Ansorg J, Hassan I, Fendrich V, Polonius M J, Rothmund M, Langer P
Berufsverband der Deutschen Chirurgen, BDC/Service, Berlin.
Dtsch Med Wochenschr. 2005 Mar 11;130(10):508-13. doi: 10.1055/s-2005-863084.
One of the reasons for young doctors to leave the clinical work to go abroad or into non-clinical fields is insufficient quality of training under bad circumstances. Aim of the study was to evaluate the surgical training in Germany from the viewpoint of the residents.
A questionnaire was prepared by residents and consultants and approved by the German surgical societies (Deutsche Gesellschaft fur Chirurgie und Berufsverband der Deutschen Chirurgen). It was sent to surgical residents between June 2003 and June 2004, published in "Der Chirurg BDC" and distributed among residents taking part in courses conducted by the BDC. It could be answered anonymously by email, mail or online.
The questionnaire was sent back by 584 surgical residents (about 30 % of all). 58 % of the residents declared that they finished the training in the intended time (6 years). Rotation-systems as part of a structured residency program existed for 43 %. Standard surgical procedures were discussed or explained before the procedure in only 46 %. 61 % of the residents were not satisfied with the teaching assistance by their clinical teachers in the OR. Only 33 % had regular talks with the Chief about their progress in surgical training. 18 % of residents felt, that the hospital is interested in their progress in training. Indication-conferences took place in 52 % and mortality-conferences in only 20 % of programs. Regular seminars on recent issues took place in 62 %, and 61 % of residents did not get financial support to attend congresses. 36 % of residents had to use their holidays to attend congresses.
Surgical training structures are not well established in about 50 % of the training hospitals from where we got answers to our survey. The training potential of daily surgical work is not used appropriately. It is therefore imperative to develop guidelines for surgical training, the use of log-books and rotation-programs.
年轻医生离开临床工作转而出国或进入非临床领域的原因之一是在恶劣环境下培训质量不足。本研究的目的是从住院医生的角度评估德国的外科培训。
由住院医生和顾问编制了一份问卷,并得到德国外科学会(德国外科协会和德国外科医生职业协会)的批准。该问卷于2003年6月至2004年6月发送给外科住院医生,发表在《Der Chirurg BDC》上,并分发给参加BDC举办课程的住院医生。可以通过电子邮件、邮寄或在线方式匿名回答。
584名外科住院医生(约占总数的30%)回复了问卷。58%的住院医生表示他们在预期时间(6年)内完成了培训。43%的培训存在作为结构化住院医师培训计划一部分的轮转系统。只有46%的标准外科手术在术前进行了讨论或讲解。61%的住院医生对临床教师在手术室的教学帮助不满意。只有33%的人定期与主任谈论他们在外科培训方面的进展。18%的住院医生认为医院对他们的培训进展感兴趣。52%的培训项目召开了适应症会议,只有20%召开了死亡率会议。62%的培训项目定期举办关于近期问题的研讨会,61%的住院医生没有获得参加学术会议的资金支持。36%的住院医生不得不利用假期参加学术会议。
在我们进行调查并收到回复的培训医院中,约50%的医院外科培训结构不完善。日常外科工作的培训潜力没有得到充分利用。因此,制定外科培训指南、使用日志和轮转计划势在必行。