柏明　李露　李洋平

[摘要] 专科医师培训是培养医学精英人才的重要环节。我国慢性肾脏病患病率高达10.8%，对肾脏病专科医师需求量大，而我国精英肾科医师短缺。美国专科医师培训制度和体系相对成熟。此文分析了美国肾脏病专科医师培训的管理结构、培训时间要求、培训目的、培训安排、培训考核等方面的内容。进一步就我国肾脏病专科医师培训的有效开展提出了一些建议，认为在培训时间安排、培训考核等方面均可做出参考，具体执行过程中也许结合我国现状，形成我国肾脏内科专科医师培训的特色。

[關键词] 培训；专科医师；肾脏病；住院医师

[中图分类号] R05 [文献标识码] A [文章编号] 1673-7210（2018）05（a）-0117-04

Enlightenment of American graduate medical education system on Chinese nephrology specialty education

BAI Ming LI Lu LI Yangping ZHAO Lijuan WANG Huang SUN Shiren

Department of Nephrology， Xijing Hospital， Air Force Medical University， Shaanxi Province， Xi'an 710032， China

[Abstract] Specialty education is one of the most important stages of thetraining of high-quality physicians. The prevalence of chronic kidney disease in China is 10.8%. There is short of nephrology specialties for the supply of high quality medical services. The American specialty education system is one of the advanced system for graduate medical education. This article analyzes the strategies of American nephrology specialty education， including the organization model， training time， training targets， training arrangement， and training evaluation strategies. Furthermore， it presentes several suggestions for the nephrology specialty education of our country and believes that the American strategies of the training time and training evaluation have important reference value for the construction of our training strategies. Of course， the nephrology specialty training model of our country should adapt the current situation of our hospitals and have Chinese characteristics.

[Key words] Train； Diplomate； Nephrology； Resident

毕业后医学继续教育是高级医师培养的重要环节。美国的医学教育在世界上处于领先地位，具有非常成熟的体系和规章制度。从1904年美国医学教育委员会成立以来，美国医学教育日趋完善，逐渐发展为院校医学教育、毕业后医学教育、继续医学教育阶段[1]。我国在院校医学教育、毕业后医学教育方面已基本与国际接轨，但是在继续医学教育方面，还处于起步阶段，尤其是医学精英人才培养的专科医师培训项目，处于试点阶段[2-3]。我国慢性肾脏病患病率高达10.8%，患病人数超1.2亿，住院患者急性肾损伤发病率为7%～18%，重症患者急性肾损伤发病率可高达50%，肾脏病专业专科医师严重缺乏，水平参差不齐，严重影响了我国国民的健康水平[4-5]。此文分析了美国继续教育中的肾脏病专科医师培训情况，并就我国肾脏病专科医师培训的开展谈谈我们的体会。……