北京大学医学部全科住院医师规范化培训的探索与实践

The exploration and practice of general practice residents standardized training in Peking University Health Science Center

随着国家深化医药卫生体制改革意见的出台,健全基层医疗服务体系是深化医改的重要举措。全科医学的发展是分级诊疗实施的关键,而人才培养是学科发展的核心环节。全科医生是综合程度较高的复合型临床医学人才,承担着基层常见病多发病诊疗、预防保健、慢性病管理等连续性医疗服务,管理人群涉及不同性别年龄及其所处的生理、心理、社会等各层面的健康问题。因此,全科医生的培养内容须涵盖医学相关的诸多领域。目前我国基本确立了以"5+3"为主体、"3+2"为补充的全科医生培养模式。全科住院医师规范化培训是培养高质量全科医生的最佳途径。北京大学医学部全科医学学系自2011年开展全科住院医师规范化培训以来,积极致力于探索符合我国国情、适应行业特点、满足患者需要的全科医生培养道路。经过近8年的实践,在管理体系建设、优化培训策略、基于"岗位胜任力"培养方面,积累了丰富的经验并取得了良好的效果。从建立全科住院医师项目委员会管理队伍建设和严格师资队伍选拔方面完善培训体系;从优化导师管理并通过学员反馈优化医院及社区轮转方案提升培训质量;采取以形成性评价和终结性评价相结合的特色多样化评估手段,阶段性稳步提升学员技能,以"岗位胜任力"为目标培养优秀全科医学人才。探索规范高效、可复制、可推广的全科住院医师规范化培训体系,为实现全科人才培养的可持续发展进行了有益的探索。

With the introduction of the national opinion on deepening the reform of health care system reform, improving the basic medical service system is an important measure to deepen medical reform. The development of general practice is the key to the implementation of hierarchical medical system and talent training is the key link of the disciplinary development. General practitioners are interdisciplinary clinical medical talents with a high degree of integration. It has undertaken continuous medical services such as diagnosis and treatment of common diseases, preventive health care and chronic disease management. The people management involves different ages of sex and their physical, psychological and social health problems. Therefore, the training of general practitioners should cover many fields related to medicine. At present, China has basically established a general practitioner training model with ＂5 ＋ 3＂ as the main part and ＂3 ＋ 2＂ as the supplement. General practice residences standardized training is the best way to train high quality general practitioners. Since 2011, the department of general practice in Peking University has carried out standardized training for general practitioners, actively committed to exploring ways to train general practitioners in line with China＇ s national conditions, adapt to the characteristics of the industry and meet the needs of patients. After nearly eight years of practice, we accumulated rich experience and achieved good results in the management system construction, the optimization training strategy and competency based training. The training system has been improved from the establishment project committee of general practitioners to management team construction and strict selection of faculties. We improved the training quality from tutor management and optimized hospital/community rotation program through the feedback of trainees. A characteristic and diversified evaluation method combining formative assessment and finalization assessment was adopted, in order to steadily improve the skills of the students, and training excellent general practitioners with the aim of ＂competency based＂. The department of general practice in Puking University had explored the general practice residences standardized training system with high quality and can be generalized and duplicated. It has been made beneficial exploration to achieve sustainable development in train qualified general practitioner.