谈全科医学的教学团队

TeachingFamilyMedicine:

WhoShouldDoit?

全科医学教学团体ChrisJenkins,MDFamilyMedicineEducationInternationalBeijing谈全科医学的教学团队第1页ProgramImplementation–Overview

项目实施—概况TosuccessfullyimplementaCurriculumorProgram,thedevelopermustensure:为了成功地实施一个课程或项目，领导者必须确保：Sufficientresources充分资源Politicalandfinancialsupport政治和财政支持DevelopmentofeffectiveAdministrativestrategiesofsupport发展支持有效管理策略Tobesuccessfulaprogram

musthavegoodteachers取得成功前提是好师资谈全科医学的教学团队第2页IdentificationofResources判定资源Personnel人力Time时间Facilities设备Funding/Cost经费谈全科医学的教学团队第3页Identification/AssessResources

判定/评定资源

Personnel人力资源Faculty教职员Adequatenumbers充分数量Teachingandcontentskill教学技巧Facultydevelopment教职员得到发展Secretarial/Othersupportstaff秘书/其它支持人员Prepare/distributecurricularmaterials,schedulesevaluationtools,etc.准备/分发课程材料，日程表，评定工具等Generalsupportoflearningactivities对于教学活动总体上支持Patients-adequatenumbersandvariety病人-数量充分病种多样谈全科医学的教学团队第4页Identification/AssessResourcesTime

判定/评定资源时间Faculty教职员Preparation/Teachingtime准备/教课时间Plan/Administerthecurriculum计划/管理课程安排Learners学习者Scheduledlearningactivities计划好学习活动Read/IndependentLearning阅读/独立学习Clinicalrotations临床轮转Supportstaff支持工作人员谈全科医学的教学团队第5页FormFollowsFunction

形式由功效而定“Familyphysiciansacquireandmaintainabroadandvaryingarrayofcompetencies,dependingupontheneedsofthepopulationstheyserve,thecommunitiesinwhichtheypractice,andtheenvironmentsinwhichboththeyandtheirpatientsworkandlive.”全科医生需要并具备能力范围很宽，会因他们服务人群、从事医疗小区、他们及病人工作生活环境不一样而有很大不一样。谈全科医学的教学团队第6页LookingIntoTheFuture展望未来WhatwillbetheneedsofChinaforhealthcare?中国对于健康照料需求是什么？Whatdoesthegovernmentperceiveyourroletobeandwhataretheirexpectations?政府认为你角色是什么？政府期望是什么？Howwillfamilypracticeintegrateintothecurrenthealthcaresystem?全科医学怎样整合到当今医疗体系中？HowwilltheChinesepopulationreacttothis

typeofspecialist?中国人对这种全科类型专科医生有什么反应？谈全科医学的教学团队第7页OurRoleAsFamilyPhysicians全科医生角色Beingabletofulfillalloftheserolesrequiresustohaveclinicaltraininginsettingswherepatientswillfindthemselveswhenillorinneedoftheirdoctor:病人生病或需要医生帮助时会去哪些地方，全科医生就需要在那些环境里受过培训以胜任在那个地方工作角色。Outpatientdepartment门诊Hospital医院IntensiveCareUnit重症监护病房OperatingRoom手术室HospiceUnit临终关心机构DeliveryRoom分娩室Nursery婴儿室谈全科医学的教学团队第8页RuralorUrban:农村或城市

DoFPbelongonlyinruralareas?

家庭医生只属于农村地域吗？NeededinRuralareas:villages,towns,smallcities在村、镇、小城市等农村地域需要：Notenoughspecialiststosupplyallsmalltowns没有足够教授能够为全部小镇提供医疗服务Notenoughdemandtosupportalltheotherspecialties

没有那样多对全部专科医疗需求FP/GPneedstobewelltrainedtohandlemanycomplexproblemsandprocedures家庭/全科医生需要得到很好培训以应付很多复杂问题和操作9谈全科医学的教学团队第9页RuralorUrban:农村或城市

DoFPbelongonlyinruralareas?

家庭医生只属于农村地域吗？NeededinUrban/cityareas在城市也需要SpecializationisoneofthereasonsFMisneeded需要家庭医生一个理由是专科化Managementofcareisevenmorecritical更为关键是健康照料管理Costcontrol费用控制Prevention预防谈全科医学的教学团队第10页TrainingoftheRuralFamilyPhysician培训乡村全科医生Consideraccesstomedicalspecialists考虑到有使用专科医生权利RemotenessofPractice实践地点遥远Competent,comfortable,andconfidentinpractice对医疗实践感到能胜任、舒适而且自信Trainingtobemoreindependent:Limitedaccesstomedicalservices受过训练愈加独立：取得医疗服务受限Willneedaddedtraininginsurgical,procedural,obstetrical,andemergencyskills需要增加手术、操作、产科和急诊方面培训。谈全科医学的教学团队第11页PreparingFamilyPhysicians

forRuralAreas

让全科医生为乡村地域做好预备BroadMedicalTraining广泛医学培训Proceduraltraininginskillsthatarenoteasilyavailable操作培训那些不易得到技能Overseeingotherhealth-careproviders监督其它医务工作者Nurses,Physicianassistants,Nursepractitioners,PublicHealthpersonnel护士、医师助理、执业护士、公卫人员Knowingwhentorefer知道何时转诊Knowingyourlimitations知道你限制Comfortableinyourchosenscopeofpractice在选定执业范围内感到舒适自信谈全科医学的教学团队第12页PreparingFamilyPhysicians

forLargerCities让全科医生为大城市做好预备BroadMedicalTraining广泛医学培训Understandingofhowtousemedicalsystemresourcestothebestadvantageofthepatient了解为了病人利益怎样利用医疗体系资源Trainedtoknowwhattherestofthemedicalsystemhastooffer受过训练知道医疗体系哪些医疗资源能够利用Proceduraltraining操作技能培训谈全科医学的教学团队第13页PreparingFamilyPhysicians

forLargerCities让全科医生为大城市做好预备Overseeingotherhealth-careproviders监督其它医务工作者Nurses,Physicianassistants,Nursepractitioners,PublicHealthpersonnel,etc护士、医师助理、执业护士、公卫人员等Managementofcaregiventothepatient管理给予病人健康照料Knowingwhentorefer知道何时转诊Knowingyourlimitations知道你限制Comfortableinyourchosenscopeofpractice在选定执业范围内感到舒适自信Knowswhattests,procedures,treatments,paramedicalresourcesareavailablelocally知道当地有哪些化验、手术操作、治疗、医疗辅助资源谈全科医学的教学团队第14页WhoshouldTeachGP’s?

谁教全科医生？

PreparingtheTeachersofFamilyMedicine

准备好全科医学老师Generalpracticedoctors全科医生Specialistsingeneralpractice全科医疗中专科医师Needprimarycareperspective需要有初级保健洞察力Globaloutlook整体眼光Practicalclinicalskills实用临床技能NoteasytofindGPspecialistswhenGPisnew全科医疗是新，不轻易找到全科专科医师谈全科医学的教学团队第15页WhoshouldTeachGP’s?

谁教全科医生？

PreparingtheTeachersofFamilyMedicine

准备好全科医学老师Specialists专科医师Neededfortraininginspecialtyareas在专科领域需要他们来参加培训Needtheirexpertise需要他们专门技能Needtheircooperation需要他们合作SpecialistsneedtounderstandtheneedforandroleofGP专科医师需要了解全科医生需要和角色谈全科医学的教学团队第16页GeneralPracticeSpecialistTeachers全科专科老师Passionforgeneralpracticespecialty热爱全科这个专业Excellentbroadknowledgebase良好广泛知识基础Excellentclinicalskills良好临床技能Excellentdoctorpatientrelationshipskills良好医患关系技巧Excellentproceduralskills良好手术操作技巧Excellentteachingability良好教学能力谈全科医学的教学团队第17页SpecialistTeachers专科老师UnderstandandvaluetheroleofGPinthemedicalsystemandforpatienthealth了解并重视全科医生在医疗体系及病人健康中作用Recruitedfortheirteachingability因他们教学能力而被纳入进全科教学团体UnderstandstheroleoftheotherspecialtiesinpreparingnewGPs.了解在准备新全科医生时，其它专科医生任务TheyshouldunderstandwhatpartoftheirspecialtyGP’sneedtoknow了解在他们专科范围内全科医生需要知道哪些部分Theydon’tteacheverything他们不需要教全部TheyknowthecommondiseasesGPsneedtotreat他们了解全科医生需要治疗常见病谈全科医学的教学团队第18页SpecialistTeachers:WhichOnes?

专科老师：哪些人？SpecialistsfromalltheorgansystemareasthatGPswillberesponsiblefortreating全科医生有责任治疗、全部器官系统所包括专科Internalmedicine内科Cardiology心脏病学Pulmonology肺病学Gastroenterology胃肠病学Hematology血液学Infectiousdisease感染性疾病Neurology神经病学Rheumatology风湿病学Endocrinology内分泌学Nephrology神经病学Ophthalmology眼科Otorhinolaryngology耳鼻喉科Dermatology皮肤科Others其它谈全科医学的教学团队第19页SpecialistTeachers:WhichOnes?

专科老师：哪些人？Pediatrics儿科医生Cardiology心脏病学Pulmonology肺病学Gastroenterology胃肠病学Dermatology皮肤科Endocrinology内分泌科Otorhinolaryngology耳鼻喉科Neurology神经病学Rheumatology风湿病学Ophthalmology眼科Others其它谈全科医学的教学团队第20页SpecialistTeachers:WhichOnes?

专科老师：哪些人？Surgical手术Orthopedics骨科Generalsurgery普外科Dermatology皮肤科Obstetrical产科Gynecological妇科谈全科医学的教学团队第21页SpecialistTeachers:WhichOnes?

专科老师：哪些人？ObstetricianGynecologists妇产科Obstetrics产科Normalpregnanciesanddeliveries正常妊娠和分娩Abilitytorecognizehighriskpregnanciesandconsultortransfercarewhenneeded识别高危妊娠，当必要时请求转诊或会诊能力Gynecology妇科Normalandpathologicalconditions正常和病理情况Infectious感染Surgical手术Menarche初潮Menopause绝经Endocrinological内分泌谈全科医学的教学团队第22页SpecialistTeachers:WhichOnes?专科老师：哪些人？BehavioralMedicine行为医学Psychiatry精神病学Psychology心理学Counseling心理咨询谈全科医学的教学团队第23页ParamedicalTeachers:WhichOnes?医辅专业教师：哪些人？Pharmacists药剂师Therapists(physical,occupational,speech,others)理疗师（身体，职业，语言及其它）Dieticians营养师SocialWorkers社会工作者Nursespecialistsifavailable护士教授（假如有话）谈全科医学的教学团队第24页CurriculumofSpecialistTeachers专科教师课程Commondiseasesineachspecialty每个专科中常见病Commonprocedureswhenpracticalandneeded实用、必需常见操作Curriculumdevelopedtogetherwithprimarycarefacultyandotherspecialists课程设计由全科教职员和其它专科医师共同完成AAFPandABFMdevelopedmostoftheircurriculumincooperationwiththeotherspecialties美国家庭医生协会和家庭医学委员会课程安排都是和其它专科医生共同制订Whattorecognizeandtreat认识和治疗什么Whatprocedurestodo做哪些操作Whattorefer什么情况下转诊谈全科医学的教学团队第25页CVRequirements心血管专业培训要求

谈全科医学的教学团队第26页CVRequirements心血管专业培训要求谈全科医学的教学团队第27页TrainingSitesofGPandSpecialistTeachers

全科医生和专科师资培训地点Outpatientdepartment门诊部Hospital医院IntensiveCareUnits重症监护病房Emergencydepartment急诊科Oldpeople’scarehomes养老院Occupationalmedicine职业病学Whereverthespecialistpracticesthetraineeshouldbeincluded专科医生不论在哪里工作，受训者都应该被包含进来WherevertheGPwillpracticetheGPshouldbetrained;wherevertheGPwillreferpatientstheGPshouldbetrained全科医生将在哪工作就应该在哪里得到培训；全科医生往哪里转诊病人，就应该在哪里得到培训。谈全科医学的教学团队第28页SpecialistTeachers专科师资TreatGPtraineesequallywithspecialtyresidents平等地对待全科和专科住院医生TeachGPstudentswiththesamepositiveattitudegiventotheirownspecialtytrainees用给予本专业住院医生一样正面态度对待全