基于病案信息对我市现行妇产科住院医生培训指标的评价

Evaluation of training index system of the residents of obstetrics and gynecology in Beijing on the basis of medical record information

目的分析妇产科住院医师在规范化培训期间实际管理病种及手术操作的情况,为建立科学合理的培训标准提供参考依据。方法基于北京市某三甲妇产专科医院2012-2014的病历信息进行分析,与目前实施的《北京地区妇产科住院医师规范化培训细则(2013版)》进行比较。结果住院医师病种和手术例数指标基本达标,住院医师经过规范化培训具备基本的临床工作能力。子宫内膜息肉和子宫颈上皮内瘤变(CIN)Ⅲ级两个妇科病种实际发生例数较多,但《细则》中缺少相应的培训要求。重症病例实践匮乏。妇科手术全部达标;产科手术中,人工破膜、会阴侧切缝合术和手剥胎盘三项未满足细则要求的最低例数。结论教学医院缺少必要的重症病例、常见小手术操作机会供住院医师学习,目前实施的《北京地区妇产科住院医师规范化培训细则(2013版)》需要补充完善。

Objective To analyze the practical cases and operations in the residents training of obstetrics and gynecologyduring their standard training,so as to establish the scientific training standards.Methods Based on medical recordinformation from2012to2014in a big maternity hospital in Beijing,we compared the practical cases and operations ofthe residents with the Rules for standardized training of residents in obstetrics and gynecology in Beijing.Results Mostresidents fulfilled the set quota by the Rules,which means that they have got the basic clinical ability after the training.Bothendometrial polyps and cervical intraepithelial neoplasia(CIN)Ⅲwere the leading cases in gynecological disease,whereasthere is no corresponding requirements in the Rules.There was alack of severe cases for the residents to practice..The numberof gynecological operations met the requirements of the Rules.There were three types of obstetricoperations,includingRAM,lateral episiotomy suture and placental abruption,in which the residents failed to meet the lowest requirements of theRules.Conclusion The training hospitals should provide enough severe cases and common minor surgery for residentstraining,and Rules for standardized training of residents in obstetrics and gynecology in Beijing needs to be modified.