In order to improve the quality of postgraduate education in clinical medicine, we must strengthen the curriculum construction to meet the needs of cultivating clinical applied talents, lay a solid foundation for postgraduate clinical practice, and make students understand the frontier progress of medical science and technology development in this discipline. In order to broaden students' knowledge and facilitate course setting and teaching operation, colleges and universities strive to offer courses at the level of the first-class clinical medical discipline with the same academic level. According to the requirement of not less than five degree courses in the Trial Measures for Clinical Medical Degrees of the State Council Academic Degrees Committee, in the process of training and implementation, students generally choose 6- 1 1 courses for study and examination.
In addition to offering compulsory courses in scientific socialist theory and English, there are compulsory courses in computer application, medical statistics and specialized courses (such as surgical progress in surgery and internal medicine progress in internal medicine). Elective courses include medical research and design, applied anatomy, pharmacology, immunology, molecular biology, electron microscopy and histology. The textbooks, handouts and experimental guidance used in elective courses are mostly compiled by graduate tutors who have been teaching in various universities for a long time. The content is closely combined with clinical application and has high medical science and technology content.
Second, increase the time of clinical diagnosis and treatment and strengthen the cultivation of comprehensive ability.
According to the detailed rules for the implementation of clinical medical degrees and the training objectives, students' clinical thinking ability, diagnosis and treatment ability and related basic theories are cultivated through "correct collection of medical history, systematic and standardized physical examination and medical record writing". The training content is "mastering the operation or auxiliary diagnosis and treatment technology of this major" to improve students' clinical skills and practical ability.
In terms of time arrangement, after completing the degree course, students must engage in clinical work for at least one year under the guidance of professional tutors in the corresponding disciplines, fully cultivate their comprehensive clinical ability and strengthen unified training. The training contents mainly include: ideological education, job responsibilities, medical norms, nursing routines, scientific research methods, prevention of medical disputes, and clinical ability training objectives for professional degree graduates.
Requirements for professional dissertations of master of medicine: the dissertations can be case analysis reports or literature reviews; Papers should be closely combined with clinical practice, focusing on summing up clinical experience; The paper should show that the applicant has mastered the basic methods of clinical scientific research.
Third, strengthen the management of papers and encourage participation in academic activities.
Generally speaking, the working years required for on-the-job degree application are more than 3 years, and 80% of on-the-job clinical medical applicants with the same academic qualifications have working years of 5- 10 years. Most of them have their own fixed majors, research directions and professional specialties. Colleges and universities mainly focus on the training of basic scientific research skills, from literature reading, summary writing, topic design, experimental methods, data accumulation, sorting, statistical processing to thesis writing, so that students can master a set of ideas and methods of clinical medical scientific research, that is, "teaching people to fish" instead of "teaching people to fish". Liberate in-service students from the mode of course learning and clinical training that only accepts knowledge, encourage students to carry out selective learning according to their own interests, specialties and needs, and open up a broader space for their independent learning and clinical research.
The topic selection should be closely combined with the clinical practice, and the topic selection should generally be consistent with the specialty, and part of the tutor's topic can be completed in combination with the tutor's research topic; Students can also independently summarize clinical experience in combination with clinical work, put forward their own new views on the diagnosis, treatment and pathogenesis of diseases, or put forward new methods to improve clinical medical technology. In order to further cultivate students' innovative consciousness and ability and improve their academic communication ability, students with the same academic ability should also participate in various academic activities. The contents of academic activities should be recorded in a timely, accurate and complete manner, supervised and inspected by tutors, and given corresponding credits. This initiative carried out by various schools has effectively avoided the disadvantages of in-service students entering the clinic after completing their degree courses, and there are not many opportunities to participate in the academic atmosphere and innovative environment, so that students can better understand the domestic and international trends and latest progress of clinical disciplines.
Four, screening assessment content requirements, quantitative assessment indicators.
The operability of clinical ability assessment includes the assessment of students' clinical practice ability, clinical thinking ability and theoretical knowledge level. At the same time, in the heavy workload and extensive practical activities, their own medical ethics will also be assessed.
The main contents of the examination include: (1) "case defense": the examination team provides the ready-made medical history of common cases in this discipline, or prepares a patient with common diseases (graduate students did not participate in the treatment), and the graduate students ask about the medical history and physical examination, analyze the data, make a diagnosis, make differential diagnosis and put forward treatment suggestions; (2) Examination of operation of diagnosis and treatment technology: All majors in the internal medicine system mainly adopt auxiliary diagnostic methods or related special examinations, such as electrocardiogram examination, bone marrow puncture, chest puncture, lumbar puncture, bone marrow smear and X-ray reading. The main operation of each major in surgical system. Medical technology majors (such as imaging medicine and nuclear medicine) mainly test the use, operation and diagnosis of related instruments; (3) Teaching rounds: Graduate students take interns for teaching rounds to understand the teaching ability of interns. Scoring items include five first-level indicators, including diagnosis and treatment ability, technical operation ability, theoretical knowledge level, clinical thinking, analysis, comprehensive ability and organizational expression ability, and 13 second-level indicators. Each index has a certain score, and students who fail the clinical examination cannot enter the dissertation defense link.
The purpose of in-service postgraduate education in clinical medicine is to provide high-level medical professionals for clinical medical departments, and the quality of training will directly affect the clinical medical level. Students should be strict with themselves, get rid of impetuousness and get quick success, respect the academic laws of clinical medicine, and have the ability of scientific research and the spirit of continuous learning in order to have innovative opinions and creative achievements.