Bayley T J
Med Educ. 1995;29 Suppl 1:95-6. doi: 10.1111/j.1365-2923.1995.tb02903.x.
Specialist training must be reshaped to meet the challenges of new systems for the delivery of health care and rapid expansion in biomedical knowledge. An adequate and affordable supply of trained specialists and generalists able to deal with the health problems of populations served, is the responsibility of governments and policy-makers that fund and those who deliver graduate education. Clearly defined objectives for specialist training are needed, linked to planning for the medical workforce size. A balance between numbers of specialists and generalists is essential, although flexibility in programmes should allow individuals to change. Curricula for all specialties should be published. Strategies and methods for delivery of graduate education and training must be coherent with those of medical schools. Training should be planned and sequenced to meet the identified needs of individuals. Those who teach should themselves learn how to train and assess trainees. The location for training should reflect present and future clinical practice if disfunction between medical education and the health of populations served and their need is to be avoided. Specialist training should form the basis for continuing education by encouraging lifelong, evidence-based learning. Any reshaping of specialist training must be consistent with the continuum of medical education. Instruments for assessment of specialists in training have to be refined, based on action research. Ensuring mastery in the competencies of each component of the curriculum is essential. Those competencies will change in consequence of altered societal needs plus advances in technology and biomedical knowledge.
专科培训必须进行重塑，以应对医疗保健新体系以及生物医学知识迅速扩展带来的挑战。提供充足且负担得起的、能够处理所服务人群健康问题的专科医生和全科医生，是资助研究生教育的政府和政策制定者以及提供研究生教育者的责任。需要明确界定专科培训目标，并与医疗劳动力规模规划相挂钩。专科医生和全科医生数量之间的平衡至关重要，尽管课程设置应具有灵活性，允许个人进行转变。所有专科的课程都应予以公布。研究生教育和培训的交付策略与方法必须与医学院的策略与方法保持一致。培训应进行规划并按顺序安排，以满足个人已确定的需求。授课者自身应学习如何培训和评估学员。如果要避免医学教育与所服务人群的健康及其需求之间出现脱节，培训地点应反映当前和未来的临床实践。专科培训应通过鼓励终身的、基于证据的学习，为继续教育奠定基础。专科培训的任何重塑都必须与医学教育的连续性保持一致。必须基于行动研究来完善培训中专科医生的评估工具。确保掌握课程每个组成部分的能力至关重要。由于社会需求的变化以及技术和生物医学知识的进步，这些能力也会发生变化。
