Система медицинского образования в США презентация

Медицинский Центр,
Университет Джорджа Вашингтона, Вашингтон, США

Натэлла Рахманина

Доктор Наук
Адъюнкт-Профессор
Директор Программы
Специммунологии

practiced in New York City
Children’s Hospital of Philadelphia – 1855
Boston Children’s Hospital – 1869
Children’s National Health System – 1870
Today - ~250 pediatric hospitals in the US

Abraham Jacobi
1830–1919

medicine that deals with care of infants from birth, through childhood and adolescence until 21 years of age
For certain chronic medical conditions the upper limit for age can be extended to 24 years of age and older
Majority of the pediatric subspecialties require training in pediatrics as a first step followed by more specialized training in a fellowship program

Diseases
Pediatric Critical Care Medicine

Neonatal-Perinatal Medicine
Developmental-Behavioral Pediatrics
Pediatric Nephrology
Pediatric Emergency Medicine
Pediatric Pulmonology
Pediatric Endocrinology
Pediatric Rheumatology

of age)
College – 4 years (may be less or more)
Medical school – 4 years
Qualifying exams for entry into Medical School
Vigorous selection process involving transcripts from college, exams, letters of the recommendation and curriculum vitae
Previous experience in research, volunteer work matter!
In person interview is required

Residency Programs following completion of medical school
Vigorous selection process at each program
Application involves transcripts of the medical school, exams, letters of the recommendation and curriculum vitae
Previous experience in research and academic output matter!
Additional degree matters
In person interview is required
Computerized matching process at the end determines the final selection

surveys of the residents, fellows tailored to evaluate their perception of their educational experience, clinical experience
Yearly survey of the faculty tailored to evaluate the protected time for teaching, continued medical education
Yearly data on the program scholarly productivity (faculty and fellows) including publications, presentations, national recognition
Data on the ABP and subspecialty Boards certification success of the graduates

2600 applicants representing 63% of all medical students applying for training in pediatrics
500 invited for an interview, 40 selected
Six tracks available (primary care, community health, categorical, child neurology, neuro-developmental disabilities, medical genetics track)
Yearly in service exams to access the progress in training and preparation for the Certifying American Board of Pediatric Exam

several months of electives and opportunity for research during third year
Maximum 80 hours per week, 16 hours shifts
The longest time of uninterrupted service up to 28 hours, no more than 24 hours direct patient care
Daily rounds with an attending and medical team
Separate teaching rounds (3-4 times weekly) and simulation training (1-2 times per week)
Weekly interactive professorial rounds and weekly hospital grand rounds

week second and third year of training
REACH results 2013:
11 peer-reviewed manuscripts published
6 awards at the institutional and national levels
12 grants awarded
33 abstracts presented at the regional, national and international meetings

Medical Education and American Board of Pediatrics
Feedback from the Association of Pediatric Program Directors
Follow up through the Longitudinal Educational Assessment Research Network

learning and improvement
Interpersonal and communication skills
Professionalism
System-based practice
Personal and professional development

and efficient patient care
Assuring seamless transition of care
Interviewing patients and families for the medical condition
Complete and accurate physical examination
Making therapeutic and diagnostic decisions that result in optimal clinical judgment
Develop and carry out management plan

effective health maintenance and anticipatory guidance
Use information technology to optimize patient care
Provide appropriate role modeling
Provide appropriate supervision

partial involvement in assessment and care
Direct supervision - supervised assessment and care
Indirect supervision – independent assessment, discussion of care plan, independent care
Proficient – independent assessment and care
Mastery – supervision of others

feedback to the trainee and to the trainer
Evaluations of trainees oriented at “what would you be able to do”
Evaluations of trainer oriented at “how can I help you to learn and master”
Algorithms for assessment and care
Cross-training with nursing and physician assistants

of Pediatrics, George Washington University, Children’s National Health System
Dewesh Agrawal, MD, Director, Pediatric Residency Program, Associate Professor of Pediatrics and Emergency Medicine, George Washington University, Children's National Health System

doses and the same class of diseases in smaller bodies, but….it has its own independent range and horizon…”
Dr. Abraham Jacobi, 1889