社会化学员的探索——试点中的专科医师培训

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．     

开展专科医师培训工作的实践探索

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.     

专科医师制度的建立顺应卫生体制改革和社会发展需求

专科医师制度的建立是我国进入WTO后卫生体制与世界接轨的举措,也是人民群众日益增 长的卫生服务需求。我国的住院医师规范化培训制度的实施已为专科医师制度的建立打下了良好的基础。 总结我院规范化培训的经验和成绩作为借鉴,以顺应卫生体制的改革。     

临床医学博士专业学位与专科医师规范化培训衔接

毕业后医学教育包括研究生教育和住院/专科医师规范化培训,临床医学专业学位博士和专科医师规范化培训作为两种重要的毕业后医学教育,对医学人才的培养起着承上启下的作用.从临床医师培养规律、临床能力培养目标、制度保障以及试点经验等方面,阐述临床医学博士专业学位与专科医师规范化培训衔接的可行性,探讨可能出现的问题,并提出相应的建议,为完善我国毕业后医学教育提供依据.     

住院医师培训向专科医师培训转型工作的思考和探讨

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。     

“专培”如何达到预期成效?

近日,国家卫生计生委、中国医师协会在京启动专科医师规范化培训(以下简称专培)制度试点工作,首批选择神经外科、呼吸与危重症、心血管内科进行试点.按照初步规划,到2020年,我国将初步建立专科医师规范化培训制度,形成完整的毕业后医学教育体系.开展专科医师规范化培训试点,最终目的是要在住院医师规范化培训的基础上,培养一批能独立、规范地从事疾病专科诊疗工作的临床专科医师.     

中医类别专科医师准入制度可行性研究

目的探讨建立中医类别专科医师可行性及建立相关制度的建议。方法采用整群抽样的方法对430名中医师进行中医类别专科医师准入制度可行性问卷调查,对83名中医师进行专题小组访谈。结果实行中医类别专科医师制度可行,中医类别专科医师应有准入资质,明确了职称考试制度与建立专科医师制度的关系,明确了中医类别专科医师的培养阶段、培养内容、培训形式、培养年限、考试与考核等内容。结论明确了中医类别专科医师的准入资质,建立符合中医师特点的专科医师培养、考试制度,先行试点。逐步推进。     

我国专科医师培养制度与住院医师培训的联系和区别

全球大多数国家对临床医师执业都实行严格的培养和执业资格准入制度.尤其是欧美等发达国家经过多年的探索和实践,专科医师培训和准入制度相当完善和成熟.我国港澳台地区对临床专科医师的培训与管理也是遵循国际通用做法.     

北京大学人民医院专科医师规范化培训模式的实践与研究

医学科学发展至今，其模式已由生物医学模式向生物-心理-社会医学模式发生转变。卫生部专科医师培养标准总则中明确指出：为适应卫生改革与发展需要，完善我国医学人才培养体系，提高医师队伍整体素质，应逐步建立专科医师培训制度。     

建立我省专科医师培养制度——访省卫生厅科技教育与国际合作处副处长梁军

记者：您怎样看待专科医师培训？ 梁军：医学工作的特殊性决定了医学教育的特殊性和复杂性。医学教育体系由医学院校教育、毕业后医学教育和继续医学教育三阶段组成．其中以住院医师、专科医师培训为主要内容的毕业后教育是医学人才临床能力培养极为重要的阶段。通过住院医师、专科医师培训．     

Plea for more attention to the importance of gender during medical training

Gender is an important factor in disease and health. Male and female patients with the same disease may present with different complaints. This is especially true in cardiology. Basic medical training should specifically address this topic. Moreover, the gender of the physician is an important factor in patient care. Physicians are unaware of the influence of their gender on their performance. Reflective practice is an essential educational tool in modern specialist training. As medical specialist training in The Netherlands is being modernized at present, this may be the perfect time for physicians to become aware of their gender and its impact on their performance. This will improve medical care for both male and female patients by male and female doctors.     

Reforming higher specialist training in the United Kingdom--a step along the continuum of medical education

OBJECTIVES: The requirement to align the arrangements for postgraduate training in the United Kingdom with those elsewhere in the European Community provided the opportunity to review and reform our arrangements for higher specialist training. This paper describes the case for change--the strengths and deficiencies of the traditional pattern of postgraduate medical training, demographic influences in the medical workforce and the need for a more structural or planned approach to training. CONCLUSIONS: Over the past 5 years substantial progress has been made: the introduction of new regulatory arrangements and a new higher specialist training grade; the development of a managed and flexible system for delivering training to standards set by the Royal Colleges and which can accommodate the needs of those pursuing academic and research medicine; and the opportunity for trainees' progress to be measured against published curricula. The significant programme of change has been underpinned by careful workforce planning and the publication of comprehensive guidance. Significant reform of higher specialist training has been achieved. This paper also makes the case for a more strategic approach to planning and developing medical education across the continuum, from entry to medical school until retirement, which can guide medical education and improve patient care into the next millennium.     

Ageing medical workforce in Australia - where will the medical educators come from?

Background  

As the general practitioner and specialist medical workforce ages there is likely to be a large number of retirees in the near future. However, few Australian studies have specifically examined medical practitioner retirement and projected retirement patterns, and the subsequent impact this may have on training future health care professionals.     

Flexible training opportunities in the European Union

This paper compares the opportunities for flexible (part-time) specialist training in the UK and elsewhere in the EU in the overall context of the rising numbers of women doctors across Europe. Few other EU countries appear to provide the same opportunities for flexible training as the UK, despite high percentages of women medical students and women medical graduates. There are important differences in training patterns across the EU and some reasons are proposed for why flexible training may be more difficult to implement or may not be required elsewhere in the EU. Reasons include less centralized health care systems and more rigidly structured training programmes. In the context of four main factors affecting medical manpower--medical unemployment, contracted working hours, maternity provisions and duration of training--both the health authorities' need to implement flexible training and the trainee doctors' demand for it would appear to be greater in the UK than in other EU countries.     

急危重症专科护士在提升急诊护理质量中的作用及效果评价

目的探讨急危重症专科护士在提升急诊护理质量中的作用及成效。方法科室积极培养急危重症专科护士,并对急危重症患者的护理质量和服务效果进行评价。结果急危重症患者不良事件及护理并发症明显减少,患者的救治成功率及家属的满意度分别提高6.50 %和5.72%,差异均有统计学意义。结论急危重症专科护士通过规范化培训,管理急危重症患者可明显降低不良事件和护理并发症的发生率,提高患者的救治成功率,有助于提高患者及家属的满意度,有利于提升急诊护理质量。     

Family medicine in Iran: the birth of a new specialty

Since the revolution of 1978-1979, the government of Iran has worked toward development of a primary health care system to improve basic health for its citizens. Although infant mortality and other parameters have improved, increasing urbanization and poor lifestyle choices continue to present major challenges to improving overall health statistics in the country. Generalist physicians, with no training beyond medical school graduation, have not inspired confidence from patients or specialist colleagues. Therefore, many patients prefer to receive care for common health complaints from specialist physicians. Health care for many individuals tends to be episodic, driven by patient concerns for acute illness rather than by patient-centered, longitudinal care. The government of Iran has decided to develop family medicine as a specialty within the country to help respond to these problems. Based on an initial consultation with some leaders in the Ministry of Health and Medical Education, as well as students, nursing staff, subspecialists, administrators, and medical educators, a number of suggested steps were recommended to support the development of family medicine in Iran. These involved, among others, further development of the specialty and parity with other specialties, development of faculty and curricula, and a plan for financing rural health care.     

Social Work in the Academic Medical Center:

Although the total number of social workers within the academic medical center will probably decrease because of decreasing hospital bed usage, the role for those who remain will be that of a clinical specialist, a sophisticated and adaptable practitioner who can work flexibly under minimal supervision. The valued social work practitioner will be an independent player on the health care team who assumes a significant role which no other member of that team is equipped to take. Advanced training is more important today than ever before in the evolution of social work practice in academic health care. However, this training is not now available within the parameters of the two year master's program.     

Medizintechnik in der ärztlichen Aus-, Weiter- und Fortbildung

The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.