FitzPatrick Michael Eb, Badu-Boateng Charles, Huntley Christopher, Morgan Caitlin
University of Oxford, Oxford, UK.
Frimley Health NHS Foundation Trust, Frimley, UK.
Future Healthc J. 2021 Mar;8(1):12-18. doi: 10.7861/fhj.2020-0242.
The stellar gains in life expectancy and health over the past century have been accompanied by an increase in societal and health inequalities. This health gap between the most and least fortunate in our society is widening, driven by complex social determinants of health, as well as healthcare systems themselves. Physicians are not just well-qualified and well-placed to act as advocates for change, but have a moral duty to do so: to stand by silently is to be complicit. Following a workshop on health inequalities and medical training at the Royal College of Physicians Trainees Committee, we sought to examine how health inequalities could be addressed through changes to the medical education system. We discuss the arguments for reform in recruitment to medicine, and changes to undergraduate, postgraduate and continuing medical education in order to equip the profession to deliver meaningful improvements in health inequalities. We propose a population health credential as a mechanism by which specialists can gain additional skills to take on leadership roles addressing health inequalities, allowing them to support colleagues in public health and bring in specialty-specific knowledge and experience.
在过去的一个世纪里,预期寿命和健康状况取得了显著提升,但与此同时,社会不平等和健康不平等现象也在加剧。我们社会中最幸运和最不幸的人群之间的这种健康差距正在扩大,其驱动因素包括复杂的健康社会决定因素以及医疗保健系统本身。医生不仅具备充分的资质和条件来倡导变革,而且有道德义务这样做:袖手旁观就是同谋。在皇家内科医学院实习医师委员会举办了一次关于健康不平等与医学培训的研讨会之后,我们试图探讨如何通过改革医学教育系统来解决健康不平等问题。我们讨论了医学招生改革的理由,以及本科、研究生和继续医学教育的变革,以使该行业有能力在改善健康不平等方面取得切实进展。我们提议设立一项人群健康资质认证,作为一种机制,让专家能够获得额外技能,担当起解决健康不平等问题的领导角色,使他们能够支持公共卫生领域的同事,并引入特定专业的知识和经验。