and certification on the quality management system: Analysis based on Turkish hospitals.

Effects of certification and accreditation on hospital quality management systems (QMS) are measured to better understand the value of external recognitions. This study identifies the QMS dimensions that show significant improvements with hospital certification and/or accreditation. Data were collected from 350 Turkish hospitals using a structured questionnaire. Mean scores of nine domains of QMS were used as outcome variables. Although quality policy documents, quality monitoring by board, and training of professionals are the focus of generic QMS, ISO certification did not affect these scores significantly. Formal protocols for infection control scores are affected by hospital size and certification status. Adoption of Ministry of Health's (MOH) infection control initiatives has improved this score for all hospital types. Formal protocols for medication and patient handling, analyzing performance of care processes, and evaluating results improved with accreditation and certification status. Larger hospitals were better able to implement application of protocols, analyzing care process and evaluating results. For improvements in the QMS scores, external assessments are valuable, but quality-focused governmental regulations appear important for improving QMS of small and medium-sized hospitals. Higher QMS scores, however, may not lead to improved quality. Future studies should explore the relationship between QMS scores and service quality.