精神科專科醫師之養成：檢討與瞻望

Board Training Programme for Psychiatrists: Assessment and Perspective

專科醫師甄審制度自民國77年政府頒布實施至今已有6年，對於其培訓內容與目標，甚少有評估研究報告。本研究以南部精神科受訓醫師為對象，來探討精神科專科醫師培訓課程之問題，以作為將來培訓改進之參考。研究對象以南部各2所醫學中心與精神科專科教學醫院之20位醫師為樣本，結果發現醫師與其受訓醫院之分佈並無太大差異。各訓練中心均可達到衛生署所訂定之基本訓練標準，但私立醫療院所醫師之門診與住院工作負荷量比較大；醫學中心醫師平均花在每位門診個案時間要比專科醫院者長，而專科醫院醫師照顧住院個案量顯著的比醫學中心要多。然在必修及選修課程中，專科醫院之心理治療與照會精神醫學課程顯然有不足的現象。本研究除檢討目前的受訓外並利用上述研究結果對課程與即將實施的全民健康保險制度下之精神科訓練需求做一瞻望性之分析與建議。

The psychiatric board system has been introduced in Taiwan for 6 years, to date, there has been no reports on its assessment regarding its training programme. This study utilized the sample from psychiatric training centers at sourthern Taiwan to evaluate problems at training. The results showed that there was no difference in the distribution of the 20 trainee psychiatrists selected from 2 medical centers and 2 mental hospitals in this study. Basic training requirements for all trainees could be accomplished, however, clinical loadings from either the outpatient and inpatient services were found heavy for private institutions. Trainees at medical centers spent more time per patient seen at outpatient training, while at the same time they care only half the number of inpatients than those from mental hospitals. In addition, psychotherapy and consultation liaison training were found inadequate in the above 2 mental hospitals. Implications from the above findings were compared and analyzed in reference to the coming new national health insurance system, and proposals for change about the future training programme for psychiatrist were suggested