目的：：分析北京地区外科住院医师临床基本能力的现状。方法：北京地区250名(完成两年规范化培训)的外科住院医师参加比赛，大赛包括初赛、复赛和决赛，比赛形式为多站式客观结构化考核，内容包括医学基础理论、病史采集、体格检查、辅助检查判读、临床思维、医疗文书书写、病情解释、沟通技巧、外科手术、修改病例、团队合作以及医疗相关法律法规等。每一站采用百分制评分量表，每个打分要点2-3分。结果：250名外科住院医师，来自23个培训基地。初赛总平均分(295.38±32.88)分，按百分制80分计算，及格率27.6%。区县医院住院医师总分明显低于卫计委直属系统、市属系统(P<0.05)。进入复赛住院医师占初赛人数的35.20%，博士学位医师(54.81%)进入复赛比例最高。卫计委直属系统住院医师进入复赛的比例最高，达53.19%，其后依次是市属系统、北医系统、部队系统和区县医院。复赛总平均分(233.98±25.15)，按百分制60分及格计算，及格率42.5%。决赛为团队手术，平均分(89.05±5.17)，按百分制80分计算，及格率60%。结论：北京地区不同培训基地外科住院医师临床基本能力存在一定的差异，总体能力有待提高；当前迫切需要加强住院医师临床实践培训、师资队伍和基地建设与管理。%Objective:To evaluate the status and problams of the basic clinical competence of surgical residents in Beijing. Methods:250 surgical residents having finishaol two-year stand ardized examination participated in the competition. The competition was divided into prelimina-ry, semi-finals and finals. The assessment content included medical knowledge, history inquiry, physical examination, supplementary exam inter-pretation, clinical thinking, medical documents record, medical explanation, communication skills, surgical operation and medical related laws. Each station used percentile rating scale with each scoring points 2 to 3. Results:The 250 surgical residents were from 23 training bases. The to-tal average score of preliminary competition was (295. 38±32. 88), and the passing rate was 27. 6% according to 80 percentile calculation. The scores of residents from suburban hospitals were significantly lower than that of National Health and family Plan Commission system and Beijing's municipal health bureau systems (P<0. 05). The rate of all residents' progress into the semi-finals was 35. 2%, and that of residents with doctor degree was the highest (54. 81%). The residents from National Health and family Plan Commission system was the highest (53. 19%) , followed by Beijing's municipal health bureau systems, Peking University system, military university systems and district hospitals. The total average score of semi-finals was (233. 98±25. 15), and the passing rate was 42. 5% according to 60 percentile calculation. The score of finals with team oper-ation was (89. 05±5. 17), and the passing rate was 60. 00% according to 80 percentile calculation. Conclusion:The core competence of surgical residents in Beijing is needed to be improved, and there are some differences in different resident training base. It is urgently needs to strengthen the clinical training, construction of teaching faculty and management of the training base.
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