美國内科住院醫師訓練

Internal Medicine Residency Training in the United States

朱宗信(Tzong-Shinn Chu) ； 張家勳(Chia-Hsuin Chang) ； 謝博生(Bor-Shen Hsieh)

《Journal of Medical Education》 10卷4期 (2006/12) Pp. 267-275

https://doi.org/10.6145/jme.200612_10(4).0002

摘要

美國住院醫師訓練的目標依Accreditation Council for Graduate Medical Education的建議是培訓住院醫師六項核心能力，即病人照顧、醫學知識、臨床工作中的學習與改善、人際關係與溝通技巧、專業素養，以及制度下的臨床工作。多數醫學院內科提供的住院醫師訓練分為三大類：一為傳統路徑；二為primary care internist路徑；三為preliminary路徑。在美國，為便於住院醫師訓練，內科病房大多是一般內科病房。住院醫師的門診及急診訓練占訓練總時數三分之一以上。內科住院醫師訓練期間為三年，包括至少30個月的一般內科、內科次專科、加護醫學、急診醫學訓練。近幾年來，美國內科住院醫師訓練完畢者每年約7千名，內科專科執照通過率約90%。目前美國內科執業模式可分為三類﹕一般內科醫師、住院病患專責醫師、次專科醫師。為了拉近住院醫師訓練與執業之差距，住院醫師訓練時間要合理分配到各項執業模式並執行高品質、安全、有效、全人醫療之訓練。

關鍵字

美國 ； 内科 ； 住院醫師訓練

並列摘要

The Accreditation Council for Graduate Medical Education (ACGME) of the United States has endorsed general competencies for residents in the areas of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. Departments of internal medicine in American medical schools provide three internal medicine residency pathways: a preliminary pathway, the traditional pathway, and the primary care internist pathway. Most internal medicine wards are general wards. A minimum of 1/3 of training time must be spent in ambulatory sites. The 36 months of frill-time medical residency education must include at least 30 months of general internal medicine training, subspecialty internal medicine, critical care medicine, and emergency medicine. From 2001 to 2005, there were about 7000 first-time takers of American Board of Internal Medicine (ABIM) Internal Medicine Certification Examination per year, and their pass rates were approximately 90%. It is recognized that internal medicine practice has evolved three models of practitioners: general internists, hospitalists, and subspecialists. To close the training-practice gap, internal medicine training must provide a balanced allocation of time for each practice model, as well as additional education aimed at understanding and using tools for delivering safe and effective, high-quality patient care.

並列關鍵字

United States ； internal medicine ； residency training

參考文獻

Newton DA,Grayson MS(2003).Trends in career choice by US medical school graduates.JAMA.290,1179-1182.

Brotherton SE,Rockey PH,Etzel SI(2005).US graduate medical education, 2004-2005.JAMA.294,1075-1092.

Accreditation Council for Graduate Medical Education: ACGME outcome project: general competencies

Charap MH,Levin RI,Pearlman RE(2005).Internal medicine residency training in the 21st century: aligning requirements with professional needs.Am J Med.118,1042-1046.

Arora V,Guardiano S,Donaldson D(2005).Closing the gap between internal medicine training and practice: Recommendations from recent graduates.Am J Med.118,680-685.