2019年10月,国家卫生健康委员会印发《综合医院风湿免疫科学科建设与管理指南(试行)》,提出所有三级医院必须建立风湿免疫科,并且要在有条件的二级医院配备风湿免疫专科医师。然而,我国风湿病专科医师仍属于极度缺乏状态,亟待建立风湿病学专科医师培训体系。美国现已建立了较为完善的风湿病学专科医师培训制度,具备详细的考核与评估体系。本文系统回顾了美国基于胜任力的风湿病学专科医师培训评估体系的构建和发展,主要包括美国毕业后医学教育认证委员会内科亚专业里程碑标准1.0,风湿病学里程碑标准2.0以及风湿病学置信职业行为,以期对我国风湿病学专科医师培训体系的建立和完善提供参考。
In October 2019, the National Health Commission of China issued the Guidelines for the Establishment and Management of Rheumatology Departments in General Hospitals (Trial), mandating the establishment of rheumatology departments in all tertiary hospitals and the assignment of rheumatology specialists in qualified secondary hospitals. However, there is a significant shortage of rheumatologists in China, highlighting the urgent need to develop a comprehensive rheumatology fellowship training system. In contrast, the United States has established a relatively well-developed rheumatology fellowship training program with detailed assessment and evaluation systems. This paper systematically reviews the establishment and evolution of the competency-based training and assessment framework in the rheumatology fellowship programs in the US. It covers the Internal Medicine Subspecialty Milestones, Rheumatology Milestones 2.0, and Entrustable Professional Activities (EPAs). The goal is to provide insights and guidance for developing a rheumatology fellowship training system in China.
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