Clamp Jonathan A, Baiju Dean, Copas David P, Hutchinson James W, Rowles John M
Department of Trauma and Orthopaedics, Derbyshire Royal Infirmary, Derby, UK.
Ann R Coll Surg Engl. 2008 Sep;90(6):492-6. doi: 10.1308/003588408X301073.
The introduction of Modernising Medical Careers (MMC) is likely to reduce specialist registrar (SpR) operative experience during higher surgical training (HST). A further negative impact on training by local Independent Sector Treatment Centres (ISTCs) could reduce experience, and thus competence, in primary joint arthroplasty at completion of higher surgical training.
Retrospective case note and radiograph analysis of patients receiving primary hip and knee arthroplasty in a teaching hospital, before and after the establishment of a local ISTC. Patients and operative details were recorded from the selected case notes. Corresponding radiographs were assessed and the severity of the disease process assessed.
Fewer primary hip and knee replacements were performed by SpRs in the time period after the establishment of an ISTC.
ISTCs may adversely affect SpR training in primary joint arthroplasty.
“医学职业现代化”（MMC）的推行可能会减少专科住院医师（SpR）在高级外科培训（HST）期间的手术经验。当地独立部门治疗中心（ISTC）对培训造成的进一步负面影响可能会减少高级外科培训结束时在初次关节置换方面的经验，进而降低能力。
对一家教学医院在当地ISTC设立前后接受初次髋膝关节置换术的患者进行回顾性病例记录和X光片分析。从选定的病例记录中记录患者和手术细节。评估相应的X光片并评估疾病进程的严重程度。
ISTC设立后的时间段内，SpR进行的初次髋膝关节置换手术较少。
ISTC可能会对SpR在初次关节置换方面的培训产生不利影响。
