臺灣中醫臨床教育之探討

Clinical Chinese Medicine Training in the Republic of China

臺灣唯一的中醫學院－中國醫藥學院，以宏揚我國傳統醫藥學為興學宗旨，追而融匯中西醫學，創造新的醫藥學術體系。附設醫院於民國六十九年(1980)落成開幕，首創中西醫合作的教學醫院，病床六百八十七張，設置中、西醫兩個部，由中醫、西醫分別發展，進而從互補互助十，推行中西醫結合的醫療、研究與專業訓練。中醫部共設中醫內、婦、傷、針灸等八科與中西醫合作醫療中心。合計專任、兼任醫師七十餘位，共同從日常的業務之中，擔當現代中醫師專業訓練的工作，為國儲才。訓練管道，以學院的七年制中醫學系、學士後中醫學系的後期養成教育為主，加上考試院特種考試及格中醫的業前實習。臨床訓練以言教與身教二者並重，原則上跟診、預診、巡房之類，重在身教：晨會、病歷、病例討論會、演講會或放映錄影帶之類，不僅言教，且須問難釋疑，這是一般醫學院教學的通則。我們實施的三個訓練計劃，各有其特性，依序是：一、實習醫師訓練。為期一年或幾個月。偏重灌輸中國傳統醫療的理、法、方、藥，可與西醫部的訓練制度及方法作對比。二、住院醫師臨床交織訓練。中醫部住院醫師與西醫部住院醫師交織互訓，以期住院醫師切實兼通中西醫療學術。三、中西醫合作醫療的訓練。中西醫合作醫療中心開設多種專題持診，每診由中醫專家、西醫專家同時分別為同一病患做中醫及西醫雙重診斷，依病家意願，用中醫法或西醫法治療。做過學術性研究的住院醫師，選擇有興趣的特診跟診，並依中醫及西醫主治醫師指示，訂專題研究計劃，進行臨床研究，以造就現代化中醫師。

The China Medical College (CMC) is the only college of Traditional Chinese Medicine in Taiwan, Republic of China. It is committed to combining Chinese medicine with contemporary Western medicine, toward a new approach to medicine. The China Medical College's associated hospital opened in 1980. It is the first combined Chinese-Western medicine teaching hospital on Taiwan. The main departments have a total of 687 beds. The Chinese-Western medicine departments strive toward improving themselves, as well as cooperating, carrying out research projects and assisting in professional training.The Chinese medicine department has nine sections, including general medicine, gynaecology, massage, acupuncture and the Chinese-Western Cooperative Center, etc., The staff of more than 70 physicians comprises highly qualified medical doctors, most of whom are licenced to practice both Chinese and Western medicine. These physicians are responsible for patients, and for training students as doctors. The principal goal of the 7-year Chinese medicine program and the postbachelor Chinese medicine program of CMC is to cultivate and encourage students of exceptional ability to become competent physicians. It also provides special training courses of doctors of Chinese medicine who are selftaught and have passed the National Examination in Chinese Medicine. Clinical training consists of oral instruction and hands-on practice. Hands-on instruction includes accompanying: the resident doctor on his/her rounds, preexamination of patients and daily assesment of patient progress. Oral instruction comprises morning meetings, discussion of case reports, seminars and audio-visual instruction. During instruction, lecturers provide guidance, answer students' questions and discuss problems that may have arisen. The above represents some of the teaching principles at the China Medical College Hopital. Each of our three training programs has its individual characteristics: 1. INTERNSHIP One year, further developing student's knowledge of Chinese Medical theory, application, prescription and drug-combination. This program may be compared with the training course of Western medicine. 2. EXCHANGE PROGRAMS Additional training and exchange programs for Chinese and Western medicine doctors. Proficiency in both Chinese and Western medicine is expected of all participating physicians. 3. TRAINING COURSES FOR COMBINED CHINESE-WESTERN MEDICINE Includes numerous clinics. Patients visiting these clinics are diagnosed by both Chinese and Western methods and later treated according to the condition and choice of each patient using either Chinese or Western medicine. Resident doctors with prior experience in scientific research are permitted to chose a special field of study according to their individual inclination, and dependent on approval by a specialized doctor. The aim of the specialized training is to Carry out Uinical research in order to improve and modernize Traditional Chinese Medicine.