Naef A P
Helv Chir Acta. 1979 Dec;46(4):545-53.
The author recommends the Residency Program of the Halsted type as developed by D.C. SABISTON in the Departement of Surgery at Duke University. A two-year training in the basic problems, knowledge, and attitudes, common to all surgical subspecialties, is of fundamental importance (Fig. 1). The goal of this type of training is the US-Board Certification.--The Swiss Medical Federation considers the following factors as essential in a surgical training programm: The training of the general surgeon should be geared to broad principles without early overspecialisation. The training should allow a certain flexibility for the teacher as well as the candidate. A sufficient operative experience is paramount as well as the habit of a continuous education all trough a life-long surgical career and an understanding for economy in surgical practice.--The training of an university--or a private--surgeon does not give rise to important problems, whereas the training of surgeons for the medium sized and small Swiss hospitals represents a difficult problem. A double training in "visceral" and "orthopaedic" surgery with an accent on one or the other seems necessary in order to have one chief surgeon take the place of another during vacation, week-ends and illness. Even if such a complete training seems desirable, it can be justly questioned if under the present circumstances (emergency transportation, regionalized hospital organization, specialized hospital consultants) it is still justified to aim at the training of a "complete" surgeon who elsewhere, in a university hospital or in private practice or for that matter in other countries, is no longer absolutely necessary.
作者推荐由杜克大学外科系的 D.C. 萨比斯顿所制定的霍尔斯特德式住院医师培训项目。为期两年的针对所有外科亚专业共有的基本问题、知识和态度的培训至关重要(图 1)。这种培训类型的目标是获得美国医师资格证书。——瑞士医学联合会认为在外科培训项目中有以下因素至关重要:普通外科医生的培训应着眼于广泛的原则,避免过早过度专业化。培训应给予教师和学员一定的灵活性。足够的手术经验至关重要,同时还应养成在整个外科职业生涯中持续接受教育的习惯,并理解外科实践中的经济性。——大学或私立外科医生的培训不会引发重大问题,而瑞士中小型医院外科医生的培训则是个难题。为了在休假、周末和生病期间能有一名主刀医生替代另一名,似乎有必要进行“内脏”和“矫形”外科的双重培训,并侧重其中一个或另一个。即便这样的全面培训看似可取,但在当前情况下(紧急运输、区域化医院组织、专科医院顾问),是否仍有必要培养一名在其他地方(大学医院、私人诊所或其他国家)已不再绝对必要的“全面”外科医生,这是个值得质疑的问题。