Professional doctoral students in general practice are the important component of academic education in general practice, but the related research on their enrollment is still insufficient.
The aim was to understand the scale and distribution of enrollment of professional doctoral students in general practice in China, and provide reference for promoting the development of general practice education.
From February 2022 to September 2023, data from general practitioner doctoral enrollment information through the official website of 51 schools with clinical medical doctoral first level discipline doctoral programs nationwide and the China Graduate Enrollment Information Network was obtained. The data was analyzed to illustrate the enrollment scale, distribution of enrollment institutions and enrollment structure of professional doctoral students.
From 2021 to 2023, there were 15, 17 and 17 universities respectively enrolling professional doctoral students in general practice, and the enrollment quota was 100 in total. These enrollment universities were mainly concentrated in the eastern region. Medical universities had a relatively low proportion. These enrollment universities were mainly concentrated in B-level of discipline and the proportion of double first-class universities was not high.
Based on the investigation, it was found that there was a small number of institutions offering the professional doctoral education in general practice, with a limited enrollment scale and uneven distribution of participating institutions. Prominent issues such as weak faculty teams were also identified. Therefore, it is recommended to strengthen top-level design at the national and university levels, enhance enrollment promotion efforts, establish scientific admission standards, student support policies, and optimize the selection system for supervisors. These measures could expand the channels for enrolling professional doctoral students in general practice, and provide strong support for cultivating high-end medical professionals with comprehensive medical service capabilities.
More and more attention has been paid to the training of medical students' doctor-patient communication skills. It was necessary to improve the doctor-patient communication skills of general medicine postgraduates.
To explore the current situation of doctor-patient communication ability of postgraduates in general medicine and the influence of mentors on it.
A total of 72 full-time postgraduate students majoring in general practice, who were being supervised by 66 full-time postgraduate supervisors from the School of General Practice and Continuing Education of Capital Medical University from January to December 2023, were selected as the research subjects. The doctor-patient communication skills of the postgraduate students and their supervisors were evaluated using the SEGUE scale, and evaluate the gap between them and Beijing general practitioners and outpatient doctors in tertiary hospitals; the correlation analysis between the communication ability of the supervisors and the students in Pearson.
The professional master's degree students majoring in general practice scored lower than Beijing general practitioners in the dimensions of preparation, information collection, information provision, understanding patients, ending the consultation and the total score (P<0.05), and scored lower than the general practitioners in the tertiary grade A hospitals in Beijing in the dimensions of information collection, information provision, ending the consultation and the total score (P<0.05). According to whether the main clinical training unit is the supervisor group, the graduate students are divided into the accompanying supervisor group and the not accompanying tutor group. The preparation stage, information collection dimension score and total score of the accompanying tutor group were higher than the unrelated tutor group (P<0.05). With the supervisor group, the preparation stage, information collection, information giving, patient understanding, end of the SEGUE scale and the total score were positively correlated (P<0.05). A positive correlation was observed between the graduate students and the supervisor SEGUE scale in the supervisor group (P<0.05) .
The doctor-patient communication skills of general medicine postgraduates need to be further improved. The doctor-patient communication skills of postgraduates were closely related to their tutors. Appropriate optimization of the training mode of general medicine postgraduates should help to improve the doctor-patient communication skills of general medicine postgraduates.
General practice teaching clinic is an important training method to develop clinical thinking and improve general practice diagnosis and treatment ability of general practice residents. In this paper, we used a patient with fatigue as the main manifestation as a teaching case to introduce the Murtagh safe diagnostic strategy proposed by John Murtagh, a famous Australian general medicine expert, to inspire the diagnosis and differential diagnosis of fatigue for the general practice residents in the general practice teaching clinic: (1) What are the common diseases that cause fatigue? (2) What are the important diseases that should not be ignored? (3) What are the easily missed diseases of fatigue? (4) Are there underlying easily masked diseases? (5) Is there something the patient is not saying? Combined with the history, physical examination and laboratory findings, a preliminary diagnosis of antineutrophil cytoplasmic antibody-associated vasculitis causing rapidly progressive glomerulonephritis is highly probable. The timely referral got nephropathology which confirms the etiology of the fatigue was antineutrophil cytoplasmic antibody-associated glomerulonephritis, and achieved satisfactory outcome. Based on the Murtagh safe diagnostic strategy, the instructor helped the general practice residents to construct a systematic knowledge framework for the identification and analysis of fatigue, so as to improve their clinical logical thinking ability and the ability to solve practical clinical problems. Using the mind mapping as an auxiliary tool, the diagnosis and differential diagnosis of the Murtagh safe diagnostic strategy were concretized and visualized, so as to optimize the teaching effect.
