Gordon Gregory, Vongvichit Eksavang, Hansana Visanou, Torjesen Kristine
Harvard Vanguard Medical Associates, 133 Brookline Avenue, Boston, MA 02215, USA.
Acad Med. 2006 Apr;81(4):399-404. doi: 10.1097/00001888-200604000-00016.
The Faculty of Medical Sciences of the National University of Laos, in partnership with Health Frontiers, an American nonprofit organization, Case Western Reserve University of Cleveland, Ohio, and Khon Kaen University of Khon Kaen, Thailand, administer a postgraduate internal medicine training program for Lao physicians. Begun in 2001, the program admits six participants per year; participants complete clinical rotations in three hospitals in Vientiane, Laos, as well as one other clinical site. The goal of the program is to prepare a core group of local physicians to deliver healthcare, and train others according to an international standard of care. The program has two exceptional features. First, the vast majority of the training takes place in Laos. This avoids the "brain drain" that can occur when nationals of developing countries train abroad. In addition, because the training uses personnel, facilities, and technology available locally, graduates are better prepared to serve the needs of the Lao people. Second, the partnership is an all-volunteer model, committed to a long-term undertaking. American-trained specialists who live in Laos are available to work with the participants on a daily basis. Participants have a long period of time to acquire, reinforce, and be tested in new knowledge and benefit from learning from American colleagues who model an evidence-based approach to medical care, while still working in local conditions. As more Lao physicians receive this level of training, the program will become locally sustainable and help break a cycle of dependency on foreign expertise within the Lao health care sector. Preliminary results suggest that the program is succeeding, and could be replicated elsewhere.
老挝国立大学医学科学院与美国非营利组织“健康前沿”、俄亥俄州克利夫兰的凯斯西储大学以及泰国孔敬的孔敬大学合作，为老挝医生实施了一项研究生内科培训项目。该项目始于2001年，每年招收六名学员；学员们在老挝万象的三家医院以及另外一个临床地点完成临床轮转。该项目的目标是培养一批核心的当地医生来提供医疗服务，并按照国际护理标准培训其他人员。该项目有两个突出特点。其一，绝大部分培训在老挝进行。这避免了发展中国家国民在国外培训时可能出现的“人才流失”。此外，由于培训使用当地现有的人员、设施和技术，毕业生能更好地满足老挝人民的需求。其二，该合作伙伴关系采用全志愿者模式，致力于长期事业。居住在老挝的接受过美国培训的专家每天都与学员合作。学员有很长一段时间来获取、强化新知识并接受测试，还能从以循证医疗为典范的美国同事那里受益，同时仍在当地条件下工作。随着越来越多的老挝医生接受这种水平的培训，该项目将在当地实现可持续发展，并有助于打破老挝医疗保健部门对外国专业知识的依赖循环。初步结果表明该项目取得了成功，并且可以在其他地方推广。
