Wilcox B R, Stritter F T, Anderson R P, Gay W A, Kaiser G C, Orringer M B, Rainer W G, Replogle R L
University of North Carolina School of Medicine, Chapel Hill.
Ann Thorac Surg. 1993 May;55(5):1296-302. doi: 10.1016/0003-4975(93)90080-2.
To summarize this rather wide-ranging study, let us review the high points. The future practice of thoracic surgery will be increasingly affected by governmental factors and will have even greater technological dimensions. To do this work, we must continue to attract high-caliber individuals, and this is best accomplished by the early and continuing involvement in the educational process of strong role models from our field. These future surgeons must be motivated to do good work and should have high ethical standards as well as maturity and high intelligence. Experienced, involved faculty leading the residents through a broad program that offers graduated assumption of clinical and leadership responsibilities will facilitate the development of mature clinical judgment. Residents must be taught the clinical skills necessary to do all thoracic operations, leaving subspecialization to postresidency fellowships. The educational program should be humane in its demands and collegial in its application. It should incorporate experiences beyond the operating room, including the opportunity to read, think, and interact with local mentors and colleagues from around the country. The requirements of certification should not be so rigid as to preclude the development of different pathways to the same end. Likewise, although the accreditation process must protect the resident from exploitation, it must not be so restrictive that it does not allow for educational innovation and justifiable differences among programs. These are the thoughtful opinions of our colleagues. They deserve serious consideration.
为总结这项涉及面相当广泛的研究，让我们回顾一下要点。胸外科未来的实践将越来越受到政府因素的影响，并且会有更大的技术层面。要开展这项工作，我们必须持续吸引高素质人才，而这最好通过本领域的优秀榜样尽早并持续参与教育过程来实现。这些未来的外科医生必须有做好工作的动力，应具备高道德标准以及成熟度和高智商。经验丰富、积极参与的教员带领住院医师参与广泛的项目，该项目提供逐步承担临床和领导职责的机会，这将有助于培养成熟的临床判断力。必须教授住院医师进行所有胸科手术所需的临床技能，将亚专业培训留到住院医师培训之后的 fellowship 阶段。教育项目在要求上应有人情味，在实施上应具有合作性。它应纳入手术室之外的经历，包括阅读、思考以及与当地导师和来自全国各地的同事互动的机会。认证要求不应过于严格，以至于排除实现同一目标的不同途径。同样，虽然认证过程必须保护住院医师不被剥削，但也不能过于限制，以至于不允许进行教育创新以及各项目之间合理的差异。这些是我们同事深思熟虑后的意见。它们值得认真考虑。
