The Practical Education Program for Comprehensive Medicine in a New Establishment Medical School

本研究旨在为社区初级保健制定一套切实可行的教育方案。这样的项目在任何医院都是不可能建立的。选择的研究领域包括内海山区和岛屿的村庄。以公立诊所为基地，当地人民和公共卫生服务局支持这一计划。实践教育项目包括保健、治疗和护理，并与综合医疗保健相结合。参与的学生是五年级和六年级的学生，他们接受过临终关怀实践培训。在此期间，每两到三名学生组成的小组接受了10个小时的实践培训。该计划包括：(1)出诊，了解生活条件和环境对人们健康状况的影响；(2)常见病、慢性病的管理和急性病的初级保健。(3)社区集体检查，包括系统的过程方法和对社区、家庭和个人进行持续跟踪研究的意义。(4)核心医院与日间和/或短期住院中心之间的沟通渠道。没有人民的同意和支持，社区实践培训是不可能实现的。我们的计划促进了社区卫生保健程度的提高，因为增加了人才和熟练的审查员。家访计划将注意力集中在因病被限制在室内的老年人身上。刺激当地人民的合作是次要的效果。根据这一经验，我们在新建一所医学院的基础上，制定了《综合医疗服务教育培训方案构想》，对医生在区域卫生服务中的作用进行了重新思考。

This study aims at making a practical education program for primary care in the community. Such a program is impossible to set up inside any hospital.The reserch field selected comprised villages in the mountains and islands in the inland sea. The public clinics were used as bases, the local people and public health service bureau supported this program. The practical education program consisted of health care, cure and nursing connected with conprehensive medical care. The students involved were fifth and sixth graders who had expenrienced hosptal practical training. Each small groups of two or three students received 10 hours of practical training during the period. The program included, (1) Making house calls and understanding how the life stile and envilonment could affect the people's health condition, (2) Management of ordinal illness, chronic diseases and primary care of acute diseases. (3) The mass examination in community, including systematic process approach and the significance of continuous follow up study for the community, family and the individual. (4) The communication avenues between the core hospital and the day and /or short stay centers.Practical training in the community was not realizable without the people's consent and support. Our program contributed to an increase in the degree of the health care in the communities, because of the increase in talent and skilled examiners. The house call program focused attention on elderly who were confined indoors because of illness. Stimulated cooperation by the local people was a secondary effect. Based on this experience, we formulated a plan for "the conception of an education and training program on comprehensive medical services" based out of a newly established medical school, rethinking the role of doctors in regional health services.