San Diego Hospice and The Institute for Palliative Medicine, San Diego, California 92103, USA.
J Palliat Med. 2013 May;16(5):471-7. doi: 10.1089/jpm.2012.0478. Epub 2013 Feb 28.
The need for doctors who have skills in pain management and palliative medicine is greatest in low and moderate resource countries where patients most frequently present to their health care system with advanced illness and greater than 80% of the global deaths occur. While medical students trained in the United States are required to have training in palliative medicine, international medical graduates (IMGs), who have completed medical school outside North America, may not have the same exposure to palliative medicine training as U.S. physicians. The goal of this study was to evaluate whether a four-week course in palliative medicine could bring IMG attitudes, concerns, competence, and knowledge to the level of U.S. trainees.
As part of a prospective cohort study, 21 IMGs from 14 countries participated in a four-week course in palliative medicine. Attitudes, concerns, self-reported competence, and knowledge were assessed pre-course and post-course. The course was evaluated weekly and at the end of the four-week program. The data from the IMGs was compared to data from U.S. medical students and residents using the same assessment tools.
After the course, IMGs had significantly decreased concern about ethical and legal issues in palliative medicine to the level of U.S.-trained residents and a significant increase in knowledge and self-rated competence equivalent to the level of U.S. trainees.
A four-week course in palliative medicine can improve the levels of concern, knowledge and self-assessed competence in IMGs to the level of US trainees.
在资源匮乏和中等资源国家，需要具备疼痛管理和姑息医学技能的医生，因为这些国家的患者经常因晚期疾病而就诊于他们的医疗体系，并且全球超过 80%的死亡发生在这些国家。虽然在美国接受培训的医学生必须接受姑息医学培训，但在北美以外完成医学院学业的国际医学毕业生（IMG）可能没有像美国医生那样接受同样的姑息医学培训。本研究的目的是评估为期四周的姑息医学课程是否能使 IMG 的态度、关注点、能力和知识达到美国受训者的水平。
作为一项前瞻性队列研究的一部分，来自 14 个国家的 21 名 IMG 参加了为期四周的姑息医学课程。在课程前后评估态度、关注点、自我报告的能力和知识。每周和四周课程结束时评估课程。使用相同的评估工具，将 IMG 的数据与美国医学生和住院医生的数据进行比较。
课程结束后，IMG 对姑息医学中的伦理和法律问题的担忧显著降低，达到了美国受训住院医生的水平，并且在知识和自我评估能力方面有了显著提高，达到了美国受训者的水平。
为期四周的姑息医学课程可以提高 IMG 的关注程度、知识水平和自我评估能力，使其达到美国受训者的水平。
