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美国住院医“不以钱为念”?非也!只是……

2017-06-20 常 路 环球医学

2014年,我国住院医师规范化培训启动,众人可谓是怨声载道,其中吐槽最多的就是住院医待遇过低问题。作为住院医师规范化培训历史悠久、经验丰富的美国,其住院医待遇如何?美国的住院医们对自己的待遇又是如何看待的?在美国,几乎所有医学毕业生都要接受至少3年的住院医师培训,某些专业长达8年。内科要求为3年,皮肤科要求1年内科加3年专科,而胸外科则要求5年普外科加3年专科。美国住院医师的工作强度非常大,曾经实

2014年,我国住院医师规范化培训启动,众人可谓是怨声载道,其中吐槽最多的就是住院医待遇过低问题。作为住院医师规范化培训历史悠久、经验丰富的美国,其住院医待遇如何?美国的住院医们对自己的待遇又是如何看待的?

在美国,几乎所有医学毕业生都要接受至少3年的住院医师培训,某些专业长达8年。内科要求为3年,皮肤科要求1年内科加3年专科,而胸外科则要求5年普外科加3年专科。

美国住院医师的工作强度非常大,曾经实行24小时住院制,外科住院医师每周通常工作110小时。1989年,为保障住院医师的休息时间,纽约州卫生部门在美国率先开始执行严格的规定限制住院医师的工作时间,即“405规则”。之后,ACGME提出了与“405规则”非常近似的规定,并于2003年7月7日起,在全国所有的教学医院开始执行。规定提出,住院医师一周工作不得超过80小时,而且值班之后必须休息10小时。

关于收入,据了解,住培期间美国住院医工资低于其他专业本科生,2015年平均年工资为55400美元。虽然住院医的工资偏低,但超过60%的住院医认为自己所得“尚属公平”。

在问卷回复中,最具代表性的回答是:“我选择学医因为我以助人为乐为目的。我有超过20万学费贷款要偿还,钱当然是考虑因素。”

美国是资本主义制度,“不以钱为念”最多只是在收入有保障而且相对不低时才说得出来的漂亮话。相反,将受教育作为一项投资,估计投资与预期回报的比率是多数人选择未来专业实实在在的一个重要考量。正是因为医生职业在美国不仅收入有保障,同时还可以伴有职业荣誉感,这也是在美国医学成为最热门专业的主要原因。而住院医之所以对自己偏低的工资没有怨言,那是因为培训期一旦完成,成为开业医生以后的前途将既清楚又充满光明与期待。

现如今,我国住院医师规范化培训已经成为必然。美国经验告诉我们,单纯提高或保障培训期间的待遇最多只能在培训的有限期间内缓解问题,根本解决之道在于彻底提高医生职业的待遇与荣誉感,让这一职业成为人人向往并充满光明的职业。

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  1. 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    2017-06-22 saikp
  2. 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    2017-06-22 hfuym10906

    好!!!!!!!!

    0

  3. 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level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Wed Jun 21 08:02:13 CST 2017, time=2017-06-21, status=1, ipAttribution=)]
    2017-06-21 133****2089

    好,学习了。

    0

  4. 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level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Wed Jun 21 08:02:13 CST 2017, time=2017-06-21, status=1, ipAttribution=)]
    2017-06-21 1dd7a091m35(暂无匿称)

    学习了。。。。。

    0

  5. 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level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Wed Jun 21 08:02:13 CST 2017, time=2017-06-21, status=1, ipAttribution=)]
    2017-06-21 Y—xianghai

    是啊怎么才能提高职业荣耀感

    0

  6. 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level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Wed Jun 21 08:02:13 CST 2017, time=2017-06-21, status=1, ipAttribution=)]
    2017-06-21 139****5926

    好文章学习了

    0

  7. 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createdName=hfuym10906, createdTime=Thu Jun 22 03:46:59 CST 2017, time=2017-06-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213518, encodeId=c29321351809, content=好,学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5512077238, createdName=133****2089, createdTime=Wed Jun 21 13:56:38 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213480, encodeId=458a21348034, content=学习了。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo51eheDrP8dFkRicVB5LyaVk2Nc1S87J8nCBgASWQ4rrorsyzzr0UzN8N5bibeqGofE7ZtdT6YNZHEQ/0, createdBy=79351625688, createdName=1dd7a091m35(暂无匿称), createdTime=Wed Jun 21 10:15:06 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213467, encodeId=f68e21346e86, content=是啊怎么才能提高职业荣耀感, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jun 21 09:51:28 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213457, encodeId=862e21345e3a, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 21 09:08:10 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213439, encodeId=c0192134396c, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed Jun 21 08:54:45 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213392, encodeId=d4222133924c, content=提高医生职业的待遇与荣誉感,让这一职业成为人人向往并充满光明的职业。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Wed Jun 21 08:02:13 CST 2017, time=2017-06-21, status=1, ipAttribution=)]
    2017-06-21 1e1b8538m79(暂无匿称)

    这也许就是文化差异

    0

  8. 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createdTime=Wed Jun 21 10:15:06 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213467, encodeId=f68e21346e86, content=是啊怎么才能提高职业荣耀感, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jun 21 09:51:28 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213457, encodeId=862e21345e3a, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Wed Jun 21 08:02:13 CST 2017, time=2017-06-21, status=1, ipAttribution=)]
    2017-06-21 明月清辉

    谢谢分享,学习了

    0

  9. 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level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Wed Jun 21 08:02:13 CST 2017, time=2017-06-21, status=1, ipAttribution=)]
    2017-06-21 135****7952平儿

    学了。。。。。。。。。。

    0

  10. 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createdTime=Wed Jun 21 10:15:06 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213467, encodeId=f68e21346e86, content=是啊怎么才能提高职业荣耀感, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Jun 21 09:51:28 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213457, encodeId=862e21345e3a, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Wed Jun 21 09:08:10 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213439, encodeId=c0192134396c, content=学了。。。。。。。。。。, beContent=null, objectType=article, channel=null, level=null, likeNumber=106, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Neru1qt53a14aACuSzg3TZhkTcsPYVibyHibhTZ5L4k9qIBWiaej4lgomIsGptf8N16E4mTuIq2DVdJXjPjmwZKrLib/0, createdBy=5a0f2055853, createdName=135****7952平儿, createdTime=Wed Jun 21 08:54:45 CST 2017, time=2017-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=213392, encodeId=d4222133924c, content=提高医生职业的待遇与荣誉感,让这一职业成为人人向往并充满光明的职业。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Wed Jun 21 08:02:13 CST 2017, time=2017-06-21, status=1, ipAttribution=)]
    2017-06-21 Julie W

    提高医生职业的待遇与荣誉感,让这一职业成为人人向往并充满光明的职业。

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