谈执业医师资格考前培训需求与推广

执业医师资格考试属于行业准入考试,是一项面广量大经常性的国家考试.由于其通过率较低,每年均有大量的考试对象.因此,各种形式的执业医师资格考前培训就成了社会需求,也形成了相互竞争的格局.文章对执业医师资格考前培训市场进行了分析,介绍了24小时医学频道优势与薄弱环节,提出了24小时医学频道主要的推广办法.     

护理专业人才培养的现状与展望

多年来,我国护理人才的培养沿袭固定的模式,即初中毕业生进入护校,经过3年的专业培养,毕业后由国家统一分配至各级医疗机构,从事护理工作,再根据各单位的需要决定其具体工作岗位.这时,毕业生年龄大约在十八九岁左右,经过5年以上的一线锻炼,开始进入婚育年龄阶段,大约在30岁左右进入一个事业稳定时期,在专业技能及人际交往等方面,趋于成熟.这时,她可能会成为一名一线护理骨干或护士长.但与此同时,长期的工作、家庭压力及倒班等不规律的作息时间又使得她在35岁以后,精力、体力逐渐下降,40岁后更加明显,如晚上夜班时打针看不清血管,极易疲劳而又不易恢复.所以一名护士真正能在一线岗位上工作的时间也就只有在40岁以前,那么进入工作状态的时间越早,相对她在一线工作的时间也就会越长.     

Surgical trainees benefit from good consultant working practices: an audit on the effect on training of a new consultant rota

PURPOSE: To retrospectively assess operative supervision for orthopaedic trainees over an 18 week period when trauma and orthopaedic consultants changed their on call working practice from one week on call to a four day/three day block, during a fortnight period. OUTCOME: The rota changes had important implications on workload and consultant availability to supervise juniors during operation with a positive effect upon training such that trauma surgery supervision rates increased significantly (p<0.001) after the introduction of these new working arrangements. Working life for consultants and ultimately patient care were also felt to improve and consultants' working hours were closer to the European working hours directives.     

Surgical care in rural Canada: training and planning for the future.

The survey results reported by Chiasson and Roy in this issue (see pages 1447 to 1452) document a growing problem with the provision of surgical services in rural western Canada. Recognizing the need to improve access to surgical services in rural communities, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada have proposed guidelines for training family physicians in resuscitative and surgical techniques as well as in the safe transfer of seriously ill patients to specialized facilities. It is hoped that these guidelines will provide the basis of a national policy for general-practice training that will improve the standard of surgical care in rural communities.     

The future prospects for living wills.

Following the first enactment of living will legislation in California in 1976 the majority of the states of the USA have now passed similar laws. However, flaws have been identified in the way they work in practice and many states are considering reviewing their legislation. In Britain there is no legislation but the subject is currently commanding considerable interest. This paper assesses the future prospects for living wills in both the USA and Britain, analysing the different options available and comparing the two countries. If patients who become permanently incompetent are to have their previous autonomous decision-making respected, there is general agreement that advance directives for health care must be introduced. The difficulty is in deciding how to implement them, and especially whether this should be by statutory or non-statutory means, the traditions in the two countries being very different in this respect. It is concluded that whichever route is taken, promoting respect for patient autonomy is as much a matter for education and persuasion of doctors as of the adoption of particular instruments. Doctors should therefore be trained in what constitutes good medical practice in this area and, to ensure that it can be carried out properly, the general level of medical facilities for these patients must also be protected and promoted.