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Comparison and Reflection on the Training System of Foreign Critical Care Medicine Specialists
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摘要: 我国重症医学专业发展迅速，在重症患者救治、突发灾害和公共卫生事件中发挥重要作用。专科医师规范化培训是毕业后医学教育的重要组成部分，也是培养合格专科临床医师的常规途径。作为国家第二批试点专科，重症医学专业已建立全国专科医师培训制度，成为培养学科专业人才梯队的重要途径。本文从培训体系和平台建设方面对比思考国外重症医学专科医师培训制度的异同，为推进我国重症医学专科培训制度不断完善提供借鉴。Abstract: Critical care medicine in China has developed rapidly and played an irreplaceable role in the treatment of critically ill patients, emergency disasters and public health events. The standardized training of specialists is not only an important part of medical education after graduation, but also a conventional way to train qualified specialized clinicians. As the second batch of national pilot specialties, critical care medicine has established a national unified specialist training system, which has become an important way to cultivate professionals. This study compares the similarities and differences of critical care medicine specialty training in foreign countries from the aspects of training system and platform construction, so as to provide reference for promoting the continuous improvement of critical care specialist training system in China.
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Key words:
- critical care medicine /
- specialist training /
- system
作者贡献：崔娜、汤铂负责论文选题策划和框架设计；汤铂负责撰写论文初稿；胡小芸负责提供相关资料；崔娜、隆云、杜斌负责审阅并提出修改意见。利益冲突：所有作者均声明不存在利益冲突 -
表 1 国外重症医学专科医师培训基地与师资要求
项目 ACGME(美国) CoBaTrICE(欧洲) CICM(澳大利亚和新西兰) 培训基地 床位数量 - 6张及以上 ≥5张且≥3张可行有创机械通气 患者数量 专培医师与患者比例为1∶10 未规定年收治人数，但要求＞25%的患者机械通气时间大于24 h，或患者住ICU总时长的40%以上应用机械通气 年收治ICU患者数≥250人，内、外科患者兼有，且包括接受有创机械通气＞24 h的患者 培训资源 培训站点有重症监护病房；有模拟和技能实验室、在线影像系统、软件资源；足够的计算机和工作空间 能提供必要的设施和资源(互联网、图书馆、教室)及职业咨询 能提供互联网、教材、期刊等教育资源 资质认证 发起机构符合ACGME对培训基地的要求；参与站点与发起机构签订PLA 必须通过国家培训权威机构认证 通过CICM认证 复审工作 PLA每10年需进行一次更新；PLA由指定的培训基地官员批准 能够提供接受定期审查的材料 认证有效期为5年；在5年周期将结束时，需由医院认证委员会更新认证 培训师资 培训主管 通过相关专业委员会和ACGME评审委员会的双重认证；具有培训场所的执业证书；负责重症监护病房日常工作；每周10%的非临床时间参与培训项目管理 ICU临床主任兼任 ICU主任 教师资格 具有执业资格并被医疗机构聘用；亚专业导师需具备相关亚专业资质认证 有经验的重症医学专家，获得国家重症医学培训机构的聘用；能够提供长期从事重症医学专业的证明 具有3年以上经验、除ICU主任外的重症监护专家；至少有1名重症监护专家为重症监护学院院士；每周至少8 h参与培训 师生比例 指导医师与培训对象的比例为1∶1 - 指导医师与培训对象的比例不超过1∶10 ACGME：毕业后医学教育认证委员会；CoBaTrICE：重症技能培训计划协作组；CICM：重症医学学院；PLA：项目协议书 
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