中国全科医学 ›› 2026, Vol. 29 ›› Issue (01): 58-66.DOI: 10.12114/j.issn.1007-9572.2025.0135

• 全科医学教育研究 • 上一篇    下一篇

全科医学住院医师规范化培训延期结业成因及改革策略的跨国对比研究

温大志1, 李珍淑2, 李贞姬3, 王妮4, 刘冬5, 周宪春1,*(), 玄春花1,*()   

  1. 1.133000 吉林省延吉市,延边大学附属医院(延边医院)
    2.133000 吉林省延吉市,延边朝鲜族自治州医学教育考试服务中心
    3.133000 吉林省延吉市公园社区卫生服务中心
    4.130000 吉林省长春市,吉林省卫生健康委员会
    5.130000 吉林省长春市,吉林省住院医师规范化培训指导中心
  • 收稿日期:2025-03-31 修回日期:2025-07-02 出版日期:2026-01-05 发布日期:2025-12-18
  • 通讯作者: 周宪春, 玄春花

  • 作者贡献:

    温大志负责研究设计、数据收集与论文撰写;李珍淑负责文献分析与图表制作;李贞姬负责文献的收集与整理;王妮负责政策资料整理;刘冬提供培训体系数据;周宪春负责全文审校与质量把控,对文章整体负责;玄春花负责国际案例比较与结论修订。

  • 基金资助:
    吉林省教育科学"十四五"规划课题(GH24593)

Delayed Completion in General Practice Residency Training: a Cross-National Comparative Study on Causes and Reform Strategies

WEN Dazhi1, LI Zhenshu2, LI Zhenji3, WANG Ni4, LIU Dong5, ZHOU Xianchun1,*(), XUAN Chunhua1,*()   

  1. 1. Affiliated Hospital of Yanbian University, Yanji 133000, China
    2. Yanbian Korean Autonomous Prefecture Medical Education Examination Service Center, Yanji 133000, China
    3. Yanji City Park Community Health Service Center, Yanji 133000, China
    4. Jilin Provincial Health Commission, Changchun 130000, China
    5. Jilin Provincial Resident Standardized Training Guidance Center, Changchun 130000, China
  • Received:2025-03-31 Revised:2025-07-02 Published:2026-01-05 Online:2025-12-18
  • Contact: ZHOU Xianchun, XUAN Chunhua

摘要: 本文聚焦全科医学住院医师规范化培训(以下简称住培)延期结业问题,对世界上11个有代表性的发达国家、发展中国家的培训体系、延期现状、成因及改革策略展开跨国对比分析。研究发现,全球全科住培延期结业现象普遍,延期率受临床资源短缺、考核标准提升、突发公共卫生事件及住院医师心理健康等多重因素影响,发展中国家因区域资源不均问题更显突出。各国应对策略呈现差异化特点:美国依托动态评估机制优化培训路径,日本通过政策激励提升基层医生留存率,中国借助信息化手段强化过程管理等。破解该问题需从适应性培训模式重构、支持性生态网络构建、危机响应机制迭代三大维度协同发力,在效率与人文、标准与个性间寻求平衡,以提升全科医学教育韧性与医疗服务质量。

关键词: 全科医学, 住院医师规范化培训, 延期结业, 跨国比较, 卫生人力

Abstract:

This review focuses on the delayed graduation issue in standardized residency training for general practitioners (GPSRT), conducting a cross-national comparative analysis of training systems, current status of delays, contributing factors, and reform strategies across 11 representative developed and developing countries. Findings reveal that delayed graduation in global GPRT programs is widespread, with postponement rates influenced by multiple factors including clinical resource shortages, elevated assessment standards, public health emergencies, and residents' mental health challenges. Developing countries face more pronounced challenges due to regional resource disparities. Nations demonstrate differentiated countermeasures: the United States optimizes training pathways through dynamic assessment mechanisms, Japan enhances grassroots physician retention via policy incentives, while China strengthens training process management through digital technologies. The study proposes that resolving this issue requires coordinated efforts across three dimensions: restructuring adaptive training models, building supportive ecosystem networks, and iterating crisis response mechanisms. This approach seeks to balance efficiency with humanistic care, standardization with personalization, ultimately enhancing the resilience of general practice education and healthcare service quality.

Key words: General practice, Residency training, Delayed completion, Comparative analysis, Healthcare workforce

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