The Research On The Feasibility Of Implementation Of The Specialist Physician System In Tianjin

Objective:To give some recommendations of establishing the specialist physician system in Tianjin,the methods of the specialist training,access and management system in abroad and other parts of our country were collected and compared,the actual situation of standardized training of residents in Tianjin was investigated,the major factors that could impact the establishment of specialist physician system in Tianjin were analyzed,including policy support,integration system,operational mechanism,and so on.Method:①Document study:collect and search the content and method of specialist training,access and management system in other countries or regions,with the relevant information we did the systematic analysis and comparison,from the Ministry of Health Information Network to get the specialist physician system related policies,laws,regulations,decrees and comprehensive measures,as well as the situations in some provinces and municipalities which have already carried out this system.②Sampling survey:1100 managers,clinical experts,resident and medical education managers in 18 secondary and tertiary hospitals in Tianjin were selected using cluster and stratified sampling.Meanwhile,the collected information were described and analyzied.③Expert consult:the experts in the fields of health management,health policy or public policy,laws and regulations,hospital management,health economics or macro-economic,sociology,public health were consulted,and discussed the specialist physician system deficiencies and problems in Tianjin,which all based on the analysis of the theme of the research and the questionnaire results.Results:95.10%people thought it necessary for Tianjin to establish the specialist physician system,96.25%thought it was the duty of Ministry of Health to establish the laws.And there were 81.67%and 82.60%thought professional academies should take in charge of the development of training standards and qualification,respectively.83.8%of the investators believed that the standardized residency training could be a part of the specilist system,and there was no statistic differences among the different kinds of the investators(P＞0.05),and there were 86.98%thought the specilist system should contain seperated phases mode(3+X). The top 3 conditions of the establishment of the specilist basement were appropriate teachers and educationgal resources(27.77%),the subject level in China and representative diseases extention(18.07%).About the content of specilist trainting, 24.28%thought it should contain clincal technology,24.10%thought it should contian medical knowledge,21.55%thought it should contian teaching skills and research capability.78.0%thought the qualified practitioners should be got before the specilist training without any stastic differences among different groups of people (P＞0.05).There were 82.3%thought the day-to-day assessment and cycle system should be the duty of the training base,the annual assessment was responsible for the hospital where the training base was,phase examination should be taken by the graduated medical education committee.94.69%thought the doctors who had taken the specilist training should participate in the qualified examination,and 89.27% thought the doctors should take in the qualifed examination regularly even after the specilist qualifacation,74.9%thought the training fee should be taken both by the government and individuals,90.6%thought it necessary to improve the evaluation system by the addition of specilist quatification.Conclusions:with the experience of other countries or regions and the results of the investigation,combining the present situation of specilist,we could take the administrative authority mode to establish the management framework of specilist system in Tianjin,develop laws and supporting policies,make the management responsibilities and authority clearly,exert the academic advantage and the talents of the medical institutions fully,to build the situation that every department has its responsibility gradually;practise the newly personnel management system,the way to recruit students could be dual-track system,to improve the mechanism of competition for talent and the streaming furtherly,to explore the sharing of personal,unit support, the government and other donor-funded and community financing for multi-channel approach.At the same time,specilist qualified could take the PCRR mode.