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专科医师培训主要是指医学专业毕业生完成院校教育之后,在经过认可的培训基地,以住院医师的身份,接受以提高临床能力为主的系统、规范的培训。其培训目的是使住院医师达到某一临床专科所需要的基本理论、基本知识和基本技能要求,成为能独立从事某一专科临床医疗工作的专科医师。整个培训过程分为普通专科培训和亚专科培训两个阶段。 相似文献
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2003年卫生部在全国开展住院医师规范化培训和全科医师培训基础上.开展“建立我国专科医师培养和准入制度”课题研究.探索我国专科医师制度。在“中国医师协会2005年度医师管理者峰会”上.卫生部科教司副司长孟群明确指出我国现有的住院医师培训制度与专科医师培训制度的联系:“住院医师培训制度是专科医师培训制度一个重要的组成部分.住院医师培训是一个必备的过程. 相似文献
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完善的制度是专科医师规范化培训的关键。温州医学院附属第二医院自1993年开始进行住院医师的培训工作,2005年开始向社会招收培训学员,2007年初通过评审成为浙江省第一批经过卫生部认可的专科医师培训基地。在多年的组织培训的实践过程中,积累经验,逐步完善和健全专科医师培训的管理模式和考核制度,对如何做好住院医师培训向专科医师培训转型工作进行了一些有益的探讨;对专科医师培训模式、培训期间人事管理、培训方案等方面进行了大胆的改革和实践,并就培训过程中遇到的一些焦点和难点进行了思考。 相似文献
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专科医师培训工作的实践与认识 总被引:3,自引:2,他引:1
专科医师培训是医学生成长为能独立从事临床医疗工作医生的关键阶段.属于毕业后医学教育范畴.是医学教育连续统一体的重要组成部分.对提升临床医生的临床诊疗水平、提高医疗质量发挥着重要作用Ⅲ。而目前我国的专科医师培训工作尚处于试点阶段.在此阶段医院如何有效地做好专科医师培训工作.是医院管理者急需考虑的问题。本文以医院管理者的视角.简要介绍医院医师培训的概况.分析医院开展专科医师培训工作取得的经验.并结合工作实践提出做好专科医师培训工作的措施和建议。 相似文献
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2010年2月卫生部等五部委发布了<关于公立医院改革试点的指导意见>,明确提出"建立住院医师规范化培训制度",并作为改革试点的九项主要任务之一,把住院医师培训作为全科医生、专科医生培养的必经环节[1].住院医师/专科医师培训是遵循医学人才成长规律的必然要求,对培养临床医师的临床工作能力至关重要[1-4].我国的专科医师培训工作目前尚处于试点阶段[2],在此阶段医院如何有效地做好专科医师培训工作,是目前医院管理者急需考虑的问题.我们从基地软件建设角度出发,简要分析医院开展专科医师培训工作的意义和面临的主要问题,并分别从医院可采取的措施和需政府部门协调的措施二个层面提出相应的对策和建议. 相似文献
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对临床住院医师实施"三基"培训的思考 总被引:2,自引:2,他引:2
临床医师规范化培训是培养高水平医学专业人才的重要手段和必经途径。为适应知识经济时代医疗卫生服务对临床医学人才的新要求,进一步提高临床医师的基础理论、基本知识和基本技术,笔者谈几点体会。1主要问题1.1部分科室领导为应付眼前工作,经常抽调正在参加培训的住院医师回科工作,干扰了培训计划和培训任务的完成。1.2随着医学科学技术的不断发展,医院学科越来越细,专业越来越细化。住院医师过多注重专科知识,对基础知识的培训积极性不高,影响了培训质量。1.3受市场经济大环境的影响,部分科室过分追求医疗收入,存在“重使用轻带教”倾向。… 相似文献
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目的调查参加规范化培训的住院医师/专科医师对带教师资综合职业能力和培训管理的满意度,进一步了解不同医院开展毕业后医学教育所面临的问题和进行毕业后医学教育规范化培训异同。艿珐采用自制问卷对成都市4所三级甲等医院598名住院/专科医师进行问卷调查.对收集的数据进行因子分析和方差分析。结呆受调查的598名住院医师/专科医师对带教师资的综合职业能力的满意度评分在3.83~4.11之间(满分为5分).而对培训管理的满意度评分在2.91~3.75之间,且不同医院住院医师/专科医师的满意度有差异性P〈0.05。结论无论教学医院还是非教学医院,都应加强带教师资建设和培训管理.才能提高住院医师/专科医师对规范化培训的满意度,以促进住院医师/专科医师规范化培训的顺利开展。 相似文献
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A C Twaddle 《Social science & medicine (1982)》1987,25(5):515-524
This paper reports the results of focused interviews with child health and maternal health physicians in the public ambulatory care sector of a large Swedish city to describe (1) the organization of their work activities, (2) their perspectives on their work, and (3) their perspectives on the medical care system. Child health physicians (who were attached to a major teaching hospital) practiced in child health clinics for preschoolers and school health clinics. Each physician covered several such settings. Maternal health physicians were attached to local hospitals and practiced full time in maternal health centers. Child health physicians described their work in terms of preventive care, patient care, integration of ambulatory and hospital services, and technological sophistication; they described the system in terms of quality of care, quality of diagnosis and treatment, adequacy of resources, and distribution of services. Maternal health physicians described work in terms of a biophysical orientation, practice independence, relations with hospitals and other specialists, and dependence on nurses; they described the system in terms of technological sophistication, ambulatory and hospital care, and problems of other specialties. Both were more positive about both work and the system than were district general practitioners, and some interpretation is offered. 相似文献
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J Zweifler 《Public health reports (Washington, D.C. : 1974)》1995,110(3):312-318
An inadequate number of trained primary care clinicians limits access to care at Community Health Centers. If family practice residents working in these centers can provide care to patients at a cost that is comparable to the center''s hiring its own physicians, then expansion of Family Practice Residency Programs into community centers can address both cost and access concerns. A cost-benefit analysis of the Family Practice Residency Program at the Fresno, CA, community center was performed; the community center is affiliated with the University of California at San Francisco. Costs included (a) residents'' salaries, (b) supervision of the family practice residents, (c) family practice program costs for educational activities apart from supervision at the community center, and (d) administrative costs attributable to family practice residents in the community center. Benefits were based on the number of patients that residents saw in the community center. Using this approach, a cost of $7,700 per resident per year was calculated. This cost is modest compared with the cost of training residents in inpatient settings. The added costs attributable to training residents in community health centers can be shared with agencies that are concerned with medical education, providing physicians to underserved communities, and increasing the supply of primary care physicians. Redirecting graduate medical education funding from hospitals to selected ambulatory care training centers of excellence would facilitate placing residents in community centers. This change would have the dual advantage of addressing the current imbalance between training in ambulatory care and hospital sites and increasing the capacity of community health centers to meet the health care needs of underserved populations. 相似文献
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目的探索三甲医院对“托管”二级医院实施护理管理改革的有效措施。方法通过调研,结合当地医院实际,采取组织培训、对被托管医院的护理管理者及护理骨干轮换到托管医院进修学习、并由托管医院委派一名护理部副主任到被托管医院具体把关、沟通交流等措施,协助被托管医院建立健全各项规章制度,落实APN排班制度、大包干责任制,开展护士床边工作制,建立和完善护理质量标准体系与安全管理体系、护理质量持续改进的长效机制、护士培训体系等。提高被托管医院优质护理服务工作。结果被托管医院管理人员及患者的满意度调查结果显示,医院管理者、医生对护理工作满意度较以前提高,医护沟通协作密切,基础护理较以前到位,护士对护理工作总体感觉满意。病区管理质量、护士技术操作、护理文书质量、护理安全管理、护理服务满意度均优于实施前(P〈0.001),差异有统计学意义。结论有效的托管能提高二级医院的护理水平,对提高区域内护理服务水平、将优质护理服务向三级医院靠近有着积极的意义。 相似文献
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建立以诊所为基础的医疗卫生服务体系 总被引:3,自引:3,他引:0
吴荣荣 《中华医院管理杂志》1999,15(1):26-28
卫生资源的合理分配、全科医学的兴起、全科医生的培养和出现,为诊所的建立奠定了理论和人员基础,以此构成一个以分布广泛、数量众多、服务质量达到较高标准的诊所为基础的,二、三级医院为主体,外加一些经改造的原一级医院为补充的这样一个新颖的、具有相当医疗水准的、整体医疗设施配备较为健全的、分布较为合理的社会医疗卫生服务网络,使任何一位公民都可在尽可能短的时间内及时方便地得到优质的医疗卫生服务和迅速的院前抢救,以满足不同层次的医疗卫生服务的需求。 相似文献
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De Pietro C 《Health policy (Amsterdam, Netherlands)》2006,78(1):56-69
This study explores how Italian public hospitals can use private medical activities run by their employed physicians as a human resources management (HRM) tool. It is based on field research in two acute-care hospitals and a review of Italian literature and laws. The Italian National Health Service (NHS) allows employed physicians to run private, patient-funded activities ("private beds", surgical operations, hospital outpatient clinics, etc.). Basic regulation is set at the national level, but it can be greatly improved at the hospital level. Private activities, if poorly managed, can damage efficiency, equity, quality of care, and public trust in the NHS. On the other hand, hospitals can also use them as leverage to improve HRM, with special attention to three issues: (1) professional evaluation, development, and training; (2) compensation policies; (3) competition for, and retention of, professionals in short supply. The two case studies presented here show great differences between the two hospitals in terms of regulation and organizational solutions that have been adopted to deal with such activities. However, in both hospitals, private activities do not seem to benefit HRM. Private activities are not systematically considered in compensation policies. Moreover, private revenues are strongly concentrated in a few physicians. Hospitals use very little of the information provided by the private activities to improve knowledge management, career development, or training planning. Finally, hospitals do not use private activities management as a tool for competing in the labor market for health professionals who are in short supply. 相似文献
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A significant part of the restructuring in the health care industry has involved hospitals joining health networks and health systems. While the proclaimed purpose of this strategy has been to improve hospital performance, studies have found that not all member hospitals reap the desired outcomes. Variations in performance have been linked to, among other things, service provision at the network/system level versus individual hospital level. This study examined the impact of network and system use to provide services on hospital X-inefficiency (i.e., the difference between actual and optimal costs) in a national sample (n = 1,368) of U.S. urban, general, hospitals. Stochastic frontier analysis (SFA) revealed a mean hospital X-inefficiency of 14.85%. Results suggest that hospitals providing a moderate to high proportion of services at the network or system level were more efficient than hospitals that did not use networks or systems for service provision. Low users of networks or systems and nonusers had comparable levels of efficiency. 相似文献
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Physician geographic maldistribution is a problem in the United States health care system. Innovative strategies are needed to entice resident family physicians training in the larger, more numerous suburban and urban training programs to practice in rural areas upon completing their training. This paper describes a strategy used at St. Elizabeth Medical Center Family Practice Residency Program, Dayton, OH, to encourage rural practice. In the St. Elizabeth plan, the interested family practice resident moonlights in a rural practice provided by the local county hospital. The county medical staff covers the resident physician's practice during the frequent absences. The residency program faculty provide on-site supervision, telephone back-up coverage, and practice consultation. The county hospital provides billing services; the resident physician retains 100 percent of collections. The resident physician gains exposure to the knowledge, skills, and attitudes needed in rural practice. Upon completion of residency training, the physician remains in practice and is not required to pay back any expenses incurred by the hospital. Two resident physicians participate currently; three others have expressed interest in practicing in the community. A similar plan might work in parts of the United States where, like Ohio, training programs and rural communities are not far apart. 相似文献
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Adamiak GT Karlberg I 《International journal of technology assessment in health care》2004,20(4):516-523
OBJECTIVES: The research question was whether training level of admitting physicians and referrals from practitioners in primary health care (PHC) are risk factors for emergency readmission within 30 days to internal medicine. METHODS: This report is a prospective multicenter study carried out during 1 month in 1997 in seven departments of internal medicine in the County of Stockholm, Sweden. Two of the units were at university hospitals, three at county hospitals and two in district hospitals. The study area is metropolitan-suburban with 1,762,924 residents. Data were analyzed by multiple logistic regression. RESULTS: A total of 5,131 admissions, thereby 408 unplanned readmissions (8 percent) were registered (69.8 percent of 7348 true inpatient episodes). The risk of emergency readmission increased with patient's age and independently 1.40 times (95 percent confidence interval [CI], 1.13-1.74) when residents decided on hospitalization. Congestive heart failure as primary or comorbid condition was the main reason for unplanned readmission. Referrals from PHC were associated with risk decrease (odds ratio, 0.53; 95 percent CI, 0.38-0.73). CONCLUSION: The causes of unplanned hospital readmissions are mixed. Patient contact with primary health care appears to reduce the recurrence. In addition to the diagnoses of cardiac failure, training level of admitting physicians in emergency departments was an independent risk factor for early readmission. Our conclusion is that it is cost-effective to have all decisions on admission to hospital care confirmed by senior doctors. Inappropriate selection of patients to inpatient care contributes to poor patient outcomes and reduces cost-effectiveness and quality of care. 相似文献
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This paper study labour market responses to hospital mergers. The market consists of two hospitals providing horizontally and vertically differentiated services. Hospitals compete either in price and quality or just in quality (non-price competition). To provide medical care, hospitals employ health care workers (e.g., physicians, nurses). The workers collectively bargain wages either at a central level, firm level or plant level. Anticipating wage responses, hospitals decide whether or not to merge. The main finding is that the bargaining structure, the nature of competition and the patient copayment rate have a crucial impact on the profitability of hospital mergers. 相似文献