目的 了解住院医师规范化培训(以下简称住培)协同培训现状,分析存在的主要问题,提出协同培训质量控制对策。方法 2019年11月,采用多阶段随机抽样法,选取6个省(自治区)的15个国家首批住培基地及其40个协同单位、793名协同单位住培指导医师进行问卷调查,采用Excel软件进行描述性统计分析。结果 15家住培基地中,平均每个住培基地与3家单位协同;39.2%(134/342)专业开展协同培训,25.4%(34/134)专业同时与2个以上单位协同。40家协同单位中,85.0%(34/40)的为三级医院,55.0%(22/40)的为专科医院,90.0%(36/40)的落实培训“一把手”负责制,90.0%(36/40)的对住培工作有投入,60.0%(24/40)的独立承担整个期限培训工作,35.0%(14/40)的专职管理人员不足2人。22家专科医院中,95.5%(21/22)的体现专科特色。793名指导医师中,18.5%(147/793)的不符合指导医师职称条件,12.5%(99/793)的未经住培指导医师培训。结论 协同单位基本具备协助住培基地开展培训工作的能力和条件,但协同培训要求有待明确、一体化协同组织管理有待加强、协同单位培训能力有待提升,需要通过加强协同培训制度顶层设计、完善协同培训机制、严格协同培训质量控制、加强协同单位培训能力特别是指导医师能力建设等,完善住培协同培训工作。

Objective To understand the current situation of collaboration in standardized residency training program (hereinafter referred to as residency training), so as to analyze the main problems, and propose the quality control countermeasures for collaborative training. Methods In November 2019, with the multi-stage random sampling method, the first batch of 15 national residency training hospitals and its 40 collaborative hospitals in 6 provinces (including autonomous regions), as well as 793 instructing physicians in collaborative hospitals were surveyed using questionnaire. Descriptive statistical analysis was performed by Excel software. Results Among the 15 residency training hospitals, each one was cooperated with 3 collaborative hospitals on average. Thirty-nine point two percent (134/342) of specialties were carried out collaborative training, and 25.4% (34/134) of specialties were cooperated with more than two collaborative hospitals at the same time. Among the 40 collaborative hospitals, 85.0% (34/40) were tertiary hospitals, and 55.0% (22/40) were specialized hospitals, and 90.0% (36/40) implemented the “chief” responsibility system, and 90.0% (36/40) invested in residency training, and 60.0% (24/40) independently undertook the training work of the whole period. Thirty five percent (14/40) had less than 2 full-time management personal. Among the 22 specialized hospitals, 95.5%(21/22) reflected specialty characteristics. Among the 793 instructing physicians, 18.5% (147/793) did not meet the requirements for the title of instructing physician, and 12.5% (99/793) did not receive the training. Conclusions The collaborative hospitals have basically been equipped with the ability and conditions to assist residency training hospitals to carry out training. However, the requirements of collaborative training need to be clarified, the integrated collaborative management needs to be strengthened, and the training ability of collaborative hospitals needs to be improved. The suggested measures are to strengthen the top-level design of collaborative training system, improve the collaborative training mechanism, strictly control the quality of collaborative training, and strengthen the training ability of collaborative hospitals, especially the ability of instructing physicians, so as to further improve the collaborative training of standardized residency training program.