Transcript 基层医生对社区精神医学的培训： 香港大学的经验 Training of General Practitioners in Psychological

Training of General Practitioners in Psychological
Medicine in Hong Kong: Experience at HKU
基层医生对社区精神医学的培训：
香港大学的经验
LAM Tai Pong
林大邦
西澳大利亚大学(The University of Western Australia) 内外全科医学士;
澳大利亚莫那什大学(Monash University) 家庭医学硕士；
悉尼大学(The University of Sydney) 哲学博士（医学)；
香港大学医学博士；
澳洲皇家全科医学院(The Royal Australian College of General Practitioners) 院士；
香港医学专科学院院士（家庭医学）；
Family Medicine Unit
The University of Hong Kong
香港大学家庭医学部
Population 7 million
七百万人口
What is the healthcare system like in
Hong Kong?
香港医疗服务系统知多少?
• 5% GDP on health sector
• 医疗服务开支占本地生产总值的百分之五
• Public hospitals account for over 40% of total expenditure
• 公立医院占医疗服务总开支的百分之四十以上
• 70% primary care is private vs 6% of hospital care
• 百分之七十的基层医疗服务属私营 VS百分之六是医院
服务
What is the healthcare system like in
Hong Kong?
香港医疗服务系统知多少?
• 185 specialist psychiatrists (end of 2006) i.e. 2.6
psychiatrists/100,000 people
• 185位精神科专科医生（截至2006年底），即：每
十万人只有2.6位精神科医生
• Long tradition of General Practice
• 存在已久的全科医疗传统
Background 背景
• Patients presenting with psychological problems are
frequently seen by primary care doctors
• 基层医生经常遇到心理疾病患者来向他们求诊
• It is estimated that up to 20% of primary care patients have
one or more psychological problems
• 据统计，在使用基层医疗服务的病人中，有近两成的病
人患有一种或一种以上的心理疾病。
• Most of these patients’ psychological problems are not
serious in nature and will respond well to treatments by their
primary care doctors if these are recognised and treated early
• 这些病人的心理疾病大都并不严重，只要接受基层医生
的及早诊断与治疗，一般都可获得不错的成效
Background 背景
• It is anticipated that the number of patients with
psychological problems will continue to increase and
comprise an even greater proportion of those seeking
health services
• 预计，香港的心理疾病患者人数将持续增加，那么他
们使用医疗服务的比例也会上升
• However, most of the primary care doctors practising today
have little or no formal undergraduate training in the health
care issues that are relevant to patients with psychological
problems
• 然而,目前的大部分基层医生在有关心理疾病医务方面
普遍缺乏正式的专业培训。
Background 背景
We therefore aim to improve health care for these
patients in Hong Kong by improving primary care
doctors’ knowledge and skills in the care of the
patients with psychological problems.
因此，我们希望通过丰富基层医生对心理疾病的
认识和改善他们的治疗技巧，来提高对该类患
者的治疗水平。
Organising institutions
主办机构
A postgraduate diploma programme was launched in 2002
by Family Medicine Unit, Department of Medicine,
Faculty of Medicine, the University of Hong Kong, in
conjunction with Department of Psychiatry, the University
of Hong Kong and other specialist Psychiatrists.
香港大学家庭医学部与精神学系、以及其他精
神科专科医生，于2002年联合开办了深造文凭
课程。
The objectives of the programme are as
follows 课程目标包括：
• To promote the practice of psychological medicine
among primary care doctors
• 鼓励基层医生应用心理医学
• To improve the knowledge, skills and confidence of
primary care doctors in the care of the patients with
psychological problems
• 在治疗心理疾病患者方面，丰富基层医生的相
关知识，增强技巧，增加信心。
The objectives of the programme are as
follows 课程目标包括：
• To emphasise the aspects of care that are
different for patients with psychological
problems
• 强调心理疾病患者的护理与其他患者治疗的
不同之处
• To present information on the medical care of
patients with psychological problems that is
practical, concise and relevant to primary care
• 在对心理疾病患者的护理方面，向学员提供
实用、简洁和与基层医疗相关的资讯
The objectives of the programme are as
follows 课程目标包括：
• To appreciate the interdisciplinary nature of psychological
medicine
• 帮助学员进一步认识心理医学的跨学科性质
• To focus on community care, i.e. assessment of patients
with psychological problems in their normal community
environment, and the use of community resources as an
integral part of their care
• 强调社区护理，即：在患者的社区环境内对他的病情
进行评估，并利用社区资源为患者提供护理
The objectives of the programme are as
follows 课程目标包括：
• To emphasise the importance of prevention and
health maintenance in patients with psychological
problems
• 强调预防心理疾病和心理疾病患者保持健康的
重要性
• To present a positive model of psychological
medical practice
• 推介一个积极有效的心理医学应用模式
Duration of the course
课程为期时间
The Diploma programme lasts one
year on a part-time basis.
该课程为期一年，
学员以兼读模式修读。
Methods of instruction
教学方法
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Twenty seminars
专题研讨会，共二十次
Eight group discussion sessions of cases
小组个案讨论，共八次
Five clinical training sessions in psychotherapy
心理治疗临床培训，共五次
Seven clinical teaching sessions by specialist clinicians
精神科及家庭医学专科医生临床教学，
共七次
Seminars 专题研讨会
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Somatoform disorders
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身心症
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Anxiety disorders – panic and phobic disorders
•
焦虑病症－惊恐症与恐惧症
•
Anxiety disorders – obsessive-compulsive and related
disorders
•
焦虑病症－强迫症与相关病症
•
Mood disorders and suicide
•
情绪病与自杀
•
Substance abuse including alcoholism
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药物滥用包括酗酒
Seminars 专题研讨会
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Psychotic disorders and organic disorders
精神病与神经性疾病
Child and adolescent psychiatry
儿童与青少年精神医学
Psychogeriatrics
老年精神病学
Group discussion of cases
小组个案讨论
Students are divided into small groups to
present their clinical cases to their specialist
tutors for discussion and clinical
management.
学员分为几个小组，分别与各自的专科
导师研究、讨论个案及其临床治疗方法。
Clinical training sessions in psychotherapy
临床心理治疗培训
Students are attached to clinical units at
participating hospitals for psychotherapy
training.
学员将在教学医院的临床部门接受心理
治疗培训。
Clinical teaching sessions by specialist clinicians
精神科及家庭医学专科医生临床教学
Students are attached to primary care and
psychiatric outpatient clinics and
rehabilitation facilities at participating
hospitals for their clinical training.
学员将在基层医疗社区诊所、教学医院
的精神科门诊和康复部门接受培训。
Applicants qualifications
入学资格
Applicants are required to hold a medical
degree from a recognised university.
申请人需持有任何一所被认可大学所颁发
的医学学位
Assessment 评估办法
• The performance in written assignments and clinical
sessions provides continuous assessment
• 学员的书面作业成绩和临床课堂表现作为持续评估项
目
• Final examinations with a written paper and a clinical oral
examination
• 期末考试包括笔试和口试
• Examiners comprise of family physicians and psychiatrists
• 考官由家庭医生和精神科医生担任
• Local and/or overseas external examiners are invited to
participate in the final examinations
• 期末考试将邀请本地和/或海外学者担任校外考官
Profiles of Students 学员资料
(2002 - 08年)
Enrolled 已报读
Graduated 已毕业
157
120 (截至2007年9月)
Male 男
Female 女
Gender 性别
129
28
Working
Organization
工作机构
Private sector 私营
Public sector 公营
130
27
Total number
of students
学员人数
Higher qualifications Mainland qualifications
高等学历
国内大学毕业
Qualifications
资历
(专科院士)
32
9
Experience gained 经验分享
• Quality is most important
• 课程质量最重要
• Regular course evaluation is useful, particularly
with a new course
• 定期的课程评估很有必要,特别是对于新开办的
课程
• Students like clinical teaching (~100% attendance)
• 临床教学最受学生欢迎(出席率接近百分之百)
• Students accepts electronic communication
• 学员可以接受以电子方式通讯
Rewards
课程成果
• Bigger impact than Impact Factor
• 成效比影响因子更显著
• Students can apply their learning immediately
• 学员可立即学以致用
• Growing interest in the care of patients with psychological
problems among primary care doctors
• 基层医生对治疗心理疾病患者的兴趣锐增
• Growing alumni group, 120 doctors have graduated
• 毕业生人数日益增多, 目前已有120名毕业生
• Enhance working relationship with psychiatrists
• 与精神科医生的合作关系更加密切
Thank you very much !
谢谢各位!
Training of General Practitioners in Psychological
Medicine in Hong Kong: Experience at HKU
基层医生对社区精神医学的培训：
香港大学的经验
LAM Tai Pong
林大邦
西澳大利亚大学(The University of Western Australia) 内外全科医学士;
澳大利亚莫那什大学(Monash University) 家庭医学硕士；
悉尼大学(The University of Sydney) 哲学博士（医学)；
香港大学医学博士；
澳洲皇家全科医学院(The Royal Australian College of General Practitioners) 院士；
香港医学专科学院院士（家庭医学）；
Family Medicine Unit
The University of Hong Kong
香港大学家庭医学部