Ross M, Willer B
Med Care. 1982 Feb;20(2):235-41. doi: 10.1097/00005650-198202000-00009.
There is considerable argument for the value of educating medical students in the basics of primary care, comprehensive care and concern for psychological needs of patients. However, medical schools do not place much emphasis on primary care. Most clinical experiences take place in tertiary care centers, and most teaching is provided by specialists. Relatively little attention is paid to psychological issues of care and development of interpersonal skills among would-be physicians. The impact of the tertiary care orientation is widespread. Medical students are expected to adopt the role of the physician-specialist or technologist. Those who want to be primary care physicians have to face value conflicts with the establishment, and some develop emotional problems. The effects carry over into practice. Physicians who do not develop adequate personal skills are less likely to be viewed as competent by their patients. They are also more likely to develop mental health problems themselves. This article argues for a modification of the medical school curriculum to reflect the orientation of the primary care model.
对于医学生进行初级保健基础、全面护理以及关注患者心理需求等方面的教育的价值，存在着诸多争议。然而，医学院校并不十分重视初级保健。大多数临床实习在三级医疗中心进行，并且大多数教学由专科医生提供。对于未来医生而言，护理中的心理问题以及人际技能的培养相对很少受到关注。三级医疗导向的影响广泛。医学生被期望承担专科医生或技术专家的角色。那些想要成为初级保健医生的人不得不面对与现有体制的价值冲突，并且有些人会出现情感问题。这些影响会延续到实际工作中。个人技能发展不足的医生不太可能被患者视为称职。他们自身也更有可能出现心理健康问题。本文主张修改医学院校课程，以体现初级保健模式的导向。
