醫學系一般公費生培育制度之檢討

我國醫學系一般公費生培育工作，自民國64年開始實施，至95年度我國共培育公費醫學生6183名，這些公費醫師初期對公立醫療機構的醫師人力有很大助力，也幫忙推動醫療網等公共衛生建設，但近年來我國專科醫師訓練制度已完成，這些醫學系公費生服務期滿後的執業狀況與原先政策所要求的提供偏遠地區醫療人力及平衡醫療專科發展兩大目標有很大的出入。研究顯示此制度只有分發的效應，沒有續留的效果，而且公費生醫師對此制度本身亦有很大的不滿，認為此制度僅滿足其成為醫師的願望，卻不能使公費生醫師持續具有服務偏遠地區或冷門科系的熱忱，因此行政院衛生署針對此現象深入檢討，並做適當的調整措施，也期待醫學先進們不吝給予指教。

關鍵字

醫學系公費生；醫師培育制度；職業選擇

並列摘要

In Taiwan, the public funded medical education program has two main purposes. Firstly, to provide highly qualified physicians that practice for a long period in medically underserved areas and secondly to balance the development across the full range of medical fields by targeting physicians into less attractive medical specialties. Since 1975 this program has generated more than 6000 capable physicians for our country. However, these two purposes have not been fulfilled. The most useful outcome of this program is that it has allowed individual doctors to fulfill their dream of a medical career; specifically, the public interest aspect of the program aimed at directing these doctors into specific fields and in specific geographical areas has failed. The main reason for this failure may be the selection process for the public funded medical undergraduates. High school graduates are selected forthis program based on their performance in the university entrance examinations. Their specific responsibilities to the program after training are beyond the understanding of these students at the beginning of their training and even doctors who have completed this program complain a great deal about the rigidity of the program's regulations and the frequent change in the program's regulations and restrictions. More than half of the doctors who have graduated through this program would not enter the program if they had a second chance to make the choice. Based on these facts, the Bureau of Medical Affairs, Department of Health, has advocated several measures to improve the situation in 2006. Further comments and advice would be appreciated in order to successfully modify this program.

並列關鍵字

public funded medical education program ； medical underserved area ； career choice

參考文獻

US Department of health and human resources(1980).Summary report of the graduate medical education national advisory committee.(Summary report of the graduate medical education national advisory committee).,::Washington (DC).

Google Scholar

Haviland MG,Werner LS,Behrens L(1995).Preparing for health care reform and an LCME site visit: addressing the generalist-non-generalist imblanace.Acad Med.70,298-304.

Google Scholar

Rabinowitz HK,Diamond JJ,Markham FW(1999).A program to increase the number of family physicians in rural and underserved areas: impact after 22 years.JAMA.281,255-260.