脑病科规范化培训住院医师带教体会

住院医师规范化培训是医学生毕业后教育的重要组成部分,作为脑病科的一名带教老师,在带教实践中,重视规培医师的入科思想教育,加强规培医师业务能力的培训,培养规培医师良好的沟通能力,完善规培医师的考核制度。规范化培训阶段是住院医师成长为一名合格医生的重要阶段,进行规范化培训的住院医师是医院临床、教学和科研工作未来的主力军和后备力量。     

我国住院医师规范化培训现状的系统评价

目的:系统评价我国住院医师规范化培训现状,提出相应的政策建议。方法:以2014年1月至2020年12月为检索时限,"住院医师规范化培训现状""住院医师规范化培训进展""住院医师规范化培养现状""住院医师规范化培养进展"为主题检索词,系统检索中国知网、万方、维普等数据库的相关文献。结果:我国住院医师规范化培训总体实施效果较好,但在薪酬待遇、人文关怀、科研能力和师资队伍等方面存在一定的不足。结论:住院医师规范化培训应更加注重提升学员的人文素养和科研能力,并建立健全培训考核机制,加强带教师资队伍建设。     

肿瘤内科住院医师规范化培训策略

规范化培训是有效提高肿瘤科住院医师临床能力的重要步骤,本文从岗前培训、培训的模式、科研能力的培养以及考核方式等方面,谈在肿瘤内科住院医师规范化培训中的体会。     

住院医师规范化培训存在问题分析与对策探索

住院医师是医院人才梯队建设的基础。完善临床住院医师规范化培训工作,是提高青年医师综合素质的重要途径,对培养高层次的医学人才起着承上启下的作用。针对住院医师规范化培训与在职研究生教育中的衔接不畅、评估考核机制不善、政策落实不力以及软硬件设施急需提高等问题,提出了实现二者的有效衔接,通过完善评估机制、配套设施和服务体系,以期探索出完善医师培养方法并提高青年医师综合素质的新途径。     

南京鼓楼医院基于能力进阶和里程碑的住院医师规范化培训的实践探索

基于能力的医学教育在美国等发达国家被广泛运用于住院医师规范化培训.南京鼓楼医院成立Johns Hop-kins—鼓楼医院住院医师合作项目后,逐步实践基于能力进阶和里程碑的住院医师规范化培训,围绕岗位胜任力,力争培养高质量的具人文素养和独立临床实践能力的住院医师.     

试论儿科专科医师培养模式问题及对策

我国自20世纪80年代开始了临床住院医师的培养试点工作，1993年卫生部颁发了《住院医师规范化培训试行办法》，为建立专科医师培养制度打下了基础。我院1988年首批参加了北京市住院医师培训试点，已有342名住院医师接受规范化培训，有188名住院医师取得了培训合格证书，75人考取研究生。他们多数已成为我院临床、教学、科研及管理工作的骨干力量。     

住院医师规范化培训将有“国标”

国家卫生和计划生育委员会网站发布《住院医师规范化培训标准(试行)》草案,向社会公开征求意见。《标准》提出,住院医师规范化培训是培养合格临床医师必经的毕业后医学教育阶段,为期3年的住院医师规范化培训以临床实践培训为重点,取得培训合格证书将逐步作为临床医师在医疗机构独立从事诊疗工作和进入专科医师培训以及中级职称晋升的必备条件。为尽快全面建立和实施住院医师规范化培训制度,进而为建立实施专科医师培训制度奠定基础,国家卫生计生委委托中国医师协会组织专家制定了《住院医师规范化培训标准(试行)》。该《标准》包括培训总则和     

加强住院医师规范化培训管理 提高临床医学人才质量

住院医师规范化培训是临床医师成长的重要阶段，对于培养出高质量、高层次的临床医师队伍、确保医疗质量具有非常显著作用。总结笔者所在医院住院医师规范化培训的工作，并提出加强规范化培训工作的建议。     

强化师资培训,构建培训平台——记中日友好医院临床技能模拟培训中心投入使用

住院医师规范化培训是培养合格临床医师的必经途径,是加强卫生人才队伍建设、提高医疗卫生工作质量和水平的关键。中日友好医院作为首批国家住院医师规范化培训基地之一,医院领导充分认识到,住院医师规范化培训工作重点是切实加强师资队伍建设。     

期待规培管理制度进一步健全

正回应《培训规范化的住院医=?》(2014年第3期封面文章)建立住院医师规范化培训制度是加强临床医师队伍建设的一项重大系统工程。笔者认为,除了做好国家层面的顶层设计,加强统一组织领导和确保培训资金投入外,还需要建立健全住院医师规培工作的管理制度,加强宏观指导力度,完善培训者的人事政策保障等,以有利于实现我国医师培养的标准化、规范化和同质化。譬如在住院医师规     

The Role of the Medical School in Rural Graduate Medical Education: Pipeline or Control Valve?

Although rural-based graduate medical education is critically important in the training of competent rural family physicians, the number of physicians selecting these programs is highly dependent on what happens earlier in the pipeline, i.e., during medical school. Using the experience and outcomes research from Jefferson Medical College's Physician Short-age Area Program, as well as from published literature describing six other medical school programs with similar goals, this paper addresses the important role of these programs in substantially increasing the number of physicians interested in rural family practice. Although each of these programs differs in its structure, all contain three core features: a strong institutional mission; the targeted selection of students likely to practice in rural areas, predominantly those with rural backgrounds; and a focus on primary care, especially family practice. Outcomes show that all seven programs have been highly successful. Medical schools, therefore, can have a major impact on the number of rural physicians they produce by acting not only as a pipeline or conduit to residency programs, but also as a control valve, beginning as early as the admissions process. In order to maximize their impact on the supply and training of rural family physicians, rural residency programs should understand, support, collaborate with and help develop medical school programs whose mission is to provide rural physicians.     

Practice location as a function of medical school and residency location: implications for resident selection

Numerous studies have documented an association between the state in which a physician practices and prior education in that state. To determine whether this relationship exists for recent family practice residency graduates, 95 randomly selected programs in which residents completed training in 1979 were surveyed to obtain information regarding practice location and medical school location for their graduates. Seventy-nine percent of physicians completing residency and medical school in the same state also practiced in that state. Of those completing residency in a state other than that of their medical school, 43 percent stayed in the state of their residency to practice, and 22 percent returned to the state of their medical school. An analysis of the impact that a policy restricting house staff positions to in-state students would have on physician supply for the state reveals that only about 10 percent more physicians would be expected to start practice in a state if such a policy were implemented.     

Length and content of family practice residency training

BACKGROUND: Family practice residency programs are based largely on a model implemented more than 30 years ago. Substantial changes in medical practice, technology, and knowledge necessitate reassessment of how family physicians are prepared for practice. METHODS: We simultaneously surveyed samples of family practice residency directors, first-year residents, and family physicians due for their first board recertification examination to determine, using both quantitative and qualitative methods, their opinions about the length and content of family practice residencies in the United States. RESULTS: Twenty-seven percent of residency directors, 32% of residents, and 28% of family physicians favored extending family practice residency to 4 years; very few favored 2- or 5-year programs. There was dispersion of opinions about possible changes within each group and among the three groups. Most in all three groups would be willing to extend residency for more training in office-based procedures and sports medicine, but many were unwilling to extend residency for more training in surgery or hospital-based care. Residents expressed more willingness than program directors or family physicians to change training. Barriers to change included disagreement about the need to change; program financing and opportunity costs, such as loss of income and delay in debt repayment; and potential negative impact on student recruitment. CONCLUSION: Most respondents support the current 3-year model of training. There is considerable interest in changing both the length and content of family practice training. Lack of consensus suggests that a period of elective experimentation might be needed to assure family physicians are prepared to meet the needs and expectations of their patients.     

The Rural Physician Workforce in Florida: A Survey of US- and Foreign-Born Primary Care Physicians

CONTEXT: To meet the challenge of primary care needs in rural areas, continuing assessment of the demographics, training, and future work plans of practicing primary care physicians is needed. PURPOSE: This study's goal was to assess key characteristics of primary care physicians practicing in rural, suburban, and urban communities in Florida. METHODS: Surveys were mailed to all of Florida's rural primary care physicians (n = 399) and a 10% sampling (n = 1236) of urban and suburban primary care physicians. FINDINGS: Responses from 1000 physicians (272 rural, 385 urban, 343 suburban) showed that rural physicians were more likely to have been raised in a rural area, foreign-born and trained, a National Health Service Corps member, or a J-1 visa waiver program participant. Rural physicians were more likely to have been exposed to rural medical practice or living in a rural environment during their medical school and residency training. Factors such as rural upbringing and medical school training did not predict future rural practice with foreign-born physicians. Overall, future plans for practice did not seem to differ between rural, urban, and suburban physicians. CONCLUSIONS: Recruiting and retaining doctors in rural areas can be best supported through a mission-driven selection of medical students with subsequent training in medical school and residency in rural health issues. National programs such as the National Health Service Corps and the J-1 visa waiver program also play important roles in rural physician selection and should be taken into account when planning for future rural health care needs.     

Fixing family medicine residency training

The number of US medical students entering family medicine continues to decline. Despite the increased presence of family physicians on medical school faculty and increased exposure to family medicine during training, students still cite lack of respect and excessive knowledge base to master as reasons for not choosing our specialty. Specific changes must be made to family medicine residency training to make it more attractive to students and more compatible with the realities of practice today. These changes include eliminating maternity care as a requirement, lengthening training to 4 years, and reducing the number of residency slots available. These changes will ensure that graduating family physicians will be better prepared for practice, better qualified to obtain privileges in the hospital and clinic, and more respected by their colleagues and the public.     

Postdoctoral training in medical informatics: a survey of National Library of Medicine-supported fellows

The National Library of Medicine (NLM) funds training programs in medical informatics and plans to significantly increase the number of program sites in the future. The authors surveyed all NLM-funded trainees at the nine sites supported in the spring of 1988 to determine their backgrounds, current research interests, and career plans. Forty-three fellows were identified, of whom 39 returned a mailed questionnaire. All but four were physicians (89.7%), 82.1% had at least one year of postdoctoral clinical training, and 61.5% had completed a residency. Seventy-one percent of those completing residency had done so in internal medicine. The most common areas of current research were decision support/decision analysis, knowledge representation, and artificial intelligence. The overwhelming majority of the fellows planned to seek positions in a medical school on completion of their fellowships, and most preferred affiliation with a department of medical informatics or medicine.     

Cultural sensitivity training among foreign medical graduates

OBJECTIVES: To examine the effectiveness of culture sensitivity training for foreign-trained medical graduates licensed to practice in Ontario, Canada. DESIGN: A study of pretest-post-test design was conducted to determine the effect of cultural sensitivity training on newly immigrated physicians licensed in Canada. Twenty-four physicians, those who had passed the medical licensing exam in 1996 and had not yet started their residency program, were given 15 hours of cultural sensitivity training and were considered the experimental group. This group was compared with a control group of 24 physicians who had passed the licensing exam and were in the process of completing residency. SETTING: University of Toronto. SUBJECTS: Foreign-trained medical graduates. RESULTS: Both groups completed the Cross-Cultural Adaptability Inventory both before and after the training of the experimental group. Statistical significance in three subscales of the Open-Mindedness/Flexibility, Emotional Resilience and Perceptual Acuity dimensions were demonstrated in the experimental group as compared with the control group. CONCLUSIONS: In order for Canada to mould professional and effective physicians great care must be taken in the design and process of cultural sensitivity programmes to enhance both knowledge and skills. Follow-up should be undertaken to compare their effectiveness with the control group.     

Family medicine: a medical care alternative for Latin America

This paper presents the experience of a residency in family medicine organized 7 years ago by the medical school of the Universidad Autónoma de Nuevo León, Mexico. The residency aims to prepare physicians to provide primary health care. In efforts to teach graduate students the social as well as the biological causes of diseases most commonly reported at the primary care level, graduate students take courses in clinical disciplines, social and behavioral sciences and public health. In its training methodology the program combines teaching, service and research. By now, the department of family medicine has graduated five classes of specialists, all of whom are working in the field of family medicine at the primary level. This fact is particularly worth noticing in a country where there are thousands of unemployed/underemployed physicians. It is suggested that family physicians are satisfying an unmet medical demand of many thousands of Mexicans, and that the care provided by them is less expensive and of better quality than the same care provided by other specialists.     

Using financial incentives to attract medical residents to the periphery: The Israeli experience

Background

In 2011, Israel instituted financial incentives as part of a larger program to attract doctors to residency programs in peripheral hospitals.