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医师教育:美国疾病控制与预防中心的视角

The education of physicians: a CDC perspective.

作者信息

Koo Denise, Thacker Stephen B

机构信息

Career Development Division, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

出版信息

Acad Med. 2008 Apr;83(4):399-407. doi: 10.1097/ACM.0b013e3181667e9a.

Abstract

The Centers for Disease Control and Prevention (CDC) strongly supports integrating population health perspectives into the education of physicians. Physicians with critical-thinking skills, a commitment to the health of a community, and a systems-based approach are critical partners for the agency in its mission to protect and promote the public's health. To cultivate such physicians, integrating population health concepts solely into undergraduate medical education would be inadequate. A multipronged approach that establishes and maintains population health concepts with physicians at all stages of their education is needed: before medical school, during medical school, during residency and fellowship, and in research and practice (particularly for faculty who train the next generation). The authors describe relevant, CDC-conducted or CDC-supported activities that support such physician education during all these stages. Based in part on recent, cutting-edge trends assimilating community health particularly into primary care residencies, the authors also offer ideas for new ways that CDC can participate in the development of physicians who are truly competent at both medicine and population health in an integrated fashion -- physicians who focus on and care for individual patients but who also take a broader population or community perspective and can act effectively in either arena. Physicians who take such a systems approach -- who view and understand medicine and public health as a continuum rather than as distinct arenas -- are sorely needed to help solve the current health system crisis and to contribute to improving health in other ways.

摘要

疾病控制与预防中心(CDC)大力支持将人群健康视角纳入医师教育。具备批判性思维技能、致力于社区健康且采用基于系统方法的医师,是该机构在保护和促进公众健康使命中的关键合作伙伴。为培养此类医师,仅将人群健康概念纳入本科医学教育是不够的。需要一种多管齐下的方法,在医师教育的各个阶段(医学院前、医学院期间、住院医师培训和专科培训期间以及研究与实践中,尤其是对于培养下一代的教员而言)建立并维护人群健康概念。作者描述了疾病预防控制中心开展或支持的相关活动,这些活动在所有这些阶段支持此类医师教育。部分基于近期将社区健康特别是融入初级保健住院医师培训的前沿趋势,作者还提出了一些新思路,说明疾病预防控制中心如何能够参与培养真正在医学和人群健康方面都具备综合能力的医师——这些医师专注于并关心个体患者,但也能从更广泛的人群或社区角度出发,并能在任何一个领域有效发挥作用。迫切需要采用这种系统方法的医师——即将医学和公共卫生视为一个连续统一体而非不同领域的医师,以帮助解决当前的卫生系统危机并以其他方式促进健康改善。

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