Gupta Tarun K Sen, Murray Richard B, Beaton Neil S, Farlow David J, Jukka Clare B, Coventry Natasha L
School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.
Med J Aust. 2009 Jul 20;191(2):105-9. doi: 10.5694/j.1326-5377.2009.tb02705.x.
Major developments in medical education in Australia include increasing the numbers of students and educating more students within the community and in regional, rural and remote settings. Rapid growth of student numbers and the rural orientation of the James Cook University medical school course has meant that northern Queensland had to deal with these issues earlier than other regions. One solution has been to transform some rural hospitals into teaching health services. Two hospitals that have successfully made this transformation, and another on its way, suggest that important factors include local commitment to quality clinical services, medical and academic leadership, coordination of local resources, community support, and strategic links between key organisations. Transformation to a teaching health service involves senior doctors functioning as true consultants with cascading supervision as in the traditional consultant-registrar-resident model. As both clinical and teaching capacity develops, the workforce may stabilise, infrastructure and teaching culture are established, and long-term recruitment and retention strategies emerge. Applying these models in other rural and community settings may make it possible to manage the increased training capacity and address workforce needs without compromising the educational experience - indeed, it may be enhanced.
澳大利亚医学教育的主要发展包括增加学生数量，以及在社区、地区、农村和偏远地区培养更多学生。学生人数的快速增长以及詹姆斯·库克大学医学院课程的农村导向意味着昆士兰州北部比其他地区更早地必须应对这些问题。一种解决方案是将一些农村医院转变为教学健康服务机构。两家已成功实现这一转变的医院，以及另一家正在转型的医院表明，重要因素包括当地对优质临床服务的承诺、医学和学术领导力、当地资源的协调、社区支持以及关键组织之间的战略联系。向教学健康服务机构的转变涉及资深医生担任真正的顾问，并采用传统顾问 - 住院医师 - 实习医生模式中的级联监督。随着临床和教学能力的发展，劳动力可能会稳定下来，基础设施和教学文化得以建立，长期招聘和留用策略也会出现。在其他农村和社区环境中应用这些模式，有可能在不影响教育体验的情况下管理增加的培训能力并满足劳动力需求——事实上，教育体验可能会得到提升。
