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財團法人醫院評鑑暨醫療品質策進會 Taiwan Joint Commission on Hospital Accreditation
2014 Taiwan Jonint Conference in Health  Care & ASQua's Annual Conference
 
 
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Medical education
Updated by 2014.04.30


 
In response to the rapid changes in medical knowledge and environment and the expectations of the general public towards healthcare professionals, cultivation of core competence has recently become an important key for the development of medical education. The World Federation for Medical Education (WFME) proposed the concept of continuous unity in medical education by using institutional medical education as a starting point to integrate education and training, and life-long professional capabilities through continuous professional development. Based on previously mentioned concepts, the Ministry of Health and Welfare has contracted this Committee to plan for a post-graduate clinical training system for medical staff to connect the clinical education between school education and post-graduation. This allows new medical staff to receive standardized professional training base on the existing school education and the guidance of experienced clinical instructors, to cultivate professional core competencies in order to achieve independent practical nursing capabilities, and ensure the quality of healthcare services. Since 2007, the Ministry of Health and Welfare has supported and reimbursed each teaching hospital in executing training for post-graduate medical staff through “Instruction Fee Reimbursement Programs for Teaching Hospitals.” This Committee has invited 11 medical professional groups and specialist to establish a post-graduate clinical training system, and to set up the training items for each medical field, training targets, training times, training methods, evaluation standards (methods), and training locations and conditions, and has included the training in the scope for hospital accreditation as a basic requirement of execution for each institution. In 2014, the three occupational classes, audiologist, language therapist and dental technician, were included into the entire program.



     

Post Graduate Year, PGY

Physicians

Over the years, medical students in Taiwan received organ-focused, disease-oriented and specialty treatment training at different specialty departments after graduating from medical schools, in order to develop their specialties and sub-specialties. However, the problems and deficiencies of such a system was exposed during the SARS outbreak in 2003. Therefore, the Department of Health proposed the Clinical Education Training and Reform Program after the epidemic was stabilized. In July 2003, the Department of Health officially announced the Post Graduate Year Program to rectify the resident physician training system’s overemphasis on early specialty training.

In consideration of the training capacity, faculty size and training venue readiness, the TJCHA implemented the program in three stages. The first stage took place between July 2003 and June 2006. During this period, resident physicians were required to receive general medicine practice for three months in the first year of their residency. With the support and concerted efforts of hospitals and society, the overall teaching atmosphere of teaching hospitals in Taiwan has been improved, and the spirit and concepts of general medicine were thus established. The second stage began in July 2006. At this stage, the 6-month general medicine training was designed to lend into curriculum guidelines of specialty training for postgraduate physicians, and the model for postgraduate general medicine training was established. The third stage started from July 2011. The postgraduate participated the joint training group that “focuses on the main training hospital” to receive training by the selection system. Now, PGY training has entered a new milestone, because they are no longer the first year resident physician of each sub-specialty, but a PGY physician.

Since the 2013 academic year, the Ministry of Education has amended the year of study for medical school from 7 years to 6 years. In combination with the PGY training for the period of 2 years after graduation in the future, the overall medical education has more comprehensive planning and connection from integrated medical education to school and to clinical. The TJCHA implemented this program on commission of the Ministry of Health and Welfare in organizing a pilot PGY training system (divided into internal medicine, surgery, gynecology, and pediatric trainings in general medicine) starting with three medical centers in the 2013 academic year to connect specialty training in the future. We hope that the graduate students from the 6-year education system have a more rigid continuous unity in medical education all the way from school education, post-graduate general medical training to specialty training.

Dentist

After graduating from dentistry school and getting license, dentists need to practice in dental clinic or hospital for two year so that they can run a clinic. However there’s no consistency training program and qualified sites for two-year training. To improve training quality and cultivate well dentists, the Ministry of Health and Welfare announced dentists who wish to run a clinic or residency training have to receive two year post graduate year training by Article 18 of Medical Care Act.

The Ministry of Health and Welfare launched Two-Year of Dental Post Graduate Year Program. The training program includes 68-hours fundamental seminar; obligatory courses include general practice, society healthcare services, and oral and maxillofacial surgery clinic and emergency treatment within 18 months; elective courses for 6 months. 78 hospitals and 213 clinics were certified by the Ministry of Health and Welfare, approximately 65% of dentists receive training in hospitals and 35% in dental clinics.

DPGY training program launched from physicians, then other healthcare providers to improve clinical practice after graduating. Teaching hospital tuition subsidy program from 2007 and DPGY program from 2010. Through system design such as hospitals establish teaching atmosphere, prompt educational activities and achieve general practice training.




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