Prislin M D, Morohashi D, Dinh T, Sandoval J, Shimazu H
Department of Family Medicine, University of California-Irvine, USA.
Fam Med. 1996 Oct;28(9):624-8.
Community health centers (CHCs), sponsored by US Public Health Service (USPHS) Section 330, represent successful models of the application of community-oriented primary care principles. Recently, increased interest has been shown in conducting medical education programs in CHCs. The USPHS has tried to facilitate this interest, particularly through its support of establishing linkages between CHCs and family practice residency programs. In this paper, we describe an integrated CHC-family practice residency continuity training clinic program. We discuss the challenges inherent to conducting family practice residency training in the CHC, including the educational content of clinical experiences, the impact of provider productivity expectations, the academic and operational governance of the program, and the financial considerations pertinent to the integrated function of the program. We conclude that while the clinical experiences available in the CHC differ somewhat from mainstream family practice, successful adaptations can be made, and a CHC offers a rich educational environment. We also conclude that the challenges inherent to integrated CHC-family practice residency programs can be successfully addressed. Of great concern, however, are financial considerations relevant to the operation of such integrated programs. These considerations underscore the urgent need for a reassessment of the funding of ambulatory clinical medical education.
由美国公共卫生服务局（USPHS）第330条款资助的社区卫生中心（CHC），代表了以社区为导向的初级保健原则应用的成功模式。最近，人们对在社区卫生中心开展医学教育项目的兴趣有所增加。美国公共卫生服务局一直试图推动这种兴趣，特别是通过支持在社区卫生中心与家庭医学住院医师培训项目之间建立联系。在本文中，我们描述了一个社区卫生中心与家庭医学住院医师连续性培训诊所的综合项目。我们讨论了在社区卫生中心开展家庭医学住院医师培训所固有的挑战，包括临床经验中的教育内容、对医疗服务提供者生产力期望的影响、项目的学术和运营管理，以及与该项目综合功能相关的财务考量。我们得出结论，虽然社区卫生中心提供的临床经验与主流家庭医学有所不同，但可以成功进行调整，并且社区卫生中心提供了丰富的教育环境。我们还得出结论，社区卫生中心与家庭医学住院医师综合项目所固有的挑战可以得到成功解决。然而，与此类综合项目运营相关的财务考量令人极为担忧。这些考量突出了重新评估门诊临床医学教育资金的迫切需求。
