我国医药卫生人才培养战略研究
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摘要
本文在基于数据与证据综合分析医药卫生人才培养总体现状的基础上,充分借鉴国际经验并考虑我国国情,以建立人才培养供需平衡机制和提高人才培养质量为重点内容开展研究。研究提出如下政策建议:一是继续提升战略定位,在国家层面建立宏观管理协调机制;二是科学规划招生、改革课程体系,分阶段逐步实现医学教育精英化和均质化;三是逐步取消临床医学硕士和博士招生统考制度和学位论文制度,将规培与学位并轨,并推进医生由单位人过渡为行业人;四是加快人事薪酬制度和评价制度改革试点与实施;五是构建以大健康为中心的公共卫生人才培养体系;六是积极推动以"师承教育+学位教育"为特色的中医药人才培养体系;七是建立国家健康研究基金。
This study aims to propose policy recommendations for improving the quality of medical education and clinical training in China. Using several strategic research methods such as data and evidence analysis, we learned the experiences and lessons for a homogenization of medical education and clinical training as well as a balanced mechanism between medical professionals' supply and medical demands. Results and conclusions are presented as follows. First, it is important to enhance the strategic position of medical education and personnel training and to establish a coordination mechanism at the national level. Second, we recommend a dynamic planning for the enrollment of China's medical schools based on the systematic analysis of medical demand, and promoting medical curriculum system reform. We suggest gradually arriving at a tradition of elite education and a homogenization of clinical training. Third, we argue progressively abolishing the entrance examinations and dissertations for achieving the master and doctoral degree in clinical sector. The best way is to combine personnel training with master and/or doctoral degree granting, and promote the role transition for clinicians from "institutional staff" to "medical professionals". Fourth, we recommend accelerating a pilot reform of personnel compensation system and performance evaluation system for clinicians to reshape the attractiveness of medical career. In addition, it is imperative to build a public health-oriented clinical training system based on the concept of "health for all". Furthermore,it is also very important to reform traditional Chinese medicine(TCM) higher education in China and explore a new clinical training model for TCM residents. Last but not least, we recommend establishing a National Health Research Foundation to improve the innovation capability of clinical research in China.
This study aims to propose policy recommendations for improving the quality of medical education and clinical training in China. Using several strategic research methods such as data and evidence analysis, we learned the experiences and lessons for a homogenization of medical education and clinical training as well as a balanced mechanism between medical professionals' supply and medical demands. Results and conclusions are presented as follows. First, it is important to enhance the strategic position of medical education and personnel training and to establish a coordination mechanism at the national level. Second, we recommend a dynamic planning for the enrollment of China's medical schools based on the systematic analysis of medical demand, and promoting medical curriculum system reform. We suggest gradually arriving at a tradition of elite education and a homogenization of clinical training. Third, we argue progressively abolishing the entrance examinations and dissertations for achieving the master and doctoral degree in clinical sector. The best way is to combine personnel training with master and/or doctoral degree granting, and promote the role transition for clinicians from "institutional staff" to "medical professionals". Fourth, we recommend accelerating a pilot reform of personnel compensation system and performance evaluation system for clinicians to reshape the attractiveness of medical career. In addition, it is imperative to build a public health-oriented clinical training system based on the concept of "health for all". Furthermore,it is also very important to reform traditional Chinese medicine(TCM) higher education in China and explore a new clinical training model for TCM residents. Last but not least, we recommend establishing a National Health Research Foundation to improve the innovation capability of clinical research in China.
引文
[1]国家卫生与计划生育委员会.2017中国卫生和计划生育统计年鉴[M].北京:中国协和医科大学出版社,2017.National Health Commission of the PRC.National health and family planning statistical yearbook 2017[M].Beijing:Peking Union Medical College Press,2017.
[2]中国科协调研宣传部,中国科协创新战略研究院.中国科技人力资源发展研究报告--科技人力资源与创新驱动[M].北京:清华大学出版社,2018.Research and Publicity Department of China Association for Science and Technology,National Academy of Innovation Strategy of China Association for Science and Technology.The report on the development of HRST in China[M].Beijing:Tsinghua University Press,2018.
[3]National Institute of Science and Technology Policy(NISTEP).Japanese science and technology indicators 2016[R].Tokyo:National Institute of Science and Technology Policy,2016.
[4]A Working Group of the Advisory Committee to the Director.Biomedical research workforce working group report[R].Bethesda:National Institutes of Health,2012.
[5]Council on Graduate Medical Education.Physician workforce policy guidelines for the United States,2000-2020[R].Rockville:Health Resources and Services Administration,Depart ment of Health and Human Services,2005.
[6]IHS Inc.The complexities of physician supply and demand:Projections from 2013 to 2025[R].Washington,DC:Association of American Medical Colleges,2014.
[7]Department of Health and the Higher Education Funding Council for England.Planning of medical and dental school intakes in England[R].England:Department of Health and the Higher Education Funding Council for England,2012.
[8]Moses H,Matheson D H M,Cairnssmith S,et al.The anatomy of medical research:US and International comparisons[J].The Journal of the American Medical Association,2015,313(2):174-189.
[9]Jiang L X,Krumholz H M,Li X,et al.Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system[J].Lancet,2015,386(10002):1493-1505.
[2]中国科协调研宣传部,中国科协创新战略研究院.中国科技人力资源发展研究报告--科技人力资源与创新驱动[M].北京:清华大学出版社,2018.Research and Publicity Department of China Association for Science and Technology,National Academy of Innovation Strategy of China Association for Science and Technology.The report on the development of HRST in China[M].Beijing:Tsinghua University Press,2018.
[3]National Institute of Science and Technology Policy(NISTEP).Japanese science and technology indicators 2016[R].Tokyo:National Institute of Science and Technology Policy,2016.
[4]A Working Group of the Advisory Committee to the Director.Biomedical research workforce working group report[R].Bethesda:National Institutes of Health,2012.
[5]Council on Graduate Medical Education.Physician workforce policy guidelines for the United States,2000-2020[R].Rockville:Health Resources and Services Administration,Depart ment of Health and Human Services,2005.
[6]IHS Inc.The complexities of physician supply and demand:Projections from 2013 to 2025[R].Washington,DC:Association of American Medical Colleges,2014.
[7]Department of Health and the Higher Education Funding Council for England.Planning of medical and dental school intakes in England[R].England:Department of Health and the Higher Education Funding Council for England,2012.
[8]Moses H,Matheson D H M,Cairnssmith S,et al.The anatomy of medical research:US and International comparisons[J].The Journal of the American Medical Association,2015,313(2):174-189.
[9]Jiang L X,Krumholz H M,Li X,et al.Achieving best outcomes for patients with cardiovascular disease in China by enhancing the quality of medical care and establishing a learning health-care system[J].Lancet,2015,386(10002):1493-1505.
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