OXFORD UNIVERSITY PRESS

Let Me Heal: The Opportunity to Preserve Excellence in American Medicine

ISBN : 9780199744541

参考価格(税込): 
¥5,995
著者: 
Kenneth M. Ludmerer
ページ
456 ページ
フォーマット
Hardcover
サイズ
164 x 236 mm
刊行日
2014年10月
メール送信
印刷

In Let Me Heal, prize-winning author Kenneth M.Ludmerer provides the first-ever account of the residency system for training doctors in the United States and, by tracing its evolution, explores how the residency system is of fundamental importance to the health of the nation. In the making of a doctor, the residency system represents the dominant formative influence. It is during the three to nine years spent in residency that doctors come of professional age, acquiring the knowledge and skills of their specialty or subspecialty, forming a professional identify, and developing habitts, behaviors, attitudes, and values that last a professional lifetime. Let Me Heal examines all dimensions of the residency system: historical evolution, educational principles, moral underpinnings, financing and administration, and cultural components. It focuses on the experience of being a resident, on how that experience has changed over time, and on how well the residency system is fulfilling its obligation to produce outstanding doctors. Most importantly, it analyzes the mutual relationship beetween residency education and patient care in America. The book shows that the quality of residency training ultimately depends on the quality of patient care that residents observe, but that there is much that residency training can do to produce doctors who practice in a better, more affordable fashion.

目次: 

1. ANTECEDENTS
The Search for Clinical Experience
The Quest for Specialty Training
The Passion for Discovery and the Birth of Clinical Science
2. JOHNS HOPKINS AND THE CREATION OF THE RESIDENCY
Graduate Medical Education Enters the University
The Scientific Practitioner and the Promise for the Nation
Work as Play
Diaspora
3. THE GROWTH OF GRADUATE MEDICAL EDUCATION
Completing the Infrastructure
The Maturation of the Internship
The Spread of the Residency
In Search of a System
4. THE AMERICAN RESIDENCY
Educational Principles
The Moral Dimension of Graduate Medical Education
The Learning Environment
Cultural Influences
5. THE LIFE OF A PRE-WORLD WAR II HOUSE OFFICER
Obtaining a Residency
Experiencing the Residency
Education and Service
6. CONSOLIDATING THE SYSTEM
The Second Reform of Medical Education
The Rise of the Specialty Boards and the Triumph of Residency
Graduate Medical Education and the Public Good
7. THE EXPANSION OF THE RESIDENCY IN AN ERA OF ABUNDANCE
From Privilege to Right
The Maturation of Clinical Science and the Creation of Subspecialty Fellowships
The Ascendance of Specialty Practice
The Propagation of Wastefulness
8. THE EVOLVING LEARNING ENVIRONMENT
The Decline of the Ward Service
The Preservation of Educational Quality
Maintaining the Moral Mission
9. THE LIFE OF A POST-WORLD WAR II HOUSE OFFICER
Changes and Continuities
Quality, Safety, and Supervision
Education and Service, Again
10. THE WEAKENING OF THE EDUCATIONAL COMMUNITY
The Marginalization of House Officers
House Staff Activism
The Discovery of Burnout
11. THE ERA OF HIGH THROUGHPUT
The New Learning Environment
The Subversion of the Moral Mission
Changing Attitudes toward Work and Life
12. THE ERA OF ACCOUNTABILITY, PATIENT SAFETY, AND WORK-HOURS REGULATION
Work Hours Restriction
Perpetual Dilemmas
13. PRESERVING EXCELLENCE IN RESIDENCY TRAINING AND MEDICAL CARE
Challenges, New and Old
Aligning Education and Patient Care

著者について: 

Kenneth M. Ludmerer is Professor of Medicine, Professor of History, and the Mabel Dorn Reeder Distinguished Professor of the History of Medicine, Washington University, St. Louis, Missouri.

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