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[外科高级培训的挑战与选择:德国医院结构改革背景下的跨学科立场文件]

[Challenges and options for advanced training in surgery : An interdisciplinary position paper against the background of the hospital structural reform in Germany].

作者信息

Schlottmann Frederik, Drossard Sabine, Dey Hazra Maria, Blank Beate, Herbolzheimer Marit, Mulorz Joscha, Kröplin Juliane, Huber Tobias, Doukas Panagiotis, Sadat Najla, Rüsseler Miriam, Rösch Romina, Bouffleur Frederic, Lif Keller Sarah, Freund Gerrit

机构信息

Junges Forum der Deutschen Gesellschaft für Plastische, Rekonstruktive und Ästhetische Chirurgie (DGPRÄC); Klinik für Plastische, Ästhetische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Klinik für Plastische, Ästhetische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

出版信息

Chirurgie (Heidelb). 2024 Jul;95(7):539-545. doi: 10.1007/s00104-024-02113-x. Epub 2024 Jun 12.

Abstract

BACKGROUND

Even now the further training in surgery faces considerable challenges. The planned hospital structural reform will result in new bureaucratic and organizational hurdles, which could lead to a considerable loss of quality in advanced surgical training across all disciplines.

OBJECTIVE

The aim of this position paper is to describe the current and future challenges for advanced surgical training and to identify possible approaches and opportunities for the further development against the background of the planned hospital structural reform.

MATERIAL AND METHODS

For the development of this position paper a committee of representatives of the Young Forums of the German surgical societies identified and critically discussed current problems and challenges of the present residency training system and formulated a list of demands for a sustainable residency training concept.

RESULTS

The planned shift to outpatient treatment and centralization were identified as central challenges for surgical residency training. Surgical training must be considered consistently and from the outset in all political reform efforts. In addition to a transparent and cost-appropriate financing of residency training, we call for the involvement of all German surgical societies in the reform process. Furthermore, the social framework conditions for junior surgeons should be considered.

CONCLUSION

The structural change in the hospital landscape in Germany, which is being forced by politicians, harbors the risk of a further loss of quality and experience in surgical treatment and training. At the same time, the planned hospital reform offers a unique opportunity to address existing problems and challenges in surgical training and to consider them as a starting point for structural changes which are fit for the future.

摘要

背景

即使在当下,外科的进一步培训仍面临巨大挑战。计划中的医院结构改革将带来新的官僚主义和组织障碍,这可能导致所有学科的高级外科培训质量大幅下降。

目的

本立场文件的目的是描述高级外科培训当前和未来面临的挑战,并在计划中的医院结构改革背景下,确定进一步发展的可能方法和机遇。

材料与方法

为撰写本立场文件,德国外科学会青年论坛的代表委员会确定并批判性地讨论了当前住院医师培训系统存在的问题和挑战,并制定了一份可持续住院医师培训概念的需求清单。

结果

计划向门诊治疗的转变和集中化被确定为外科住院医师培训的核心挑战。在所有政治改革努力中,必须从一开始就始终如一地考虑外科培训。除了为住院医师培训提供透明且成本合理的资金外,我们呼吁所有德国外科学会参与改革进程。此外,还应考虑初级外科医生的社会框架条件。

结论

德国医院格局的结构变化是由政治家推动的,这潜藏着外科治疗和培训质量及经验进一步流失的风险。与此同时,计划中的医院改革提供了一个独特的机会,可解决外科培训中现有的问题和挑战,并将其作为未来适应性结构变革的起点。

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