Page 92 - 2022-28-中国全科医学

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of Hebei's assistant GP training bases in 2020，and put forward policy suggestions targeting the existing problems. Methods
We conducted this study during July 27 to 31，2020. We assessed the 23 assistant GP training bases in Hebei using the Assistant
General Practitioner Training Base Assessment System developed by the Chinese Medical Doctor Association，involving general
condition，training management，faculty team，process management，quality control and supporting measures. We also
conducted a questionnaire survey with trainees randomly selected from these bases（two or three trainees chosen from each base）
for understanding their socio-demographics，understanding of the training，satisfaction with the training，attitudes on the career
prospect of an assistant GP，and level of intention to work in rural areas. Results The rates of qualified，basically qualified and
unqualified bases were 65.2%（15/23），34.8%（8/23），and 0，respectively. Thirteen 13 bases（56.5%） had not yet set
up an independent general medicine department；11 bases（47.8%） had qualified teaching rounds assessed in terms of number
and implementation standards；10 bases（43.5%） carried out small lectures and case discussions appropriately assessed in
terms of number and implementation standards. The rate of passing the national Assistant Physician Licensing Examination once
was ≥ 85% in 2019 for trainees in 8 bases（34.8%）. The rate of passing the completion examination at the end of the training
conducted for the first time in all bases in 2019 was ≥ 85% for trainees in 12 bases（52.2%）. A total of 50 trainees attended
the questionnaire survey. The prevalence of being satisfied with the design of the rotation of departments，training contents，
clinical training base，primary care practice base，and the teaching team was 90.0%（45/50），90.0%（45/50），92.0%
（46/50），86.0%（43/50），and 94.0%（47/50），respectively. The career prospect of an assistant GP was thought to be
good by 39 trainees（78.0%）. Twenty-six trainees（52.0%） were willing to practice in rural areas. The level of satisfaction with
policies related to the training for assistant GPs or primary care practice bases differed significantly by age in trainees regardless of
whether the bases were qualified or basically qualified（P<0.05）. Conclusion In general，Hebei's training bases for assistant
GPs were found with a low rate of setting an independent general medicine department，unsatisfactory training quality，and low
trainee satisfaction. It is suggested that these training bases should strengthen the establishment of a general medicine department
and connotation construction of general practice，improve the construction of primary care practice bases，standardize the process
management，thereby improving the training quality.
【Key words】 General practitioners；Assistant general practitioners；Education，medical；Training base；Evaluation
results；Hebei

为深化医药卫生体制改革、推进落实分级诊疗制度， 家基地均为综合医院，其中二级医院 19 家（82.6%），
加快提升基层全科医生数量及质量，我国现阶段推行以 三级医院 4 家（17.4%）；冀中地区 12 家（52.2%）、
“5+3”（5 年临床医学本科教育 +3 年住院医师规范化 冀南地区 4 家（17.4%）、冀北地区 4 家（17.4%）、冀
培训）为主体、“3+2”（3 年临床医学专科教育 +2 年 东地区 3 家（13.0%）。
助理全科医生培训）为补充的全科医生培养方式 ［1-2］ 。 1.2 研究方法
其中，助理全科医生培养模式主要面向农村地区，旨在 1.2.1 基地评估人员 由河北省第一批住院医师规范化
改善城乡医疗资源失衡现状，提高农村基层医疗服务水 培训基地的全科医学科主任担任组长，由河北省第二批
平 ［3］ 。各级医疗行政部门对助理全科医生培训工作的 住院医师规范化培训基地的全科医学科主任 / 副主任、
评估与督导是规范助理全科医生培养、确保全科医生培 优秀基层实践基地主任组成评估小组，另设秘书 1 名。
训质量，为农村基层培养“下得去、用得上、留得住” 1.2.2 基地评估标准 依据中国医师协会发布的《助理
的全科医学人才的重要环节。河北省自 2016 年开始助 全科医生培训基地评估指标》，结合往年基地评估中发
理全科医生培训工作 ［4］ ，目前已招收 5 届学员，助理 现的问题，设置本次基地评估指标体系。评估指标体系
全科医生培训基地建设也从“完善制度建设”逐渐向“内 包括基本条件、培训管理、师资队伍、过程管理、质量
涵质量建设”转变。本研究报告了河北省助理全科医生 控制、保障措施 6 个一级指标，各一级指标下包括若干
培训基地的评估情况，并对在培学员开展调查，以了解 个二级、三级指标，每项三级指标的评估内容和评分
各基地在建设过程中存在的问题，从而为进一步加强培 标准均给出了详细定义和解释。以基本条件合格（即
训基地建设提供政策建议，也为其他地区开展培训基地 一级指标中基本条件项总得分≥ 9 分），且总分≥ 80
建设提供参考。 分，培训质量得分（即一级指标中质量控制项总得分）
1 对象与方法 ≥ 28 分为合格；以基本条件合格，总分为 65~<80 分，
1.1 研究对象 于 2020 年 7 月 27—31 日，对河北省 培训质量得分为 23~<28 分为基本合格。
13 个地市共 23 家助理全科医生培训基地开展评估。23 1.2.3 基地评估方法 参照国家住院医师规范化培训基