八十年代台灣施行學士後醫學系學制之經驗研究

Experience with Graduate-entry Medical Programs in the 1980s in Taiwan

蔡淳娟(Tsuen-Chiuan Tsai) ； 林其和(Chi-Her Lin) ； 劉克明(Keh-Min Liu) ； 賴其萬(Chi-Wan Lai)

《Journal of Medical Education》 12卷4期 (2008/12) Pp. 225-235

https://doi.org/10.6145/jme.200812_12(4).0004

摘要

我國於1982-1991年間有五所學校曾實施學士後醫學系學制，除了高雄醫學院外，其餘各醫學院均已停止辦理，此段期間的施行經驗及反省，可以提供醫學院學制與招生改革的重要參考。本研究主要以半結構訪談的方式，與當年創辦後醫系之學校領導者進行深入對談，研究結果顯示當年設置後醫系的原因多半由學校上層決定實施，或是基於行政考量而創辦，並未廣徵意見與共識即已施行。當年舉辦後醫系主要目的有二：一、培養偏遠地區醫師人力，二、培養基礎醫學研究人才，從實施結果來看，並未達到當初設立的目標。後醫系招生方式為筆試加上面談；配套措施上，並沒有為後醫系學生特別編擬課程，也沒有特別增加師資或其他資源；停辦的主因是學生的適應不良，導致後醫學生基礎醫學成績不如七年制學生，另外，學生過於注重務實面，無法選到真正有熱忱願意服務偏遠地區，或願意從事基礎醫學研究的醫學生。至於實施成效上，當年學校領導者均表示沒有達成預期目標，並且一致認為若要重新實施後醫系學制，不能是兩種學制同時存在，要先召開公聽會廣納各界意見，從入學招生方式、課程設計、教學方法及成效評量等，有一完整的規劃。面談方法與參與面談教師必須受過嚴謹規畫與訓練，此外還需一套健全的招生制度，才能挑到適合習醫的學生。為了確保畢業生的素質，他們建議施行醫學生的淘汰機制，讓不適合習醫的學生有機會轉換科系，或是設置醫預科學制，讓學生在決定習醫前先有準備。今日醫療環境與醫學教育變革反應出遴選醫學生與醫學院學制改革的重要性。

關鍵字

醫學教育 ； 學制 ； 招生 ； 後醫學制 ； 教育改革

並列摘要

In 1982~1991, graduate-entry medical programs (GMPs) were implemented in five medical schools in Taiwan. All of the GMPs have since been suspended, except the GMP at Kaohsing Medical University. Reflections derived from the GMP experience can provide valuable information for future curricular reform and student selection methodologies. By inerviewing the educational leaders who were in charge of implementing the GMPs, this study explored their rationale, implementation, and outcomes. Results: The drives for changes were top-down (i.e., initiated by leaders), with little communication with other stakeholders. The goals of the programs were to cultivate physicians for the underserved and researchers in basic medicine, and the program were considered to have failed to achieve these purposes. The methods of selecting students included written examinations plus interviews. Little curricular and manpower changes were made to the GMPs. Many of the selected students in the GMPs were deemed profit-oriented, and lacked passion for serving the underserved or pursuing basic sciences research. The GMPs were suspended mainly because of the poor performance in basic sciences when compared to that of undergraduate-entry medical programs (UMPs). To achieve the goals of selecting good doctors for the future, educational leaders suggested more communication about changes, and a systematic plan for student selection, curricular design, teaching strategies, and evaluations. To ensure student quality, there should be a mechanism of eliminating the unsuited and a good pre-med program before entering medical school. These research results can benefit medical curricular reform and improve student selection methodologies in Taiwan.

並列關鍵字

medical education ； curriculum ； entrance ； medicine for post-baccalaureate ； educational reform

參考文獻

Common program requirement

科學月刊

光華雜誌

王國照(2004).The comparison between medical students with postgraduate vs undergraduate background at Kaoshiung Medical College.International Conference on Medical Education.(International Conference on Medical Education).

黃天祥(2004).Experiences with post-college medical school education at National Taiwan University.International Conference on Medical Education.(International Conference on Medical Education).