Permanence of otolaryngologists in public service after graduating from the specialty and factors associated with this

Abstract

Introduction: In Chile there is a problem in the distribution of ENT surgeons between the public (PHS) and private health system. Furthermore, only since this year there is a formal link between some recent ENT surgeons graduates, so there is a deficit of ENT in PHS. Aim: To describe the group of ENT graduates in the last decade and evaluate their permanence working in the PHS. Material and method: Cross sectional study. There were analyzed the ORL graduates in the period 2003-2012. We evaluated by an email questionnaire if working at PHS, workload, time worked, reasons why linking with PHS, and advantages and disadvantages of this. Results: There were 114 graduates. The number of trained specialists has remained at about 12 per year from all teaching centers of the country. Of the total, 43 completed the questionnaire, of whom currently work in PHS hospitals 58.1%. The type of contract in the PHS decreased with time in 26.2% of cases. The average time worked in the PHS was 3 years 10 months. Among the main advantages of working in the PHS, they men- tioned gain surgical experience, complexity of pathologies and teamwork, and within the disadvantages mentioned low payment, and poor availability of infrastructure, instrumental and operating rooms. Discussion: It is important to consider these factors when designing policies of linking and retention of ENT surgeons in public health system hospitals.