美国医学教育中的职业化问题：从证据到责任

Professionalism in Medical Education, an American Perspective：from Evidence to Accountability

职业化是维护公众对医学职业信任的核心要素，也是医患关系的本质所在。但有证据表明，公众对医学职业的信任日渐消失，医生也在维护医学职业价值观念时面临着各种挑战。本文在医学教育背景下界定”职业化”的定义和框架，描述了职业化面临的各种挑战，也详细论述了医学院校和教学医院在维护医学职业化过程中的角色和作用。此外，还评述了现行和试行中的评价职业化的工具、方法。最后，作者提出一些建议供医学院校和教学医院参考。

Professionalism is the most important factor effecting public trust in the medical profession. It is also the essence of the doctor─patient relationship. Evidence show that doctors are losing trusts from public currently. It has posed a serious threat for doctors to keep their professional values. This paper aims to provide a definition and framework for professionalism in the context of medical education， describe current threats to medical professionalism， and the role that medical schools and academic medical canters can play in sustaining professionalism. Additionally， the paper reviews established and potential methods for measuring professionalism and thus assuring public accountability. Finally， specific recommendations are offered for medical schools and teaching hospitals to nurture and sustain professionalism.