Lie Desiree A, Boker John R, Lenahan Patricia M, Dow Emily, Scherger Joseph E
Department of Family Medicine, Division of Faculty Development, University of California, Irvine, Orange 92868-3298, USA.
Fam Med. 2004 Nov-Dec;36(10):739-46.
There are few reports of systematic international physician development programs to create family medicine as a new specialty in a developing nation. This paper describes the process and outcomes of a large-scale effort to initiate new family medicine training through the Egyptian Ministry of Health and Population (MOHP) using a 12-week US-based program at the University of California, Irvine (UCI).
Generalist physicians (n=134) with 1 year of internship training, currently working under the MOHP in Egypt, were competitively selected to participate in a training program at UCI between 1998 and 2002. Participants were assessed before, during, and after the program using multiple measures of competencies in family medicine topics, practice, and teaching. Aggregate participant data, post-program quality surveys, and follow-up surveys of the program's influence on practice behaviors comprised the main measures used for program evaluation.
Participants showed improvement in knowledge and skills for family medicine practice and teaching for topics covered in the program. After returning to Egypt, 98% reported continued use of their newly acquired skills and knowledge. Participants reported that the program advanced their careers, they taught family medicine to other physicians, and they were likely to pursue certification under a newly established Family Medicine Board of Egypt. Self-reported practice in family medicine increased to 69% after the program versus 16% before.
Overseas training programs are a viable method of introducing family medicine as a new clinical specialty. Ingredients for successful implementation and barriers are discussed.
关于在发展中国家创建家庭医学这一新专业的系统性国际医师培养项目的报道很少。本文描述了通过埃及卫生与人口部(MOHP),利用加利福尼亚大学欧文分校(UCI)为期12周的美国项目开展新的家庭医学培训的大规模努力的过程与成果。
从目前在埃及卫生与人口部工作、已完成1年实习培训的全科医师(n = 134)中竞争性选拔出参与者,于1998年至2002年参加UCI的培训项目。在项目前、中、后使用多种家庭医学主题、实践和教学能力测评方法对参与者进行评估。参与者汇总数据、项目后质量调查以及关于该项目对实践行为影响的后续调查构成了用于项目评估的主要指标。
参与者在项目涵盖的家庭医学实践和教学主题的知识与技能方面有所提高。回到埃及后,98%的人报告继续运用新获得的技能和知识。参与者报告称该项目推动了他们的职业发展,他们向其他医师传授家庭医学,并且他们很可能会根据新成立的埃及家庭医学委员会进行认证。项目后自我报告从事家庭医学实践的比例从之前的16%增至69%。
海外培训项目是引入家庭医学作为新临床专业的一种可行方法。文中讨论了成功实施的要素和障碍。