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

本研究旨在为社区的初级保健提供一个实用的教育方案。这样的程序是不可能在任何医院内建立的。选取的研究领域为内海山地岛屿村落。以公共诊所为基地，得到当地民众和公共卫生服务局的支持。实践教育课程由保健、治疗和护理组成，与综合医疗护理相结合。参与的学生是五年级和六年级的学生，他们经历过医院的实践训练。在此期间，每组2 - 3名学生接受10小时的实践训练。该项目包括：(1)上门拜访，了解生活方式和环境如何影响人们的健康状况；(2)普通疾病、慢性病和急性病的初级保健管理。(3)社区群体检查，包括系统的过程方法和持续随访研究对社区、家庭和个人的意义。(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，社区的实践培训是无法实现的。由于人才和熟练的检查员的增加，我们的方案有助于提高社区的卫生保健程度。上门服务项目的重点是那些因病待在室内的老年人。激发当地人民的合作是次要效果。基于这一经验，我们制定了以新成立的医学院为基础的“综合医疗服务教育培训方案构想”方案，重新思考医生在区域卫生服务中的作用。

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.