全科医学教育的师资标准研究——学徒式培训的启发

General Practice Education and Training-Could China Adopt Australian Apprenticing Model?

澳大利亚全科医学培训是通过学徒式教育方式,让全科医生培养全科医生,使学员掌握全科医学实践的本领,有能力提供基本的、预防的、病人为中心的、综合的、连续的、在社区提供的服务。而实现这个培训目标的师资主要依靠优秀的全科医生。为保证全科医学培训的质量,澳大利亚制定了师资和培训场所标准,规定了师资的基本条件、第一年培训的师资条件、培训过程要求和培训场所要求。中国目前的全科医学师资主要是大学理论老师和医院专科专家,师资队伍学究化和专科化倾向严重。由于过度强调学历和职称,工作在基层的有经验的社区医生往往不能进入师资培养计划中。作者认为,继承和发扬传统的师承教育方法,选拔和培训优秀的社区医生担当师资,并让他们逐步成为全科医学教育和培训的主力,这样才能培养出符合全科医学学科特征和服务于社区人群的、具有实践操作能力的全科医生。

Objective Apprenticing model of training is a feature of Australian general practice training and education program. General practitioners provide training in practice. This model can make the trainees get the skills for general medical practice by providing primary, preventive, patient - centred, comprehensive, continuous and community - based services. Outstanding general practitioners are major force of the training program. To guarantee the quality of general practice training RACGP issued standards for general practice training and education, which defined the basic conditions of trainer, the conditions of trainer for the first year training, the demand for the procedure and site of training. China＇s general practice trainers were dominated by university teachers with non -clinical experiences and hospital specialists with specific clinical skill and knowledge. As result of over- emphasizing higher education background and clinical specialist title, community doctors, especially traditional Chinese medical practitioners, almost have no chance to be selected as general practice trainers. Authors hold that apprenticing model of training should be carried on and developed by selecting and training the outstanding community doctors to be trainers, and gradually choosing them to be the major force in general practice training and education. Thus the general practitioners can be trained who are of feature of general practice, can provide community patient based services, and possess practical skills.