近观美国全科医生规范化培训有感

目的 实地了解美国全科医生规范化培训项目，为我国的全科医生培养提供参考。 方法 赴美国内布拉斯加大学医学中心(University of nebraska medical center,UNMC)参加全科医学师资培训，实地接触了解美国全科医生的规范化培训项目。 结果 美国全科医生的规范化培训项目发展比较成熟，培训效果较好，以下几点令人印象深刻:①培训项目设计严谨实用，确保经过培训的全科医生能够为居民提供安全、高质量、综合性、连续性的医疗照护。美国全科医生规范化培训项目专业设置全面，重视在社区诊所的培训和解决社区常见健康问题的能力，强调对临床实用技能的掌握，充分体现全科医学综合性、连续性的特点，不断强化全科医生的全科意识。②美国的全科医生以诊所服务、医院服务和护理院服务为主导，服务内容涵盖预防、保健、治疗、康复、健康教育等多个方面，并对慢性病患者和康复期患者进行持续追踪管理，真正实现为个人和家庭提供全面、连续的健康和医疗照顾。③注重医患沟通、提高人文修养是全科医生的必备技能，沟通技巧和人文关怀贯穿美国全科医生培训全过程和临床实践。以上几点可为我国的全科医生培养提供参考借鉴。 结论 标准化、规范化的住院医师培训项目是美国全科医生培养的基石，是美国高质量初级医疗卫生保健服务的关键。 

General practice residency training program in USA

Objective To learn more about general practice(GP)residency training program in USA and to provide helpful references to general practice training in China. Methods We went to University of Nebraska Medical Center(UNMC) and attended a training of GP faculty.During this time we got the facts of American GP residency training program and how American general practitioners worked. Results American GP residency training program had a relatively-mature development and had got well training effects.The following characters of the program were impressive.Firstly,the design of the program was strict and practical so as to ensure graduates provide safe,high-quality,comprehensive and continuous patient care in all settings.The program was designed with a broad range of block requirements and was focused on training the ability of solving common health problems and grasping common clinical techniques in community.Meanwhile,continuity clinic was designed in the training to allow graduates to provide comprehensive and continuous care.Secondly,American general practitioners provided medical service in clinic,hospital and nursing houses.The services ranged from prevention,health care,treatment,rehabilitation,and health education,etc.They also provide continuous management for patients with chronic diseases or in need of rehabilitation.In this way the general practitioners were able to provide comprehensive and continuous health care for patients and their families.Thirdly,communication and humanistic care were essential skills for general practitioners.American general practitioners paid more attention to communication and humanistic care for patients in both training program and their clinical practice.All of the above were valuable references to GP residency training in China. Conclusion Standardized and normalized residency training program is the footstone of GP training and the key guarantee of high quality primary care in USA.