以模糊多準則決策法探討醫學系學生專科選擇

A Fuzzy Multiple Criteria Decision Making Approach to Evaluate Medical Students' Specialty Choices

10.6145/jme.200509_9(3).0004

張北葉(Pei-Yeh Chang)；洪志洋(Chih-Young Hung)；王貴英(Kuei-Ing Wang)；黃元惠(Yuan-Huei Huang)；張金堅(King-Jen Chang)

醫學系學生 ； 專科選擇 ； 模糊多準則決策法 ； medical students ； specialty choice ； fuzzy multiple criteria decision making

Journal of Medical Education

9卷3期（2005 / 09 / 01）

241 - 254

繁體中文

本研究目的為評估醫學系學生進行專科選擇之主要考量準則、各準則相對權重值、及志願排序。本研究採用模糊多準則決策法(fuzzy multiple criteria decision making, FMCDM)，針對醫學系高年級學生，透過問卷進行專科選擇調查。研究結果顯示，在第一層之3項評量構面中，權重最高的為個人喜好及工作成就（權重值為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)。第三層的專科選擇績效值排序中前四名是內科(72.40)、外科(72.20)、婦產科(66.03)、與小兒科(64.11)。研究結果可供相關單位參考，及早規劃適當誘因，讓醫師人力資源能朝符合實際需求方向發展。

The purposes of this research are to investigate the determinants that influence medical students' choices of specialty, to identify the relative weighting among these determinants and to survey the ranking of choices of specialty at future. The questionnaire for survey was designed mainly by using the model of fuzzy multiple decision making (FMCDM), and was sent to senior medical students for survey their opnions. The results of study found the ranking and relative weightings in the first-tier 3 aspects are: (1) personal interest and work achievement (0.460); (2) characteristics of specialty (0.291); and (3) the process of specialty training (0.249). Under the second-tier considerations, the first 3 ranking criteria are: (1) personal Intelligence or ability (0.197); (2) opportunity of job promotion (0.107); (3) life style after training (0.094) The top 4 specialties ranked at the FMCDM results were: internal medicine (72.40), surgery (72.20), obstetric and genecology (66.03), and pediatrics (64.11). The results can be used as reference to design incentive system of medical workforce allocation.

1. Bellman RE,Zadeh LA(1970).Decision-making in a fuzzy environment.Management Sci,17,141-146.
2. Culler SD,Bazzoil GI(1995).Moonlighting behavior among young professionals.Journal of Health Economics,4,283-292.
3. Kiker, BF,Zeh, M(1988).Relative future income expectation, expected malpractice premium cost, and other determinants of physician specialty choice.Journal of Health and Social Behavior,39,152-167.
4. Phelps CE(1997).Physicians in the marketplace, Health Economics.Addison-Wesley.
5. Rice TH(1983).The impact of changing medicare reimbursement rates on physician induced demand.Med Care,21,803-815.
6. Saaty, T L(1977).A scaling method for priorities in hierarchical structures.J Mathem Psychol,15,234-281.
7. Saaty, T. L.(1980).The analytic hierarchy process.New York:McGraw-Hill.
8. Tang MT,Tzeng GH(1999).A hierarchy fuzzy MCDM method for studying electronic marketing strategies in the information service industry.J Internat Inform Managem,8,1-22.
9. Teng JY,Tzeng GH(1996).Fuzzy multicriteria ranking of urban transportation investment alternative.Transportation Planning and Technology,20,15-31.
10. Tzeng GH,Teng J Y(1994).Multicriteria evaluation for strategies of improving and controlling air-quality in the super city: A case of Taipei city.J Environ Managem,40,213-229.
11. Zadeh LA(1975).The concept of a linguistic variable and its application to approximate reasoning, Parts 1, 2, and 3.Information Science,8, 9,199-249, 301-357, 43-80.
12. Zadeh LA(1965).Information and control.Fuzzy Sets,8,338-353.
13. 江東亮(1995)。台灣地區的醫師人力政策：1945-1994。中華衛誌，14(5)，383-391。
14. 宋瑞樓(2002)。醫師培育改進之建議：特別是專科及次專科醫師。台灣醫界，45，41-42。
15. 洪碧蘭、楊志良(1998)。健保支付與醫界生態關係之初探。醫院，1，41-60。
16. 高美英、呂碧鴻、李明濱(2000)。醫學生的專科偏好與相關因素探討。醫學教育，4，23-37。
17. 張友珊、楊志良(1999)。全民健保對各科醫生消長影響之初探。中華衛誌，18，123-137。
18. 張金堅、陳炯年、朱樹勳(1998)。全民健保後外科醫師人力之調查與分析。醫學教育，2，45-53。
19. 張茂松、王泰隆、王德宏(2001)。專科醫師現況與人力規劃。我國醫事人力規劃政策建言書。
20. 黃元惠、王貴英、洪志洋(2004)。全民健保實施後外科專科醫師人力下降的可能因素探討。台灣醫界，47，40-43。
21. 楊明仁、蔡瑞熊(1999)。某醫學院學生之專科選擇及其相關因素。醫學教育，2，15-22。
22. 鄧振源、曾國雄(1987)。層級分析法(AHP)的內涵特性與運用（上）（下）。中國統計學報，27(6, 7)，5-21, 1-19。
23. 謝博生、侯勝茂、陳餘慶(2001)。醫學系招生人數及基層醫師人力規劃。我國醫事人力規劃政策建言書。

1. 張乃云(2016)。2003~2013年台灣主治醫師人力與服務量分佈之長期資料研究 －以產科、兒科、外科住院服務為主。國立臺灣大學健康政策與管理研究所學位論文。2016。1-113。 
2. 朱峻廷(2017)。模糊多準則專家決策法於五星級觀光旅館服務品質評選之研究。義守大學資訊工程學系學位論文。2017。1-104。