Ashpole R D
University Hospital, Queen's Medical Centre, Nottingham, UK.
Br J Neurosurg. 2000 Jun;14(3):235-9. doi: 10.1080/026886900408423.
In the UK there are currently great changes taking place in both higher surgical training and consultant practice. Australia inherited the British system, many aspects of which it retains, but has moved to a US type training programme. Recent experience of British and Australian neurosurgical practice allows useful comparisons to be made with possible benefit to both. Neurosurgery in Australia is a more consultant based service than that in the UK, with 73 consultants for a population of 18 million. Consultants work primarily from their private rooms and consultant numbers in the public sector are misleading as few of them approach full time. Neurosurgical training is organized on a national basis with a finite training programme. This consists of a rotation of different jobs supplemented by consultant led lectures and tutorials. Training is regularly monitored, with a final exit examination. The disadvantages are the relative lack of operating whilst training, many neurosurgeons becoming accredited with the personal operating experience expected of a British registrar; and the working hours; most trainees work 1 in 1, which precludes any sort of normal family life. In summary, the relative strengths of the British and Australian systems are largely complementary, there being ample scope for each to learn from the other.
在英国，目前高等外科培训和顾问医师执业方面都正在发生巨大变化。澳大利亚承袭了英国体系，且保留了其中许多方面，但已转向美国式的培训项目。英国和澳大利亚神经外科执业的近期经验使得双方能够进行有益的比较，有望实现互利共赢。与英国相比，澳大利亚的神经外科服务更多地以顾问医师为基础，在1800万人口中有73名顾问医师。顾问医师主要在他们的私人诊室工作，公共部门的顾问医师数量具有误导性，因为其中很少有人是全职工作。神经外科培训在全国范围内进行组织，有一个限定的培训项目。该项目包括不同工作岗位的轮转，并辅以顾问医师主导的讲座和辅导课程。培训受到定期监督，还有结业考试。其缺点在于培训期间相对缺乏手术实操机会，许多神经外科医生获得认可时的个人手术经验仅达到英国住院医师的预期水平；以及工作时长方面，大多数学员实行一周一轮换值班，这使得任何正常的家庭生活都无从谈起。总之，英国和澳大利亚体系的相对优势在很大程度上具有互补性，双方都有很大的相互学习空间。
