构建我国长期可持续发展的全科医生培养体系

全科医生队伍是我国基层医疗服务体系建设的核心与基石，对我国推进家庭医生签约和分级诊疗制度建设、维护和增进人民群众健康具有十分重要意义。本文从人才培养体系的角度分析了我国全科医生队伍建设中存在的主要问题，并提出在“5+3”长学制临床医学专业一体化培养全科医生的建议：①将我国“5+3”长学制医学生培养中的全科医生培养，定位于培养合格全科医生、全科医生临床带教师资和潜在的学术骨干；②在“5+3”医学教育中，全科住院医师培训的“3”年主要安排全科医学相关理论和临床社区实践技能培训；③通过加快推进全科医学学科建设和相关的政策引导，逐步扩大学生参加全科医学住院医师的比例；④加快推进我国临床医学教育学位体系改革，在全科住院医师培训合格且取得执业医师资格后，授予医学博士学位(MD)；对于研究有特殊兴趣的学生，可以继续攻读科学学位博士（PhD）研究生，提高科学研究能力。

Construction of sustainable training system of general practice in China

The workforce of general practitioners (GPs) is the core component and cornerstone of primary care system, which is essential for the development of family doctor contract model and the tiered health care system to maintain and promote the people’s health. This article analyzed the challenges in building up the GP workforce from the perspective of medical training. Proposals were provided on the integration of GP training in the“5+3”long-term clinical medicine education as follows: ① The integration of GP training in the“5+3”long-term education is mainly oriented to training qualified GPs; ② The 3-year GP residency training in the“5+3”long-term education will focus on learning knowledge and clinical skills relevant to general practice; ③ Academic development of general practice and policy guidelines should be promoted to increase the proportion of medical students who choose GP residency training; ④ Reform in the degree system of clinical medicine education should be facilitated to simplify the channel of clinical degree application in residency training. Doctor of medicine (MD) might be conferred upon completion of GP residency training and achievement of medical practice license. For trainees who have special interest in research in general practice, further education to promote research skills for pursuing doctor of philosophy (PhD) can be provided. Competencies in special areas based on the patients’ needs and the GP’s interest can be developed through continuing medical education.