Hefelfinger D C
Department of Pediatrics, College of Community Health Sciences, University of Alabama School of Medicine, Tuscaloosa 35487, USA.
Acad Med. 1998 Dec;73(12):1274-6. doi: 10.1097/00001888-199812000-00017.
Japanese medical education differs from U.S. medical education in a number of ways. In particular, Japanese medical students have little hands-on contact with patients in their six years of medical school; in post-graduate training, Japanese residents spend most of their time caring for tertiary care patients with complex diseases, and they generally get little practice in performing such basic patient-care tasks as history taking and physical evaluation. Invited to be a visiting professor at Japan's Chubu Hospital (which is affiliated with the University of Hawaii), the author spent three months working with Japanese pediatrics residents. During this time, he studied the residents' clinical experiences and levels of competency in such basic pediatrics skills as failure-to-thrive workups, estimation of dehydration and fluid replacement, detection of strabismus. He discusses his conclusion that these residents are ill prepared for general clinical work and the possible consequences of this poor preparation. Finally, he briefly reviews similar concerns raised by the American Academy of Pediatrics about how well pediatrics residents in the United States are prepared for general clinical practice.
日本的医学教育在许多方面与美国的医学教育不同。特别是，日本医学生在医学院的六年时间里很少有与患者直接接触的实践机会；在研究生培训阶段，日本住院医生大部分时间都在照顾患有复杂疾病的三级护理患者，而且他们在进行诸如病史采集和体格检查等基本患者护理任务方面的实践机会通常很少。受邀担任日本中部医院（该医院隶属于夏威夷大学）的客座教授时，作者与日本儿科住院医生共事了三个月。在此期间，他研究了这些住院医生在诸如发育不良检查、脱水评估与补液、斜视检测等基本儿科技能方面的临床经验和能力水平。他讨论了自己的结论，即这些住院医生对一般临床工作准备不足以及这种准备不足可能产生的后果。最后，他简要回顾了美国儿科学会提出的类似担忧，即美国的儿科住院医生对一般临床实践的准备情况如何。
