美國醫學院校擴容進程

Medical School Expansion in America

21世纪前二十几年将成为继上世纪六七十年代以来Flexner报告后美国医学教育第二次扩容高峰。本文就此对两次扩容进程中的共同问题进行回顾：费用、国家卫生政策、毕业后医学教育、基于社区的临床医学教育、多学科整合的专业卫生教育和保健服务以及扩容管理等等。此外，2007年出现的新问题有：毕业医学生就业方向多元化，四年制医学教育分校区的建立。

The first two decades of the 21st century may well be viewed as the 2nd great expansion of post-Flexnerian medical education in the United States since 1960s and 1970s. A review of the literature from that period indicates the common challenges: the cost of expansion， nation health policy， graduate medical education， community-based clinical education， interdisciplinary health professions education and care delivery， and the management of expansion efforts. Two new problems include: graduating a diverse cadre of physicians and creating regional four-year branch campuses.