美国的医学教育：过去与未来.ppt

MEDICAL EDUCATION IN THE UNITED STATES: PAST, PRESENT AND FUTURE Justin Clark, M.D. Neurosurgery Resident Barrow Neurological Institute Phoenix, Arizona, USA INTRODUCTION Medical Schools History Present day problems Future issues Graduate Medical Education Neurosurgery Residency Training Neurosurgery Residency Training at the Barrow Neurological Institute (BNI) HISTORY OF MEDICAL SCHOOLS The first medical school in North America was founded in 1765 by John Morgan at the College of Philadelphia This institution is now known as the University of Pennsylvania The faculty at the College Of Philadelphia had been trained at the University of Edinburgh The faculty used the British medical education system as the model for the school. FOUNDING OF NEW U.S. MEDICAL SCHOOLS Subsequent medical schools were also founded on the U.S. East Coast: The College of Physicians and Surgeons of Columbia University, New York, NY (1767) Harvard University, Boston, MA (1782) During the next 100 years, medical schools were founded across the country; however the majority were founded in non-academic centers Consequently, during the 19th century, there existed two types of medical schools in the United States: University-based medical schools Proprietary medical schools MEDICAL SCHOOL CURRICULUM DURING MOST OF THE 1800’s Most medical schools did not have university paid professors; instead, medical students needed to buy a ticket from the professor, in order to hear his lectures. The University of Michigan was the only exception of this rule. Students signed-up for 2 years of studies During both years, the same curriculum was taught, and learning was based on pure memorization Lectures had to be attended twice to qualify for graduation Some schools required a thesis, as well Most students that were accepted at medical schools during this time had not graduated from a college or university U.S. compared to the rest of the world In the 1850’s, the U.S. medical education system was far behind