全球衛生訓練對家庭醫學科醫師養成之影響：住院醫師的觀點

The Impact of Global Health as an Elective on the Education and Training of Family Medicine Physicians: Viewpoints of Residents

10.3966/168232812017032701006

吳柏澍(Po-Shu Wu)；蔡兆勳(Jaw-Shiun Tsai)；黃國晉(Kuo-Chin Huang)；李怡萱(Yi-Hsuan Lee)；楊昆澈(Kuen-Cheh Yang)

全球衛生 ； 家庭醫學科訓練 ； 醫學教育 ； 住院醫師 ； family medicine training ； global health ； medical education ； residents

台灣家庭醫學雜誌

27卷1期（2017 / 03 / 01）

42 - 49

繁體中文

全球衛生是強調透過多學科合作，提升健康平權、達到全人健康目標的專業領域。世界衛生組織「Alma Ata宣言」確立基層醫療服務在提升全人健康的重要性，而基層醫療服務正是家庭醫學之核心價值。因其周全性、連續性、整合性、以社區為導向之團隊照護模式，新一代的家庭醫學科醫師在全球衛生領域扮演重要角色。台大醫學院與附設醫院團隊自2013年起於印度拉達克地區建立「賦權式社區健康促進模型」。透過參與此計畫，筆者體認全球衛生訓練對家庭醫學科住院醫師養成之重要性：例如照護弱勢社群所需之溝通技巧及跨文化敏感度等。這些能力無論在全球衛生觀點或在地社區照護時同樣重要。家庭醫學科醫師具備於全球衛生領域扮演領導者的機會，全球衛生訓練更可能活化家庭醫學科專業並吸引新一代的家庭醫學科住院醫師。

Global health is a multidisciplinary field of study aiming to promote health equity and ultimately, health for all, and the importance of primary healthcare in achieving the goal of “health for all” has been well recognized since the Declaration of Alma Ata. Embracing primary healthcare as the core value of family medicine and providing comprehensive, continuous, integrated, community-oriented and team-based care, new-generation family medicine physicians thrive in the field of global health. In merely a century, Taiwan has graduated from an aid recipient to an active contributor and collaborator in global health. A team from National Taiwan University (NTU) College of Medicine and NTU Hospital has implemented since 2013 a community health promotion program striving to facilitate and achieve community empowerment in Ladakh, India. Through participating in the program, the author has realized the values of global health exposure in the training of family medicine, notably enhanced communication skills and cross-cultural sensitivities, both of which are crucial in caring vulnerable and underprivileged populations and therefore of equally significant global and local relevance. No matter as project managers, communicators, and collaborators, family medicine physicians now have great leadership potential in the field of global health, Exposure to and participation in global health can be expected to re-vitalize family medicine and attract a new generation of family medicine residents.

1. Sustainable development goals: 17 goals to transform our world http://www.un.org/sustainabledevelopment/sustainabledevelopment-goals/ Accessed May 2, 2016.
2. Dye T, Demment M, Elia J, et al: Perspectives on Hepatitis Bin Tibetan Refugee Communities (Project report) July 20, 2015. Available at http://tibetanhealth.org/wp-content/uploads/2016/05/Perspectiveson-Hepatitis-B-in-Tibetan-Refugee-Communities.pdf. Accessed September 10, 2016.
3. CanMeds Family Medicine: Working group on curriculum review, October 2009 http://www.cfpc.ca/uploadedFiles/Education/CanMeds FM Eng.pdf. Accessed May 2, 2016.
4. Declaration of Alma-Ata: International Conference on Primary Health Care, Alma-Ata, USSR, 6-12, September, 1978. http://www.who.int/publications/almaata_declaration_en.pdf. Accessed May 2, 2016.
5. United Nations : The millennium development goals 2015 http://www.un.org/millenniumgoals/ Accessed May 2, 2016.
6. Bussell, SA,Kihlberg, CJ,Foderingham, NM,Dunlap, JA,Aliyu, MH(2015).Global health education in general preventive medicine residencies.Am J Prev Med,48,593-8.
7. Drain, PK,Primack, A,Hunt, DD,Fawzi, WW,Holmes, KK,Gardner, P(2007).Global health in medical education: a call for more training and opportunities.Acad Med,82,226-30.
8. Harmer, A,Lee, K,Petty, N(2015).Global health education in the United Kingdom: a review of university undergraduate and postgraduate programmes and courses.Public Health,129,797-809.
9. Havryliuk, T,Bentley, S,Hahn, S(2014).Global health education in emergency medicine residency programs.J Emerg Med,46,847-52.
10. Hayward, AS,Jacquet, GA,Sanson, T,Mowafi, H,Hansoti, B(2015).Academic affairs and global health: how global health electives can accelerate progress towards ACGME milestones.Int J Emerg Med,8,45.
11. Institute of Medicine(2009).The U.S. Commitment to Global Health: Recommendations for the Public and Private Sectors.Washington, DC:Institute of Medicine.
12. Koplan, J,Bond, TC,Merson, MH(2009).Towards a common definition of global health.Lancet,373,1993-95.
13. Koplan, JP,Bond, TC,Merson, MH(2009).Towards a common definition of global health.Lancet,373,1993-5.
14. Pitt, MB,Gladding, SP,Suchdev, PS,Howard, CR(2016).Pediatric global health education: past, present, and future.JAMA Pediatr,170,78-84.
15. Redwood-Campbell, L,Pakes, B,Rouleau, K(2011).Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches.BMC Med Educ,11,46.
16. Rouleau, K,Janakiram, P,Nicolle, E,Godoy-Ruiz, P,Pakes, BN(2015).Global health in family medicine summer primer: course for residents and faculty.Can Fam Physician,61,614-20.
17. Stevens, K,Palmo, T,Wangchuk, T,Solomon, S,Dierberg, K,Hoffmann, CJ(2016).Hepatitis B prevalence and treatment needs among Tibetan refugees residing in India.J Med Virol,88,1357-63.
18. Walpole, SC,Shortall, C,van Schalkwyk, MC(2016).Time to go global: a consultation on global health competencies for postgraduate doctors.Int Health,8,317-23.
19. 王榮德編、江東亮編、陳為堅編、詹長權編(2015)。公共衛生學。台北:國立臺灣大學出版中心。