Brauer R B, Harnoss J-C, Lang J, Harnoss J, Raschke R, Flemming S, Obertacke U, Heidecke C-D, Busemann A
Klinikum rechts der Isar, Technische Universität München, Chirurgische Klinik und Poliklinik, München, Deutschland.
Zentralbl Chir. 2010 Feb;135(1):18-24. doi: 10.1055/s-0029-1224764. Epub 2010 Feb 16.
The shortage of surgeons in the operative disciplines field has in recent years further increased. The training of a surgeon and the required lifestyle combined with the work-life balance of the surgeons are perceived as being less attractive, so that young doctors after finishing medical school rarely decide for surgical careers. Changes in the social environment outside of our clinics has resulted in a decline of the social prestige. The modified structural preconditions require a rethinking of the training processes for studying and working conditions in surgery. The quality of surgical education is therefore a cornerstone for the future development of our subject and is directly linked to the training and junior development. The CAQ meeting in Greifswald in February 2009, has focused on the teaching in surgery and developed together with medical students of different faculties solutions for the three major problem factors: teaching, training and junior development. The students are demanding clear guidelines regarding the required theoretical and practical knowledge in the form of catalogues or learning logs. The absence of intrinsic commitment to an excellent teaching and role model is due to the ongoing conflict between patient care and teaching. Because in teaching usually neither the quantity nor the quality will be systematically registered and no sanctions promote the lesson, so that the training is always considered as a last resort. One approach could be a scoring system for teaching that reflect the quantity and quality of teaching in points. The practical year needs to be reformed, since over 25% of the students spend their surgery part abroad, because they are afraid to be considered as cheap labour. Especially at this point, the lecturer is asked to reform the education of students during the practical year and to strengthen the role model for young academic teachers.
近年来,手术学科领域外科医生短缺的情况进一步加剧。外科医生的培养、所需的生活方式以及工作与生活的平衡,都被认为缺乏吸引力,以至于医学院毕业后的年轻医生很少选择从事外科职业。我们诊所之外的社会环境变化导致了社会声望的下降。结构前提条件的改变要求重新思考外科学习和工作条件的培训过程。因此,外科教育质量是我们学科未来发展的基石,与培训和初级发展直接相关。2009年2月在格赖夫斯瓦尔德举行的CAQ会议聚焦于外科教学,并与不同院系的医学生共同为三个主要问题因素——教学、培训和初级发展——制定了解决方案。学生们要求以目录或学习日志的形式提供有关所需理论和实践知识的明确指导方针。缺乏对卓越教学和榜样的内在投入,是由于患者护理与教学之间持续存在的冲突。因为在教学中,通常既不会系统地记录教学的数量也不会记录质量,而且没有制裁措施来促进教学,所以培训总是被视为最后的手段。一种方法可能是建立一个教学评分系统,以分数反映教学的数量和质量。实习年需要进行改革,因为超过25%的学生在国外度过他们的外科实习部分,因为他们担心被视为廉价劳动力。特别是在这一点上,要求讲师在实习年改革学生教育,并加强年轻学术教师的榜样作用。