【摘要】 目的　调查国内外专科医师培养的历史、现状、问题和对策 ,为建立国际接轨、符合中国国情的专科医师分类设置提供决策依据和建议。　方法　应用广义循证医学的原理和方法 ,系统检索 2 0 0 3年 12月 31日以前来自PubMed、中国生物医学文献数据库、各国卫生主管部门官方网站、常用搜索引擎、多种杂志和医学著作的文献 ,制定统一标准 ,筛选并评定文献质量 ,综合分析后得出结论。　结果　初筛得到外文文献 12 98篇 ,中文文献 2 1篇 ,其中和分类相关的文献仅 6篇。综合美国、加拿大、英国、新加坡、澳大利亚及我国 (包括香港和台湾 )的官方网站信息发现 ,我国专科设置数量最多 ,美国次之。我国专科分类总数 >学科分类总数 >住院医师培养分类总数。某些专科重复设置现象严重 ,某些特色专科不便与国际接轨。建议　我国专科分类应综合考虑国际趋势、人才培养和学科发展的特点 ,同时兼顾我国目前的分类现状 ,分阶段平稳过渡。首先试点住院医师培养较规范、成熟 ,专科医师需求明确、培养条件好的专业 /专科 ,积累经验后再逐渐推广和完善。更多还原

【Abstract】 Objective To provide scientific evidence for the establishment of medical specialist system in China by investigating the history, current situation, problems and countermeasures of medical specialties training at home and aboard. Methods The principle and theroy of evidence-based medicine were adopted. The information before Dec. 31, 2003 of Pubmed, CBM, official website, some journals, most frequently used search engines and medical monograph were systematically reviewed. Included literatures were assessed and graded according to the pre-defined criterias. Results A total of 1 319 studies (1 298 in English, 21 in Chinese) were included, among which only 6 were related to the classification of medical specialties. Based on the information from official website of USA, Canada, UK, Singapore, Australia and China (including HK and Taiwan), it showed that China has the largest number of medical specialties, followed by that of USA. In China, the number of medical specialties has more than that of the disciplines in clinical field, which was followed by resident training programs. Some specialties were duplicate, or not international standardized. Conclusions The classification of medical specialties should be developed consecutively, which comprehensively considered the international trend, characteristics of doctor training and the current situation. Specialties whose training program are well-established and developed should initiate firstly. Others will be put into practice gradually after being fully exprienced.更多还原