Jonas H S, Etzel S I, Barzansky B
American Medical Association, Division of Undergraduate Medical Education.
JAMA. 1990 Aug 15;264(7):801-9.
The number of applicants to US medical schools, which declined steadily between 1985 and 1988, increased slightly for the class entering in 1989. The profile of entering students showed a small decline from last year in the percentage of students with grade point averages categorized as "A" (3.5 or above on a 4-point scale) and slight declines in four of the six MCAT subtest scores. The percentage of both women and minority students in the entering class increased from the previous year. An interesting observation is the large percentage increase this year in students transferring to LCME medical schools from graduate and professional degree programs and from osteopathic medical schools. While the number of full-time faculty members in medical schools continues to increase, significant vacancy rates exist in some departments. More than 5% of full-time faculty positions are vacant in genetics, pathology, dermatology, family medicine, neurology, obstetrics-gynecology, orthopedics, otolaryngology, pediatrics, and surgery departments. Along with faculty vacancies, there has been a considerable turnover of medical school deans. The curriculum in most medical schools includes some innovative instructional formats, such as problem-based learning and computer-assisted instruction. However, current data do not allow a generalization about the extent to which these are being utilized. It seems that, at least in some institutions, multiple methods are being used to assess the clinical competence of medical students (observation by faculty members and residents, written and oral examinations, and multiple station examinations), including the use of standardized patients. About half of the medical schools require students to pass the NBME Part I examination and about one third require passage of Part II. The subject examinations provided by the NBME seem to be used widely, at least in the clinical disciplines. Within the past year, about 14% of medical schools have reported the presence of students or residents who have been diagnosed with human immunodeficiency virus infection, and 12% have had students or residents diagnosed with hepatitis B virus infection. It is critical that medical schools teach students how to prevent occupational exposure to these infections, as well as ensuring that adequate health insurance coverage be provided for these conditions.
申请美国医学院的人数在1985年至1988年间稳步下降，但1989年入学班级的人数略有增加。入学学生的概况显示，平均绩点被归类为“A”（4分制中3.5或以上）的学生比例较去年略有下降，六项医学院入学考试（MCAT）子测试成绩中的四项也略有下降。入学班级中女生和少数族裔学生的比例比上一年有所增加。一个有趣的现象是，今年从研究生和专业学位项目以及骨科医学院转学到LCME认证医学院的学生人数大幅增加。虽然医学院全职教员的数量继续增加，但一些部门存在显著的空缺率。遗传学、病理学、皮肤病学、家庭医学、神经病学、妇产科、骨科、耳鼻喉科、儿科和外科部门的全职教员职位空缺率超过5%。除了教员空缺外，医学院院长也有相当大的变动。大多数医学院的课程都包括一些创新的教学形式，如基于问题的学习和计算机辅助教学。然而，目前的数据无法概括这些教学形式的使用程度。似乎至少在一些机构中，正在使用多种方法来评估医学生的临床能力（教员和住院医师的观察、笔试和口试以及多站式考试），包括使用标准化病人。大约一半的医学院要求学生通过美国国家医学考试委员会（NBME）的第一部分考试，约三分之一要求通过第二部分考试。NBME提供的学科考试似乎被广泛使用，至少在临床学科中是这样。在过去一年中，约14%的医学院报告有学生或住院医师被诊断感染人类免疫缺陷病毒，12%的医学院有学生或住院医师被诊断感染乙型肝炎病毒。医学院教导学生如何预防职业暴露于这些感染，并确保为这些情况提供足够的医疗保险，这至关重要。
