RESUMO
Medical education after graduation is the necessary step for each medical graduate to become an independent practitioner. The present medical education system or standardized residency training system in China is similar to that of the United States and Canada. This system is designed to ensure that all trained physicians are competent in practicing medicine in their trained medical specialties. The article briefly summarizes the current status of the pediatric residency and neonatal-perinatal medicine fellowship training system in the United States. The critical roles of the American Board of Pediatrics and the Accreditation Council for Graduate Medical Education are also presented.
RESUMO
Along with the application of next generation sequencing,multidisciplinary cooperation among bioinformatics,clinical research and microbiology,has made rapid and impressive progress in microbiome in various fields.During perinatal period,which is the key and plastic for development,focus on different locations of microbiota from maternal-infant shed light on the pathophysiological mechanism,and help to find potential non-invasive biomarker and treatment target.
RESUMO
No fault compensation in perinatal medicine has been established to provide aid to patients in the event of disability due to a medical accident during delivery and to strive to resolve disputes quickly that contributes to reduce medical malpractice suit in the field of perinatal medicine. Furthermore, this system is aimed to establish a mechanism that achieves higher quality of obstetric care by analyzing the causes of accidents. This system is operated by Japan Council for Quality Health Care and 99.9% of childbirth facilities in Japan registered with this compensation system. Compensation system has two major functions including compensation and cause analysis and recurrence prevention based on cases. Compensation eligibility is reviewed in the Review Committee at the organization in Japan Council for Quality Health Care and currently 1,717 cases are judged as eligible cases out of 2,250 since 2009. The cause of each eligible case is analyzed in the Cause Analysis Committee one by one. The Cause Analysis Committee has 7 independent subcommittee and each subcommittee members are consistent of obstetricians, neonatologists, pediatricians, midwives and lawyers. Original cause analysis report is sent to childbirth facility and patient's family. Questionnaire survey demonstrated that 73% of childbirth facilities and 65% of patient family were satisfied with the cause analysis report. The number of medical lawsuit in obstetrics and gynecology is significantly decreased compared to those in all medical departments since the compensation system was introduced suggesting that these cause analysis reports may contribute the decrease in medical lawsuits. The major purpose of the Recurrence Prevention Committee is striving to prevent future cases of cerebral palsy and to improve the quality of obstetric care. To accomplish the purpose, the committee routinely collect information from individual cases and analyze quantitatively and epidemiologically. Furthermore the committee choose subject from cases to discuss for future prevention and provide wide public disclosure of the information with recommendation. The committee issued 6 reports until now and these reports have been distributed to childbirth facilities, perinatal medicine-related scientific society and administrative agencies.