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[如何成为一名创伤外科医生:骨科与创伤外科新共同领域的现状分析及职业发展理念——第一部分]

[How to become a trauma surgeon: analysis of the current situation and concepts for career development in the new common field of orthopaedics and trauma surgery--part I].

作者信息

Mittlmeier T, Bonnaire F, Grützner P A, Lill H, Matthes G, Prokop A, Seifert J, Voigt C, Walcher F, Wölfl C, Siebert H

机构信息

Abt. für Unfall- und Wiederherstellungschirurgie, Chirurgische Klinik und Poliklinik der Universität Rostock, Schillingallee 35, 18055, Rostock, Deutschland.

出版信息

Unfallchirurg. 2010 Jun;113(6):504-12. doi: 10.1007/s00113-010-1793-9.

Abstract

The lack of clinical residents especially in the surgical domains, including orthopaedics and trauma surgery, is not only omnipresent but also a topic of lively discussions. This lack originates from sociopolitical and healthcare policy issues as well as from a loss of attractiveness of all surgical disciplines. The loss is caused by the high workload and disadvantageous working hours especially in those disciplines with a high rate of emergencies, e.g. trauma surgery. Moreover, it is caused by the poorly structured and unpredictable period of residency. In order to anticipate the bottleneck in supply due to the lack of trainees, a number of structural and contextual measures have to be taken to improve both undergraduate und postgraduate surgical training. Due to the numerous facets of the topic the first part of this analysis refers to the period until the trainee decides on the field of training.A basic insight into the field of orthopaedics and trauma surgery can already be offered far before the period of medical studies itself. During undergraduate medical education the existing structures should be modified, the characteristics of the discipline should be emphasized and the charm of combining theory and practical skills should be highlighted in order to enhance student's perception of the discipline. This might begin during preclinical training and should be continued throughout clinical training and elective courses (basic wound care, TEAM approach, AO course for students and seminars for M.D. candidates). Contextual and structural improvements of the practical year are indispensable to arouse students' interest in our discipline. These options conjoined with the actual offers for students provided by our scientific society, such as guided tours during the annual congress, travelling grants and the recently inaugurated summer school, might provide the basis for clearly structured information and offer a distinct stimulus to apply for residency in our field.

摘要

临床住院医师的短缺,尤其是在包括骨科和创伤外科在内的外科领域,不仅普遍存在,而且是激烈讨论的话题。这种短缺源于社会政治和医疗政策问题,以及所有外科专业吸引力的丧失。这种丧失是由高工作量和不利的工作时间造成的,尤其是在那些急诊率高的学科,如创伤外科。此外,这也是由住院医师培训结构不佳和不可预测造成的。为了应对由于学员短缺而导致的供应瓶颈,必须采取一些结构和背景措施来改善本科和研究生阶段的外科培训。由于该话题涉及多个方面,本分析的第一部分涉及学员决定培训领域之前的时期。在医学学习阶段之前很久,就可以提供对骨科和创伤外科领域的基本了解。在本科医学教育期间,应修改现有结构,强调该学科的特点,并突出理论与实践技能相结合的魅力,以增强学生对该学科的认知。这可以从临床前培训开始,并应在整个临床培训和选修课程(基础伤口护理、团队方法、面向学生的AO课程和医学博士候选人研讨会)中持续进行。实习年的背景和结构改善对于激发学生对我们学科的兴趣是不可或缺的。这些选择与我们科学协会为学生提供的实际机会相结合,如年会期间的导览、旅行资助和最近开办的暑期学校,可能为结构化的信息提供基础,并为申请我们领域的住院医师提供明显的激励。

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