Training 300000 all-around doctor how to achieve goals

Healthday LiTianShu reporters

"The state council about building the general practitioner of the guiding opinion on system, put forward to 2012, each city community health service agencies and rural rural hospitals have qualified all-around doctor; And then after a few years efforts, basic form a unified and standard all-around doctor training mode and the primary in basic service mode, basic to realize the every residents 2 ~ 3 qualified the general practitioner, better for people with continuous coordination, easy and basic medical and health services.

The general practitioner of the core system, is also the most imminent, is how to solve the problem of the general practitioner staff shortages.

According to the Chinese health statistics yearbook disclosure of data, the whole country at present registered within the scope of the general practitioner 60000. The national development and reform commission, ministry of public health, the agency and staffing committee office, the ministry of education, ministry of finance, human resource and social security ministry "issued by the joint with the general practitioner of the base is to focus on the medical team construction planning" (referred to as "the plan") make goal is, from the beginning of this year, three years 60000 all-around-doctors training doctor, to 2020 300000 the general practitioner training.

How to achieve the goal of 300000 the general practitioner? "In the" human ailment support how to get enough?

China is now the general practitioner shortage 200000

Article 3-training methods

"We have more than 20 that the general practitioner, basically is the medical college graduate, go after graduation general medical education is the way." Guangzhou shenyang street community health service center JianZhenYao said.

This belongs to the liwan district guangzhou city center of community health service covered 50000 people and all-around doctor almost all came from the guangzhou medical college and guangdong medical specialty of clinical medicine in guangzhou medical college, and accept the general medical education training, through the examination to continue professional qualifications.

JianZhenYao told reporters that the years clinical medical students looking for work is difficult, want to stay in guangzhou, the community health service is a quite good choice, plus treatment improved, so lure students not before a few years so difficult.

According to the state council request to establish the general medical system, urban and rural per residents to equipped with two to three qualified the general practitioner, shenyang street community health service center has more than the standard. But according to the standard to calculate, China's 1.3 billion population needs at least 260000 the general practitioner, and now the country after registration within the scope of the general practitioner only 60000.

Beijing is medical resources quite centralized city, but by every 600 households in the family has a family doctor configuration of the community, the city planning team need community medical staff of about 30000 people, at present all the engineers community health technical personnel only 18710 people, the gap of nearly 12000 people.

How to solve the general practitioner source problem? Hebei medical university school of public health professor XiBiao points out, can only rely on long-term training and the way of the combination of the short-term training, solve the need and standardization training with a long cycle of the contradiction between.

According to information, the general practitioner of the way to train design article basically has 3: one is through the general medical direction of formal medical degree education and resident standardization training, also is through the national order directional free medical students' form; 2 it is through the job-transfer training ways to train the general practitioner, namely to on-the-job personnel for general medical job-transfer training, and to enhance its basic medical and public health service ability; 3 it is through the "5 + 3" of the medical education after graduation and standardized training to cultivate all-around doctor.

The expert points out, the planning of the training requirements three years 60000 all-around-doctors doctor, the task has been decomposition, a is through the standardized training, training way 10000 all-around-doctors doctor, 2 it is through the job-transfer training, training 50000 gp.

The general medical professional training

--by "spontaneous" to "orders"

"The capital university of medical sciences, is the earliest recruit general medical undergraduate universities in recent years, one of the undergraduate stop recruit, mainly of postgraduate education." The health ministry, deputy director of the general medical training center set up cui told reporters, general medical graduates is always a brain drain problem.

According to information, in recent years, many medical colleges started to recruit general medical professional, but from this year basic stop recruit. The reporter inquires guangzhou medical college, in 2010, the site was recruited 150 general medical student, but this year has no plans to recruit.

Medical colleges recruit general medical professional, directly in "ice hot double day" situation. Chongqing medical university a controller tells a reporter, a few years ago, the school had a pilot for 50 general medical students graduate, all loss, main reason is community treatment is too low, not attractive.

In the summary, and said, because no mandatory measures, the students' independent 'and two-way choice of graduate employment policy, is causes the graduates the reasons for the loss.

On the other hand, the community health service after all there is a huge gap, once the community medical service to improve living conditions, will make strong talent demand. One of the most obvious example is, guangzhou medical college graduates of 2007 general medical direction, community and local health bureau reserve, and a total of 100 DuoRen graduates only 60 DuoRen.

Now, by the ministry of education and the ministry of the common start rural order directional medical students free training project, will take over in the general medical training by the state as a whole, thinking, assume for the training of medical and health institutions engaged in general the burden of medical and public health experts.

Policies the invisible hand began to play a huge role. The reporter learned from the health ministry, this year's rural order directional medical students free training plan, is expected to train 5315 clinical medical students. Reporters from anhui province to realize, in 2011, the province rural order directional medical students free training project expanded to undergraduate course and specialized subject two levels, provincial medical college JiaoJun involved. In guangxi medical university set up specifically for general medical school.

The ministry of education JiaoYuSi priests ZhangDaLiang points out, higher medical students' free, during the period of school census register will still remain on the original census register seat, after graduation, according to the entrance of the directional obtain employment agreement signed before, to the basic medical and health institutions service in 6 years.

The expert points out, this a series of measures to solve the general medical training a few big "loophole" : the first is agreement in hand, need not worry graduates "active" loss; 2 it is free training have certain appeal that can attract the best students; 3 it is according to the needs, according to the needs of all training to plan as a whole number, before the change a single college recruit students independent of blindness.

The general practitioner job-transfer training

-" emergency "and a" transition"

"A few years ago we training more than 10000 all-around-doctors doctor, the focus of two years to change his/her training, finished last year, 1933 people this year is the task of 1300 people." The general practitioner training center in sichuan province, deputy director of LiShaoMin said that the task is arduous now, according to the regulation, job-transfer training mainly for basic-level medical health service agencies are ready to engage in general or medical clinical practice (assistant) doctors to perform, to accord with a condition, according to the needs of 1 ~ 2 years in the job-transfer training.

"Due to the medical college of general practitioners training ability is limited, with a long cycle, and job-transfer training can quickly for the medical service transportation of general practitioners, is nearly 3 years the general practitioner of the training of a transitional measures." The general practitioner job-transfer training plan of one of the XiBiao points out, job-transfer training all-around doctor than the other way more rapid, economic, and more suitable for our country's situation.

The reporter understands, the general practitioner job-transfer training into the medical system, the state council issued in the medical and public health systems five key reform 2010 annual main work arrangements ", "the basic medical and health institutions on-the-job personnel for the general practitioner job-transfer training" as an important task of cure of the state council, and as with all provinces, health ministry and provincial health department (bureau) of the task of cure of signed a responsibility of content.

After the graduation medical education

-" 5 + 3 "is the best model

"All-around doctor and the emergency clinician is like, are facing the different specialized subject of the patients should be promptly, sorting, processing, need to have very high quality." Beijing union medical college hospital emergency department director doctor WangZhong said.

In the general practitioner system design, the general practitioner gradually standard training for "5 + 3" mode, is the first to accept 5 years of clinical medical undergraduate education, to take three years of the general practitioner standardization training.

The expert points out, the training of the general practitioner mode, with foreign training similar to general practitioners, the general practitioner standardized training as the core, to develop a target has a solid medicine knowledge, after the standardized training knowledge wider, strong ability to business, and can be competent for the community. From long term goals look, this is undoubtedly a the best training mode.

The reporter understands, since 2005, have all over the country to promote "5 + 3" mode. Take it in the city of Beijing, relying on big city hospital established a general practitioner standardized training base, on into the community work 3 years the general practitioner of the training, and 2 years in the clinical, 1 year in rotation communities of practice.

From 2003 in to start "establish China's health ministry of diplomate training and access system" subject research, health ministry began the specialist training routine work to the Chinese medical doctor association, general medical and included in the specialized subject as an independent.

"The specialist training base, accord with the general practitioner of the general medical discipline rule." Health ministry department a controller told reporters. Need addressing a concept is, ordinary grassroots doctor only after training after the test to become the general practitioner, no get the qualification is community service. The doctor before

Doctors more practice

-attract talents flow down

Community why didn't attract the high-end talent? The move down "blocking point"? Cui set up points out, "upstream" problem solving and the key in "downstream". Not a good platform and ideal career development prospects, no good policy to attract talents to a primary.

Many experts argue that has not clarify the definition of the general practitioner, this is high-end talent to join the general practitioner team of obstacles. The China medical association general medical branch, the chairman of the committee GuYuan points out, the general practitioner of the realization of the system is an important premise, is to put the general practitioner responsibilities set clear. For example, the general practitioner is not a doctor, the crowd of public FangBao task is through teamwork implementation, the general practitioner's first task is to the community residents of common diseases and frequent disease and chronic disease management diagnosis and treatment.

GuYuan points out, attracting talents, must break the personnel system, now in the community health services, will the general practitioner of "units are" into a "social", makes the flow of talent more easily, human resource use more fully. The expert points out, improve the general practitioner treatment, must break "big-pot roce" circles, the identity of the change, make the general practitioner can through the signing of service model to earn income, income and service quality and quantity of the hook, will be able to solve the plight of low pay.

According to information from this year, Beijing since march the pilot "the doctors more practice", hope the great hospital doctor to community service to their community, the doctor appeal.

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Countries all-around doctor training mode

Britain is home to British community health service. Britain's general medical education system including medical undergraduate phase of the education, education and continuing education after graduation three stages. Medical students pass at least 5 years of medical college study, after the graduation, after a year of clinical practice to the British medical association to apply for the registration become a doctor and registered doctors about 48% eventually become the general practitioner.

After the graduation education is the general practitioner of training, known as the "key general medical professional training", the training process last 3 years, two of which were in the hospital clinical practice, 1 years of teaching experience in a high qualification of the general practitioner clinic study, finally need through the royal institute of the general practitioner exam.

The Dutch Holland is all-around doctor responsibility system is one of the countries to complete.

In June 1983, the Dutch gp general assembly unanimously passed the Dutch general doctors manual ", the system introduced the general practitioner duty, made clear the all-around doctor work content, also put forward the general practitioner in medical knowledge not only to be fully, and should have rich knowledge sociology, must learn to management and social communication cooperation.

Australian gp education system including Australia universities education, education and continuing education after graduation three stages. Already professional qualifications of the general practitioner must accept medical education, every year to continue to certain time higher levels of academic discussion and academic conference, each year 4 weeks or so off-job training, every three years by the national organization must be continuing medical education assessment and evaluation, eligible to continue to practice as a certified, to ensure that the general practitioner level of medical treatment of updates.

There are the urban and rural Australia of unbalanced distribution of the problem, for this 2009 proposed "rural all-around doctor incentive plan", the main measures including rural resettlement allowance, work of stability allowance, etc.

American students after four years college education, after graduation to enter oneself for an examination a medical college. Complete 4 years of medical school undergraduate course to medical degree, choice of family medicine as a professional direction of the medical graduates, to hold the family doctor (that is, other countries of the general practitioner) training project application, the hospital through competition and selection, into the family medical residency programs. Training time for 3 years, mainly for the previous two years in big hospitals, mainly in the third year training community clinic training. Three years after the training, to attend unified exam, eligible for family doctor qualification certificate.

In addition, the family doctor every six years must participate in the family medical committee organization family doctor qualification authentication, the authentication again again with the general medical education link, and then continue to ensure the basic service authentication in the family doctor its knowledge skills keep up with the new medical progress. (xinjiang) field