英国骨科医师培养体制简析与借鉴

Lessons from orthopedic surgeon training system in Britain

英国的骨科医师培养体制较为完备与成熟。医学生在完成医学院校教育后，先进行为期2年的基地培养（FY1、FY2），主要学习和巩固基础知识和基本临床技能。之后，将开始为期约6年的专科培训（ST1-6），专科细分为足踝、手、肩、肘、骨盆、膝、脊柱及小儿外科。专科轮转在各外围医院进行，定期回到总院参与创伤复习、教学查房、病例讨论等。相对于我国目前基于医院“单位人”的专科医师培养制度，英国骨科医师在培训阶段“社会人”的角色，更便于在大的教学区内各医疗机构中流动，从而使培训更为全面而专业。此外，我国缺乏专科医师资格的统一考核和准入制度，各医疗机构和医师自身也缺乏进行专科培训的意识。因此，我国应该逐步形成单一的学制，统一专科医师培训规范和考核标准，使各地培训的骨科医师能够更好地流动，以保证医学教育与医疗资源在全社会范围内公平共享。

The tralning system for orthopedic surgeon in Britaln is mature and complete. After completing education in medical college, medical students receive a 2-year base tralning （FY1, FY2）, which focus on learning and consolidating basic medical knowledge and clinical skill, followed by a 6-year specialist tralning, which subdivides into tralning of ankle and foot, hand, should and elbow, hip, knee, spine, and pediatric surgery, provided by several district hospital （Peripheral hospitals）. Students are required to return to teaching center for review, ward inspection, case discussion at regular inter-vals. Compared with the specialist tralning system based on the hospital ＂staffs＂ in chi-na, the role of＂social workers＂in British during the period of tralning makes better mobility of tralnee among medical institutions and medical treatments, which makes the tralning more comprehensive and professional. In addition, there is no consistent system for examination and admittance of specialist, and awareness of specialist tralning among medical institutions and doctors is weak. Therefore, it should be done to form a single tralning system and unify the tralning specification and assessment standard.