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尼泊尔25年来家庭医学与住院医师培训的进展与挑战

Progress and Challenges in Family Medicine and Residency Training Over 25 Years in Nepal.

作者信息

Gupta Tula Krishna, Ackerman Lani Kay

机构信息

Department of General Practice and Emergency Medicine, Karnali Academy of Health Sciences, Jumla, Nepal.

Department of Clinical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA.

出版信息

Fam Med. 2025 May;57(5):328-332. doi: 10.22454/FamMed.2025.591411. Epub 2025 Apr 11.

Abstract

Over the past 25 years, Nepal has made admirable progress not only in improving living conditions and health indices but also in training family physicians, called medical doctors in general practice (MDGPs). This article examines the evolution and contributions of family physicians, the development of their own unique residency curriculum, and their current and evolving practice scope. It also evaluates recruitment and retention challenges and suggests strategies for advancing family medicine in Nepal. Family physicians have been pioneers in health care delivery in Nepal and have had a profound impact on improving access to primary and emergent medical care for the rural population. They have contributed to the decrease in morbidity and mortality rates and improved life expectancy. Family medicine residencies and physicians have been and are evolving to meet the ever-changing needs of their country, leading primary and emergency care; but urgent reforms are needed for their recruitment and retention. Despite Nepal's uniqueness and leadership in South Asia in its recognition for and development of full-scope, well-trained family physicians, MDGP leaders need collaboration and support from both their own government and medical community, as well as from international educators, to continue to lead the country in improving health and decreasing health disparities.

摘要

在过去25年里,尼泊尔不仅在改善生活条件和健康指标方面取得了令人钦佩的进展,而且在培训家庭医生(即全科医生,MDGPs)方面也取得了进展。本文探讨了家庭医生的发展历程与贡献、其独特住院医师培训课程的发展情况以及他们当前和不断演变的执业范围。文章还评估了招聘和留用方面面临的挑战,并提出了在尼泊尔推进家庭医学发展的策略。家庭医生一直是尼泊尔医疗服务的先驱,对改善农村人口获得初级和急诊医疗服务的机会产生了深远影响。他们为降低发病率和死亡率以及提高预期寿命做出了贡献。家庭医学住院医师项目和医生一直在不断发展,以满足国家不断变化的需求,引领初级和急诊护理工作;但在招聘和留用方面迫切需要进行改革。尽管尼泊尔在南亚地区因认可并培养全面、训练有素的家庭医生而独具特色并处于领先地位,但MDGP的领导者需要本国政府和医学界以及国际教育工作者的合作与支持,以便继续引领该国改善健康状况并减少健康差距。

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Family Medicine for a Changing World.变化世界中的家庭医学。
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Health System Development in Nepal.尼泊尔的卫生系统发展。
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