Lind D Scott, Deladisma Adeline M, Cue Jorge I, Thomas Andria M, MacFadyen Bruce V, Nesbit Robert R
Department of Surgery, Medical College of Georgia, Augusta, GA 30912, USA.
J Am Coll Surg. 2007 May;204(5):969-74; discussion 975-6. doi: 10.1016/j.jamcollsurg.2007.01.058.
Few data exist comparing medical student surgical education programs across the US and Canada. We conducted a 30-question, Web-based survey of 142 medical schools in the US and Canada about the administration of undergraduate surgical education programs at their institutions.
From October 2005 to January 2006, 142 Association of American Medical Colleges (AAMC) medical schools in the US and Canada were asked to complete a 30-item, Web-based questionnaire. Descriptive statistics were compiled for all responses and data were analyzed using Student's t-test.
One hundred two medical schools responded to the survey (90 of 125 US and 12 of 17 Canadian schools, overall response rate,=72%). The majority of surgical clerkships have between 16 and 30 students rotating at a time through 2 to 4 teaching sites. The most frequent overall clerkship duration was 8 weeks, divided most frequently between a 4- to 6-week general surgery rotation and a 4-week subspecialty rotation. There was no consensus about what services constitute general surgery rotations, although the most common subspecialty rotations were urology (68%) and orthopaedics (66%). American medical schools were more likely to use the National Board of Medical Examiners (NBME) subject examination for student assessment (90.9% US versus 50.0% Canadian, p < 0.05); Canadian medical schools were more likely to use an Objective Structured Clinical Examination (69.2% Canadian versus 37.7% US, p < 0.05) and other written examinations (69.2% Canadian versus 37.7% US, p < 0.05).
There is wide variation in the structure and administration of medical student surgical education programs in the US and Canada. These findings underscore the need for a clerkship directors committee and a national dialog about a core student curriculum to ensure consistency in the quality of student education in surgery.
关于美国和加拿大医学院学生外科教育项目的比较数据很少。我们针对美国和加拿大的142所医学院开展了一项包含30个问题的网络调查，内容涉及这些院校本科外科教育项目的管理情况。
2005年10月至2006年1月，美国和加拿大的142所美国医学院协会（AAMC）医学院被要求完成一份包含30个条目的网络调查问卷。对所有回复进行描述性统计，并使用学生t检验分析数据。
102所医学院回复了调查（美国125所中的90所，加拿大17所中的12所，总体回复率=72%）。大多数外科实习期间，每次有16至30名学生在2至4个教学地点轮转。最常见的总体实习时长为8周，最常见的划分方式是4至6周的普通外科轮转和4周的亚专科轮转。对于哪些服务构成普通外科轮转，没有达成共识，不过最常见的亚专科轮转是泌尿外科（68%）和骨科（66%）。美国医学院更有可能使用美国国家医学考试委员会（NBME）学科考试对学生进行评估（美国为90.9%，加拿大为50.0%，p<0.05）；加拿大医学院更有可能使用客观结构化临床考试（加拿大为69.2%，美国为37.7%，p<0.05）和其他笔试（加拿大为69.2%，美国为37.7%，p<0.05）。
美国和加拿大医学院学生外科教育项目的结构和管理存在很大差异。这些发现强调了设立实习主任委员会以及就核心学生课程开展全国性对话的必要性，以确保外科学生教育质量的一致性。
