一般內科訓練：基層醫療的觀點

醫學應該是以人爲中心的全人照護。但是，隨著醫藥知識的爆發，高科技醫療的突飛猛進，醫學教育逐漸朝向科學知識的傳授、疾病的診斷以及高難度技術的訓練，於是乎，「依器官系統而細分的專科領域越來越受到重視」，相對的，一般內科，尤其是基層醫療的訓練却被忽視。結果，年輕醫師偏重於檢驗，重視疾病的診斷以及科技層面的探討與學習，但忽視『病人的整體照護以及醫療的人性藝術層面的關懷』。最後，造就了許多欠缺一般內科素養的專科醫師（或醫匠），後果是病人受害，醫療費用高漲，幷且具「醫者之心」的良醫愈來愈少。如何以嚴肅而神聖的態度謀思改進，將是目前肩負醫學教育工作者，尤其是臨床醫學教育工作者，責無旁貸的重責大任。

關鍵字

一般內科訓練；基層醫療；臨床醫學教育

並列摘要

The science of medicine should be a holistically humanistic endeavor. However, with the explosion of medical knowledge and drastic technological advances in this rapidly growing age of information, medical pedagogy is becoming increasingly geared towards technology, diagnostic techniques, and applied technical training. There is an ever-increasing emphasis upon areas of specialty. As a result, the discipline of general internal medicine is ignored, especially in the training in primary care medicine. Physicians in training focus upon acquiring the ability to interpret laboratory results, diagnose diseases, and apply appropriate technology, all at the expense of addressing, in a holistic manner, the patient's basic needs. Ultimately, this pedagogical orientation makes for an environment where trained specialists are unfamiliar with the tradition of caring for the patient as an individual. There exists a void between technical data and the medically informed intuition that is gleaned from a patient whenever the doctor is in touch with that patient. Within this void, proper diagnoses can be found but are frequently overlooked, which can result in an increase in the patient's suffering, not to mention higher medical costs. One of the greatest challenges today for medical pedagogues, especially within the area of clinical medicine, is to reinstate an ethics of patient care which fosters, along with technical advances, humanistic concerns.

並列關鍵字

Training in general internal medicine ； primary care medicine ； Education in clinical medicine

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一般內科訓練：基層醫療的觀點

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