Ferguson T B
Ann Thorac Surg. 1977 Jul;24(1):6-18. doi: 10.1016/s0003-4975(10)64562-6.
The American specialty board system is viewed in the historical perspective of a quest for quality assessment of surgical trainees. Beginning with the American Board for Ophthalmic Examinations in 1916, a system of 22 boards has developed which, by their training requirements and examinations, essentially dictate the length and content of all postgraduate educational programs. The time has come for the boards, as a powerful force in postgraduate education and in organized medicine, to reassess their position and to be sensitive to the responsibilities they have for the future. The events of history suggest six changes that might be profitable. (1) Recognize their purpose to be broader than the administration of certifying examinations. (2) Recognize that the certificate is now a license, and deal squarely with this issue. (3) Initiate and support needed medical reforms while the private sector can still do so. (4) Assume a leadership role in the shaping and future direction of graduate medical education. (5) Relinquish a degree of autonomy in order to strengthen the American Board of Medical Specialties. (6) Define their place in the medical scene and reorganize their board structures accordingly. The primary responsibility of the boards should be to make certain all aspects of resident training in approved programs are sound. Long-range goals should be the elimination of the certifying examination, and public recognition and approval of specialty status attainment.
从对外科住院医师质量评估探索的历史角度来看美国专科委员会系统。始于1916年的美国眼科考试委员会，现已发展成一个由22个委员会组成的系统，这些委员会通过其培训要求和考试，基本上决定了所有研究生教育项目的时长和内容。对于这些在研究生教育和组织化医学中具有强大影响力的委员会而言，重新评估其立场并意识到自身对未来所负有的责任的时机已经到来。历史事件表明有六项变革可能是有益的。（1）认识到其目的比管理资格认证考试更为广泛。（2）认识到证书现在是一种执照，并切实处理这一问题。（3）在私营部门仍有能力时发起并支持必要的医疗改革。（4）在研究生医学教育的塑造和未来方向上发挥领导作用。（5）放弃一定程度的自主权以加强美国医学专科委员会。（6）明确其在医学领域的地位，并据此重组其委员会结构。委员会的主要责任应是确保经批准项目中的住院医师培训的各个方面都是合理的。长期目标应是取消资格认证考试，并获得公众对专科地位获得的认可和批准。
