医学院附院留学生实习大纲、考核手册中英文完全版1

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留学生实习考核手册

Examination Record for Internship

姓名Name______________________________ 年级Grade_____________________________ 班级Class______________________________ 专业Specialty___________________________ 学号Registration No._____________________

医学院附属医院

Affilliated Hospital of Jining Medical College

实习考核手册

Record of Internship Examination

姓名

Name 性别Sex

出生日期Date of Birth 国籍Nationality

照片 Photo 现住址Address 电话Tel 手机Mobile Phone 电子邮件E-Mail

填表说明

一、填写本手册要严肃认真，实事求是。一律用钢笔填写。

二、实习小结由本人按实习收获、体会、存在的问题及建议等内容填写。

三、本表内容应及时按规定的项目和要求准确记录。由主管实习的教师进行成绩考核

及出勤情况统计。四、每科实习结束时，有教研室汇总考核手册，教研室主任签字，然后送交医院主管

教学办公室。全部实习结束后，有由教学办公室汇总考核手册。五、本手册应妥善保存，不得遗失，毕业实习结束后存入学生档案。

Instruction

1. The Record must be filled out in ink and seriously based on facts.

2. The Internship Report must be written by the student by him/herselfon his/her own and involves the knowledge, experience and suggestion to the existing problems.

3. The records and reports of intership must be made on time according to the given items. The internship grade and the attendance record must be completed by teachers in charge of internship.

4. Upon the completion of the internship, the record should be signed by the director of department and handed in to the office of teaching affairs of the teaching hospital.

5. The record should be kept by the international college after intership as a part of student’s archives.

毕业实习目的须知

一、实习目的

毕业实习是医学生在完成医学基础理论和专业知识的学习以后，通过病房、门诊、急诊等各项医疗实践活动，在上级医师的指导下，通过接诊、处治病人，学会对常见病、多发病的诊断和处理原则，正确掌握临床工作中的常用诊疗技术，培养临床思维和独立工作能力。

同时还要了解医院的组织形式、工作常规、工作方法、工作制度和医疗法规。在工作中，树立以病人为中心的服务意识，学会正确处理医患关系，提高业务、树立高尚的医德医风。二、实习须知

1、遵守国家法令和医院一切规章制度，尊重所在医院的各级领导、医师、护理人员及其他工作人员。

2、实习期间应参加所在医院及科室组织的各项活动，关心国家大事。

3、要以病人为中心，体贴关心病人，对病人一视同仁，切忌有损于病人身心健康的言行。对病人或其家属的馈赠应一律婉言谢绝。不要随便与家属解释病情。

4、要严格按照实习大纲、实习计划的要求，完成临床实习，以巩固医学理论知识，掌握基本的医疗技能。

5、树立严肃认真、一丝不苟的工作作风。严密观察病人，严格执行各种操作常规，防止发生医疗差错和事故的发生。

6、实习期间，按计划要求在有关科室轮转，在上级医师指导下参加病房、门诊、急诊及值班等工作。工作中须服从上级医师的统一安排，不得争抢、推委。

7、着装整齐，举止端庄，作风正派，礼貌待人，团结互助，不搞无原则纠纷和闹矛盾。

Information for Internship

Ⅰ.Purpose of Internship

After completing basic science courses and professional knowledge courses, interns will learn how to diagnose common diseases and frequently-occurring diseases as well as clinical principle through practical activities in the inpatient’s room, outpatient’s department and emergency room. Under the guidance of higher level doctors, interns will master clinical techniques and develop their clinical thought and ability to work on their own in the course of saving patients lives and treating diseases.

At the same time interns should also learn to know the form of organization and every working regulation, method, system and medical statutes of the hospital. Interns should increase the consciousness of service and take priority over patients. They will know how to deal with the relationship between patients and doctors, improve their professional skills and try to become ethical doctors.

Ⅱ.Notice to Interns

1、Observe the relevant policies of China and the regulations worked out by the hospital authorities. Respect the leaders, doctors, nurses, and other staff members working in the hospital.

2、Take part in different activities of the hospital as well as departments in which you are working. Concern yourselves with affairs of state. 3、“Patients-First”—take priority for patients. Look after every patient with great care. Treat every patient equally without discrimination. Don’t say and do anything to hurt /harm the patient. Refuse any gift from patients or their relatives. Don’t explain the patients’ condition to their relatives at random.

4、Complete clinical practice in strict accordance with the outline and plan so as to strengthen the basic knowledge and clinical skills.

5、Form the serious style of work. Keep close watch over every patient and abide by operating rules and regulations. Guard against any unskilful and faulty medical or surgical treatment.

6、Practise in relevant departments in the hospital according to requirements. Join in the different work in the patient’s room, outpatient’s department, emergency room as well as being on duty under the guidance of higher level doctors. Interns must obey the unified arrangement and avoid scrambling for treatment or shirking responsibility.

7、Dress neatly and keep your behavior dignified. Treat patients in an honest and polite manner. Help each other and avoid unprincipled disputes and trouble.

毕业实习规定

一．毕业实习为48周。其中内科12周、外科实习12周、妇产科实习6周、儿科实习6周、神经

内科实习4周、影像医学2周、眼科2周、皮肤科2周、耳鼻喉科2周。实习时间为在本年7月开始至次年6月完成。实习安排在本校的大学医院和教学医院中进行。

二．医院对学生实习采取三级管理方式，即：教学处—教研室—带教教师。教学处在各教研室均

聘请一名主治医师以上的人员为班主任导师负责学生的实习管理工作。

三．入科教育：学生分组入科学习，第一天由该教研室常务副主任及教学班主任进行入科教育，

介绍本科的基本情况、规章制度，轮转科室和值班次序，安排带教教师及实习医生实习工作程序，教学查房和实习期间小讲课的时间安排等。

四．出科考核：每科轮转结束后，由带教教师及班主任共同组成考评小组，对实习生按照八项考

核评定标准，进行口试、笔试、技能操作等考核，综合实习生的平时操作、实习表现及考核成绩按照客观定量，计算在该科实习的分数。（见“指标综合评定标准”）

五．按照实习大纲要求，教学处组织教学督导组专家于学年内对每个学科进行教学查房督导评

价，教学处随机到各教研室检查实习带教及学生实习情况，征求并反馈教师和学生意见，据此每月进行综合评价。

六．实习生要遵守医院的考勤管理制度。在实习期间，实习医生一般不得请事假，如特殊情况，

一日以内者，向带教老师请假；二日以内向教研室请假，三天以内者，向教研室主任及实习医院主管部门请假；二周以上，报学校学生主管部门批准，违者按旷课处理。因病休假者必须出示就诊医院诊断证明书，并经实习医院的教学主管部门批准后方可休假。如病情严重需长期休养者，应经学校学生主管部门批准并按规定办理休学。

七．补实习规定，实习医生在内、外科实习期间，病、事假不得超过该科实习期间的1/4，其他

各科不得超过该科实习期的1/3，超过者应按该科规定的实习时间补实习。实习期间病、事假累计超过全部实习时间的1/3，应随下一届学生重新参加毕业实习。

八．学生如要求在校外或国外医院实习，应选择在大学教学医院或医疗中心级医院、规模须具备

500张床位以上，具有较强教学能力的综合性医院中进行。须本人提出申请并有接收医院开具同意接受该生实习的证明，同时出具该医院具备接受能力的资质证明。

九．无论在本校进行毕业实习还是在校外或国外医院进行毕业实习，学生在完成各科实习后须回

本校参加毕业实习综合能力考试。（考试内容为内科、外科、妇科、儿科的临床理论部分和实际操作能力部分）考试合格者方能准予毕业。考试时间安排再次年的6月份进行。附：实习考核标准

Internship Regulations

The Internship in Clinical Medicine is 48 weeks from July in anyyear to next June of the following year, in which 12 weeks for Internal Medicine18 weeks for Gynecology & Obstetrics, 6 weeks for Pediatrics， 6 weeks Neurology (including 2-week internship for Radiology), 2 weeks for The internship is arranged at the teaching hospitals of Tianjin Medical University according to the internship schedule. The students are under the supervision of the Teaching Affairs Department, Teaching and Research Office and the tutors. One attending doctor or above from each Teaching and Research Office will be put in charge of internship management respectively.

Students should be arranged to do the internship in groups. On the first day of the internship, the vice director and the teacher in charge will give the students the basic introduction to the sectors, the regulations, the sequences of working in different sectors, the programme for internship, schedule for going around the ward for inquiry and the arrangement for internship instruction.

The interns shall be given an assessment after internship in each sector by an evaluation team formed by the tutors and the teacher in charge. The eight assessment results are based on both oral and writing tests, operation skills, comprehensive operations, overall behaviors of the internship and evaluation result.

The internship should be carried out strictly according to Internship Outline. Experts from the supervision team will give evaluation and instruction to each subject and the teaching office will also ask for the advice and feedback of the tutors and students. In accordance with the above, a comprehensive evaluation will be performed monthly. Students must abide by the regulations of internship and they are not allowed to ask leave without special permission. If they have one day off, they should ask their tutors for leaving; two days, ask the teaching and research office of the department; three days, ask the director of the department and the teaching office of hospital. More than two weeks’ leave, they have to report to the students’ management department for authorization. Anyone will be regarded as absence if they take leave without permission from relevant department. If students ask for sick leave, they need to present the medical diagnosis record from the hospital and get the permission of the internship hospital. If the students suffer from serious sickness, they need to get the approval of the university authorities and then go through the probation procedure. The students will be subject to make up for the lost period if his absence accounts for one fourth in the internship of internal medicine and surgery, one third in the other subjects. Students need to repeat the internship with the next grade if he is absent from the practice for over one third because of illness or any other reason.

Students who want to do the internship aboard or out of our university should select a comprehensive hospital or medical center, with over 500 patient beds and with

medical teaching competence. The student is also required to submit an admission letter from the hospital and a certification indicating the qualification of the hospital.

Wherever the students perform internship work, at our university or aboard, they must return to the university to attend the general examination after the internship. The examination involves clinical theory and clinical ractice of Internal Medicine, Surgery, Gynecology and Paediatrics. Those who pass the exam are qualified to graduate and obtain diplomas. The examination is scheduled to be held next June. Encls: Evaluation Criteria for internship

实习成绩考核记录 GRADE RECORD OF INTERNSHIP

考核项目 items

要求 requirement

标准 standard

扣分标准 statement

得分 mark

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5; emphases:1-5

教师签字 signature

病历书写 writing

medical record 查体

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

physical examination

姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5; sequence:1-5; correct:1-5

病历分析 analysis of

medical record

表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10

临床基本

熟练准确正规迅速

技能操作

basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

表达有条理 correct answer, clear concept, logistic expression 选择题,病历讨论题

test of theory 职业道德

multiple choice, discussion record 尊敬老师爱护患者文明礼貌遵守纪律 respect teachers, 15 care about patients, civilized,be polite, observe discipline,

不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

实习医生工作职责

1、在上级医师指导下负责管理6-8张病床的医疗工作，应密切观察所管病人的病情变化。 2、每日早上应提前半小时进入病房，对所管的病人进行巡视检查，并做好查房前的各项准备工作。按时参加病房医护交班。

3、较熟练地掌握病历采取、系统体格检查、书写完整病历，新病人病历要在24小时内完成，并提出诊疗计划意见。随时整理病历，及时粘贴各种化验单及检查报告。

4、对危重病人应随时观察病人情况，报告上级医师，及时处理。

5、每天随上级医师查房，认真听取上级医师的指导，回答上级医师的提问，参与阅读各种影像图片、分析心电图和各种检验报告，有问题及时请教。

6.参与所管病人的各种诊疗、手术、检查等活动。操作前，必须得到上级医师的批准和现场指导。

7、学会书写医嘱、处方、特殊检查申请单、病假单及入院单等各种医疗文件，但均需上级医师复核、签字后生效。（教师/学生）

8、从事一定时间的病房、门诊、急诊和夜班工作。实行24小时负责制和轮流值班制。值班期间不得擅离职守。

9、参加科室的学术报告、临床病例讨论、专题讲座及实习小讲课。 10、在完成医疗工作的同时，应兼学护理，掌握基本护理操作技术。

11、严格按照实习手册所要求掌握的病种、技能，努力争取机会完成≥95%。于出科前如果未完成可与主管带教医师或班主任沟通尽可能弥补。

注：男同学检查女病人时，必须有女护士或第三者在场，不得单独处理病人。

The Duty of Interns

1. Interns will take charge of more than 6 beds under the superior physicians’ guidance

and carefully observe their patients’ progress.

2. Interns have to come into wards half an hour earlyr every morning, visit and inspect their patients, prepare for various work before going wards rounds, and take part in handing over to the next shift on the wards on time.

3. Interns should master a case acquisition, a systematic physical examination, writing an entire case history as well. The case history of new patients must be finished within 24 hours. The interns should put forward a diagnosis and treatment scheme, keep all paperwork in excellent order all times, stick various report lists and and survey reports in the case history book on time.

4. Interns should observe the seriously ill at all times, notify the superior physician and deal with the patients in good time.

5. Interns have to go on wards round with the superior physicians every day, listen to the superior physician’s guidance carefully, answer the questions put forward by superior physician, be concerned with reading various photographs, analyse cardiograms and various survey reports. If you have some questions, please ask your teacher in good time.

6. They should participating in their own patients’ various diagnosis and treatment, operations, examinations and so on. Before any operation, you have to be authorized and instructed by a superior physician.

7. Learn to write various medical papers, including doctor's advice, prescription, application form for special examination, a sick leave certificate, hospital register and so on. But these papers can only become effective after they have been checked by a superior physician with signature. (teacher /student).

8. Undertake all work including ward, outpatient’s, emergency and night shift for some time. To carry out “24 hours” responsibility and on duty by turns. You are not allowed leaving during on duty.

9. To take part in the lectures of the department, discuss the cases, attend lectures on the subject and the lessons during intership.

10. Except finishing medical work, you should learn nursing and master basic operational technology of nursing.

11. You should master an categories of illness, try to complete 95% of the requirements according to the internship’s regulations. If you don’t finish the tasks before leaving the department, you should contact with the physician or the teacher in charge of you and make up the time.

NB: when male interns are examining female patients, a female nurse or a third person should be there, otherwise they are not allowed to deal with patients on their own.

内科实习病种记录表

Record of Disease for Internship (Internal Medicine)

基本掌握疾病 Diseases to be mastered 例数 Amount 慢性阻塞性肺病 Chronic obstructive pulmonary diseases 肺气肿及肺心病 Pulmonary emphysema & pulmonale 肺炎 Pneumonia 胸膜炎 Pleuritis

肺栓塞症 Pulmonary embolism 消化性溃疡 Peptic ulcer

肝硬化及并发症 Liver cirrhosis & Complication 消化道出血 Digestive tract bleeding 炎性肠病 Inflammatory bowel disease

尿路感染（肾盂肾炎）Inflammatory bowel disease & Pyelonephritis 慢性肾功能不全Chronic renal failure 肾病综合征 Nephrotic syndrome 缺铁性贫血 Iron deficiency anemia 再生障碍性贫血Aplastic anemia 白血病Leukemia 甲亢Hyperthyroidism 糖尿病Diabetes mellitus

急性左心衰Acute left heart failure 慢性心功能不全 Chronic heart failure 高血压 Hypertension 冠心病 Coronary heart disease 心律失常 Arrhythmia

心脏瓣膜病 Valvular heart disease

系统性红斑狼疮 Systemic lupus erythematosus 类风湿性关节炎 Atrophic arthritis 成人Still’s 病Adult Still’s disease 感染性心内膜炎 Infective endocarditis 细菌性痢疾 Bacillary dysentery 一般了解的疾病 diseases to be understood 例数 Amount 支气管扩张 Bronchiectasis 肺化脓症 Lung suppuration 肺癌 Cancer of lung 胃炎 Gastritis

胃食管返流症 Stomach-oesophagus reflux 肝癌 Hepatocellular carcinoma

肠结核 Intestinal tuberculosis 黄疸鉴别 Differentiation of jaundice 肾小球肾炎 Glomerulonephritis 血小板减少性紫癜 Thrombocytopenic Purpura 甲状腺功能低下：Hypothyroidism 柯兴氏综合症 Cushing syndrome 心肌炎心包炎心肌病 Myocarditis pericarditis cardiomyopathy 流行性出血热 Epidemic hemorrhagic fever 败血症 Hematosepsis 病毒性肝炎 Viral hepatitis 院内感染 Nosocomial infectious disease 病毒性上呼吸道感染 Virus upper respiratory infection 脑膜炎 Meningitis 脊柱关节炎 Vertebral column arthrositis 一氧化碳中毒Carbon monoxide poisoning 有机磷中毒 Organophosphate poisoning

教师签字Teacher’s Signature: 日期Date：

内科实习操作技能记录

Record of Practice for Internship（Internal Medicine）

基本掌握 Procedures to be mastered 例数 Amount

病历书写Case writing 中文In Chinese(for Chinese group) 英文In English(for Chinese\\English group) 医疗文件书写Written medical documents 系统查体Systematic physical examination

X系统阅片及报告书写 X-ray diagnosis and writing report 心电图Electrocardiogram 肌肉注射Intramuscular injection 静脉穿刺 Intravenous injection 胸穿Thoracentesis 骨穿Bone marrow puncture 腹穿Abdominal paracentesis

动脉血气分析（取血）Arterial blood gas analysis(arterial blood) 给氧Oxygen inhalation

心肺复苏Cardio-pulmonary resuscitation

一般了解Procedures to be understood 数目Amount

洗胃Gastrolavage

介入治疗Interventional therapy 胃镜Gastroscope B超B-ultra

气管内窥镜Bronchoscope 腰穿Lumbar puncture

皮内注射Intradermic injection 皮下注射Subcutaneous injection 导尿Urethral catheterization 吸痰Sputum attraction

平均分管床位数The number of responsible for Inpatient-bed (in average)

教师签字Teacher’s Signature: 日期Date：

内科学 Inernal Medicine

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(内科学)

Grade Record Of Internship(Internal Medicine)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

表达有条理 correct answer, clear concept, logistic expression 选择题,病历讨论题 multiple choice, discussion record 尊敬老师爱护患者文明礼貌遵守纪律 respect teachers, 15 care about patients, civilized,be polite, observe discipline,

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退 sick leave absence leave truancy late leave early

_______________________________________________________________________________

内科学 Inernal Medicine

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(内科学)

Grade Record Of Internship(Internal Medicine)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退 sick leave absence leave truancy late leave early

_______________________________________________________________________________

内科学 Inernal Medicine

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(内科学)

Grade Record Of Internship(Internal Medicine)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退 sick leave absence leave truancy late leave early

_______________________________________________________________________________

内科学 Inernal Medicine

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(内科学)

Grade Record Of Internship(Internal Medicine)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退 sick leave absence leave truancy late leave early

_______________________________________________________________________________

内科学 Inernal Medicine

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(内科学)

Grade Record Of Internship(Internal Medicine)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退 sick leave absence leave truancy late leave early

_______________________________________________________________________________

外科实习病种记录表

Record of Diseases for Internship (Surgery)

基本掌握疾病 Diseases to be mastered 例数Amount 参加手术Operation 浅部组织的化脓性感染Acute pyogenic infection of soft tissue 手部急性化脓性感染Acute pyogenic infection of the hand 一般外伤Common trauma 热力烧伤Burns

甲状腺疾病Diseases of the thyroid gland 乳腺疾病Diseases of the breast 腹外疝Abdominal hernia

急性化脓性腹膜炎Acute pyogenic peritonitis

胃、十二指肠溃疡并发症Complications of peptic ulcer 肠梗阻Intestinal obstruction 阑尾炎Appendicitis

胆囊结石、胆囊炎Cholecystitis & cholecystolithiasis 胰腺疾病Diseases of the pancreas

原发性下肢静脉曲张Varicose vein of the lower extremity 腰椎间盘突出症Lumbar protrusion 常见骨折、脱位Common fracture and dislocation 软组织扭伤、劳损Injury and strain of soft tissue 泌尿系感染Infection of the urinary system 前列腺炎Prostatitis 泌尿系结石Urinary system calculus 尿路梗阻Urinary tract obstruction 食管癌Esophageal cancer 肺癌Lung cancer

心脏疾病Diseases of the heart 胸外伤Chest trauma

胸外伤Evaluation before anesthesia

麻醉前对病人的用药Administration before anesthesia 一般了解疾病 Diseases to be understood 例数Amount 全身外科感染General surgical infection 胆管结石、胆管炎Calculus of bile duct & cholangitis 胆管结石、胆管炎Diseases of the anus 腹部闭合性损伤Abdominal closed injury 胃癌Gastric carcinoma 肝癌Hepatic carcinoma

结、直肠癌Carcinoma of the colon and rectum

下肢动脉硬化闭塞症Arteriosclerosis obliterans of the lower extremity 深静脉血栓形成Deep vein thrombosis 门脉高压症Portal hypertension 门脉高压症Tuberculosis of the joint 泌尿系损伤Injury of the urinary system 附睾炎Epididymitis 急性肾衰Acute renal failure 颈肩痛、腰腿痛Cervix and shoulder pain & low back pain 脊柱结核Tuberculosis of spinal column

教师签字Teacher’s Signature: 日期Date：

外科实习操作技能记录表

Record of Practice for Internship(Surgery)

基本掌握Procedures to be mastered 数目Amount 病历书写Medical documentation 中文in Chinese(for Chinese group) 英文in English(for Chinese\\English group) 外科查体Physical examination of surgery

刷手戴手套穿手术衣Scrub, wear gloves and operative clothes 消毒皮肤Skin disinfection

铺消毒单Sterile drape of operative site 直肠指诊Digital examination of rectum 切皮Incision 止血Haemostasis 缝合Suture 打结Make knots

胃肠减压Nasogastric suction 换药Dressing change 拆线Remove the suture 导尿Urethral catheterization

参加麻醉例数Participation in anesthesia 麻醉记录单书写Anesthesia record writing 一般了解Procedures to be understood 数目Amount 透光试验Penetrating test 透光试验Anoscopy

阅片X-ray interpretation 局麻Local anesthesia 伤口引流Wound drainage 伤口包扎Wound dressing 静脉切开Venous cutdown

皮肤牵引骨牵引Skin traction and bone traction 夹板Splint 石膏绷带Plaster bandage 灌肠Enemas

搬运病人Transporting patients 全麻General anesthesia

腰麻Subarachnoid space block for anesthesia 气管内插管Endotracheal intubation

全麻、椎管内麻醉Intervertebral anesthesia 平均分管床位数The number of responsible for Inpatient-bed (in average) 教师签字Teacher’s Signature: 日期Date：

外科学 Surgery

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)_____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(外科学)

GRADE RECORD OF INTERNSHIP(Surgery)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5; sequence:1-5;

correct:1-5

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

病历分析 analysis of medical record

表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

_______________________________________________________________________________

外科学 Surgery

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)_____________

/年Y /月M /日D

实习小结：Intership Report

实习成绩考核记录(外科学)

GRADE RECORD OF INTERNSHIP(Surgery)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance 口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

_______________________________________________________________________________

外科学 Surgery

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)_____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(外科学)

GRADE RECORD OF INTERNSHIP(Surgery)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5; sequence:1-5;

correct:1-5

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

病历分析 analysis of medical record

表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

_______________________________________________________________________________

外科学 Surgery

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)_____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(外科学)

GRADE RECORD OF INTERNSHIP(Surgery)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5; sequence:1-5;

correct:1-5

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

病历分析 analysis of medical record

表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

_______________________________________________________________________________

外科学 Surgery

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)_____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(外科学)

GRADE RECORD OF INTERNSHIP(Surgery)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5; sequence:1-5;

correct:1-5

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

病历分析 analysis of medical record

表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

_______________________________________________________________________________

外科学 Surgery

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)_____________ to(y/m/d)_____________ 实习小结：Intership Report

/年Y /月M /日D

实习成绩考核记录(外科学)

GRADE RECORD OF INTERNSHIP(Surgery)

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5; sequence:1-5;

correct:1-5

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

病历分析 analysis of medical record

表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10

临床基本

熟练准确正规迅速

技能操作 basic clinical performance

口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

_______________________________________________________________________________

妇产科实习病种记录表

Record of Diseases for Internship（Obstetrics and Gynecology）

基本掌握的疾病名称Diseases to be mastered 例数Amount 正常分娩各产程的临床观察及处理Normal labor 产前出血Antepartum hemorrhage 产后出血Postpartum hemorrhage

妊娠期高血压疾病Pregnancy-induced hypertension syndrome 妊娠诊断Diagnosis of pregnancy 自然流产Spontaneous abortion 妇科急腹症Gynecological 宫颈肿瘤Cervical tumor 子宫肿瘤Uterine tumor 卵巢肿瘤Ovarian tumor

一般了解的疾病名称Diseases to be understood 例数Amount 妊娠合并内科疾病Medical internal complication of pregnancy 胎儿窘迫Fetal distress 子宫内膜异位症Endometriosis 妊娠滋养细胞疾病Trophoblastic disease

教师签字Teacher’s Signature: 日期Date：

妇产科实习操作技能记录表

Record of Practice（Obstetrics and Gynecology ）

基本掌握诊疗操作名称Procedures to be mastered 例数Amount 病历书写 Medical case writing 中文 Chinese 英文 English 医疗文件书写Medical document writing 妇科查体Gynecological examination 产科查体Obstetric examination 宫颈刮片Cytologibal examination of cervix 滴虫、霉菌检查Examination of pathogen 胎心监测Fetal heart rate monitor

一般了解诊疗操作名称Procedures to be understood 例数Amount 顺产接生Spontaneous delivery 剖宫产Cesarean section 上环Placement of UID 取环Removal of UID 吸宫Artificial abortion

平均管理床位数 The number of responsible for Inpatient-bed (in average)

教师签字Teacher’s Signature: 日期Date：

妇产科学 Obstetrics and Gynecology 实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)____________ to(y/m/d)_____________ 实习小结：Intership Report

年Y/ 月M/ 日D/

实习成绩考核记录(妇产科学)

Grade Record of Internship （Obstetrics And Gynecology）

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance 口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

妇产科学 Obstetrics and Gynecology

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)____________ to(y/m/d)_____________ 实习小结：Intership Report

年Y/ 月M/ 日D/

实习成绩考核记录(妇产科学)

Grade Record of Internship （Obstetrics And Gynecology）

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance 口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

儿科实习病种记录表

Record of Diseases for Internship（Pediatrics）

基本掌握的疾病名称Diseases to be mastered 例数Amount 上呼吸道感染Acute upper respiratory infection 支气管炎Bronchitis 肺炎Pneumonia 维生素D缺乏性佝偻病Rickets of vitamin D deficiency 婴幼儿腹泻Infantile diarrhea 脱水Dehydration

传染性单核细胞增多症Infectious mononucleosis 急性肾小球肾炎Acute glomerulonephritis 肾病综合症Nephritic syndrome 新生儿缺氧缺血性脑病Hypoxic-ischemic encephalopathy of the newborn 新生儿窒息Asphyxia of newborn 新生儿呼吸障碍Respiratory disturbance of newborn Asphyxia of newborn 新生儿黄疸Jaundice of the newborn 先天性心脏病Congenital heart disease 病毒性心肌炎Viral myocarditis

一般了解的疾病名称Diseases to be understood 例数Amount 支气管哮喘Bronchial asthma 营养不良Malnutrition 口腔炎Stomatitis 泌尿系感染Urinary tract infections 新生儿败血症Septicemia of newborn 风湿热Rheumatic fever 常见急症处理Disposition of common emergencies 细菌性痢疾Bacillary dysentery 婴幼儿手足搐搦症Infantile tetany 营养性缺铁性贫血Nutritional iron deficiency anemia 川崎病Kawasaki disease

教师签字Teacher’s Signature: 日期Date：

儿科实习操作技能记录表 Record of Practice（Pediatrics）

基本掌握诊疗操作名称Procedures to be mastered 例数Amount 医疗文件书写 Medical document writing 中文 Chinese 英文 English 儿科查体Physical examination of children 静脉穿刺Venipuncture 肌肉注射Intramuscular infection 心电图Electrocardiogram 小儿用药剂量计算Calculation of children's medicamentous dosage 微量血糖测定Measurement of blood glucose using finger stick method

一般了解诊疗操作名称Procedures to be understood 例数Amount 骨穿 Bone marrow puncture 腰穿Lumbar puncture 皮下注射Subcutaneous injection 皮内注射Intradermic injection 股静脉取血Femoral vein puncture

平均管理床位数 The number of responsible for Inpatient-bed (in average)

教师签字Teacher’s Signature: 日期Date：

儿科学 Pediatrics

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)____________ to(y/m/d)_____________ 实习小结：Intership Report

年Y/ 月M/ 日D/

实习成绩考核记录(儿科)

Grade Record Of Internship（Pediatrics）

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance 口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分mark:

教研室主任签字 Signature of Director:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

神经内科实习病种记录表

Record of Diseases for Internship（Neurology）

基本掌握的疾病名称diseases to be mastered 例数amount 颈内动脉系统TIA TIA of internal carotid artery system 椎-基底动脉系统TIA TIA of vertebral-basilar artery system 大脑中动脉的皮层支梗塞Cortical branch infarction of middle cerebral artery 大脑中动脉深穿支梗塞Penetrating branch infarction of middle cerebral artery 椎-基底动脉血栓形成Thrombosis formation of vertebral-basilar artery 大脑后动脉血栓形成Thrombosis formation of posterior cerebral artery 小脑梗死Cerebellar infarction 脑栓塞Cerebral embolism 脑出血Cerebral hemorrhage 脑血管病性痴呆Cerebral vascular dementia 急性脊髓炎Acute myelitis 病毒性脑炎（单纯疱疹性脑炎Viral encephalitis (herpes simplex encephalitis) 帕金森病Parkinsons disease 脱髓鞘病Demyelinating disease 重症肌无力Myasthenia gravis Duchenne 肌营养不良Duchenne muscular dystrophy 急性感染性多发性神经根炎Actue infectious polyradiculoneuritis 肌萎缩侧索硬化Amyotrophic lateral sclerosis

一般了解的疾病名称diseases to be understood 例数amount 癫痫持续状态Status epilepticus Huntingtons disease Wilsons disease 强直肌营养不良Myotonic dystrophy 多发性肌炎Multiple myositis 面神经炎Facial neuritis Alzhiemers disease 遗传性共济失调Hereditary ataxia 偏头痛Migraine 紧张性头痛Tension headache 蛛网膜下腔出血Subarachnoid hemorrhage 癫痫大发作Epilepsia gravior 颞叶癫痫Temporal lobe epilepsy ，，教师签字Teacher’s Signature: 日期Date：

神经内科实习病种记录表 Record of Practice（Neurology）

基本掌握诊疗操作名称procedures to be mastered 例数amount 病历书写 Medical case writing 中文 Chinese 英文 English 医疗文件书写The writing of medical treatment files ( progress notes ) 神经系统查体The examination of the nervous system 脊髓MRI阅片The reading of spinal MRI 头颅CT或MRI阅片The reading of head CT or MRI 腰穿Spinal puncture

一般了解诊疗操作名称procedures to be understood 例数amount 脑电图Electroencephalography 肌电图Electromyography 诱发电位Evoked potential Evoked potential 经颅多普勒超声血流图Transcranial doppler 气管切开的护理和呼吸机使用方法The attendance of incision of trachea and the use of respirator

平均管理床位数 The number of responsible for Inpatient-bed (in average)

教师签字Teacher’s Signature: 日期Date：

神经科学Neurology

实习医院名称The Name of Teaching Hospital:

实习时间Time of intership 自From(y/m/d)____________ to(y/m/d)_____________ 实习小结：Intership Report

年Y/ 月M/ 日D/

实习成绩考核记录(神经科学)

Grade Record of Internship （Neurology）

考核项目 items 病历书写 writing medical record 查体 physical examination

要求 requirement

标准 standard

扣分标准 statement

得分 mark

教师签字 signature

字迹清楚语言通顺层次分明重点突出 clear,fluent, make the key points

stand out 姿势正确顺序正规手法熟练完整准确 correct posture, regular sequence, skillful performance 表达清楚分析有序抓住重点诊断处理

正确 clear expression, orderly analysis, correct treatment

15 10

字迹不清楚1-5分;语言不通扣1-5分;层

次不分,重点不突出扣1-5分.

clarity:1-5; fluency:1-5;

emphases:1-5 姿势不正规扣1-5分;无顺序,手法不熟练

扣1-5分;有遗漏不准确扣1-5分.

posture:1-5;

sequence:1-5; correct:1-5 表达分析层次不清扣1-8分;抓不住重点扣1-8分;诊断处理欠正确扣2-10

分.perspicuity:1-8; emphases:1-8; diagnosis and treatment;2-10 不熟练扣2-10分;欠准确或不准确扣4-15

分;不迅速扣2-7分.

skillness;2-10; correct:4-15; fast;2-7

病历分析 analysis of medical record

临床基本

熟练准确正规迅速

技能操作 basic clinical performance 口试

skillful, correct, regular, fast 回答正确概念清楚

10 15

oral test

回答不正确概念不清楚扣1-10分;表达能力差扣1-5分. correct:1-10;

ability of expression:1-5

理论考试 test of theory 职业道德

按考卷评分及病历分析结果计算.according to the paper

medical ethics

不尊敬教师扣1-15分;对病人不关心不爱护扣1-15分；不遵守纪律不文明礼貌扣1-15分. respect teachers;1-15;

care about patients:1-15;

be polite and observe discipline:1-15

总分 mark:

教研室主任签字 Signature of Director: 日期Date:

科室意见Director's Review

主任签字Director's Signature:

日期Date:

_______________________________________________________________________________

考勤情况（由带教教师纪录）

Attendance Record (Record for Internship Teachers)

病假事假旷课迟到早退

sick leave absence leave truancy late leave early

实习大纲 Practice Outline

Chinese Version 40 English Version 63

内科实习大纲

总体要求

一、实习时间与安排

实习共12周。轮转不少于4个三级学科，心脏、消化、呼吸、肾科、血液、感染、内分泌、门急诊，每学科3周，实习医师在上级医师指导下分管至少6张床。各三级学科每周教学查房一次，要求尽量使用双语查房，并有记录。

二、掌握疾病要求：掌握疾病基本诊断思路，诊断、诊断依据、鉴别诊断、处理原则、急症危重病人抢救，愈后及预防。

1、呼吸系统疾病：慢性支气管炎、肺气肿、肺心病、支气管哮喘、支气管扩张、大叶性肺炎、肺化脓症、胸膜炎、肺栓塞。

2、循环系统疾病：心力衰竭、心源性休克、风湿热、风湿性心瓣膜病、感染性心内膜炎、高血压、冠心病、心肌炎、心肌病、心包炎、心律失常（室上性心律失常、房颤、房扑、室性心律失常、传导阻滞、病窦综合征）

3、消化系统疾病：胃炎、消化性溃疡、肝硬化及其并发症（腹水、食道静脉曲张出血、肝

昏迷）、原发性肝癌、肠结核、结核性腹膜炎、炎性肠病、黄疸的鉴别诊断。

4、泌尿系统疾病：急慢性肾小球肾炎、急慢性肾盂肾炎、肾病综合征、急慢性肾功能不全。

（1）血液系统疾病：缺铁性贫血、再生障碍性贫血、巨幼细胞性贫血、急慢性白血病、

淋巴病、多发性骨髓瘤。

（3）内分泌系统及代谢疾病：甲亢、糖尿病、皮质醇增多症、垂体瘤、尿崩症。（4）感染免疫科：各种脑膜炎、系统性红斑狼疮。 5、基础技能训练要求：

（1）病历书写：实习医师应于24小时内完成完整病历的采集、书写，内容要求完整、准确、重点深入、条理分明、字迹清楚整齐，不能随意涂改。内科实习结束前上交中文病历8份、英文病历2份, 英文班交英文病历8份，需有上级医师修改及签字。（2）体格检查：熟练掌握系统检查方法，手法要规范，各种手法要做到位。

（3）病程记录，出院记录，死亡记录：要求写全各种记录，能正确反映病程变化和三级

查房上级医师的意见，不能把病程记录写成流水帐，作好阶段总结，并练习写出院记录、死亡记录等，要有上级医师签字，不能随意涂改。

（4）实验室检查：掌握血、尿、便三大常规正常值、临床意义，并掌握血沉、出凝血时

间、网织红细胞计数、体腔液（胸腹水）常规生化检查，脑脊液常规生化检查，掌握肝、肾功能检查，血液流变学检查，免疫全项，风湿抗体检查，血、尿、便培养等临床意义，了解一些特殊实验室检查结果及临床意义。

（5）X线检查：掌握正确系统的阅片方法，全面有层次的阅片，不遗漏应观察的任何部

位，能写出X光报告。掌握心、肺、骨正常X线表现。肺部渗出，纤维化、钙化、空洞，肿块性病变，心脏、大血管影像，胃、十二指肠溃疡、消化道肿物等疾病。（6）特殊检查：

①心电图：能掌握正常心电图和典型的心律失常、传导阻滞及心室、心房肥大、冠心病、心绞痛、心肌梗死的心电图变化。

②骨髓；能掌握正常骨髓像。急慢性白血病骨髓像，常见缺铁性贫血，巨幼细胞贫

血，再生障碍性贫血的骨髓特点。了解细胞化学染色的临床意义，急性白血病、淋巴病等免疫分型。

③基本掌握一些特殊检查的适应症、禁忌症。如胃镜、肠镜、肺功能、超声心动图等的方法及报告的辨认。

（7）基本诊疗技能操作：

①掌握皮下注射、肌肉注射、皮内注射、静脉穿刺、取血、输血、输液。 ②掌握胸穿、骨穿、腹穿等穿刺。

③掌握吸氧、吸痰、洗胃、人工呼吸、体外心脏按压等方法。 ④掌握心电图基本方法及典型波形辨认识别。

（8）正确开医嘱及处方，掌握内科常用药物剂量、给药途径及给药时间，掌握药物的作

用，了解副作用。

6、内科常见危重症抢救及一些新技术了解。

（1）呼吸衰竭、肺梗塞、大咯血。

（2）参加急性左心衰、急性心肌梗死，严重室性心律失常，参加心肺复苏的抢救，会使用除颤器，了解起搏器的安装，心脏介入治疗情况等。

（3）对消化道大出血的抢救，了解静脉结扎的过程。了解胃镜检查。（4）掌握DIC的诊断及治疗，对输血反应能及时判断并正确处理。（5）掌握急性肾衰治疗，肾衰透析治疗的指征。

（6）掌握甲亢危象、糖尿病酮症酸中毒、高渗昏迷的处理。

各学科具体要求

呼吸科实习大纲

实习共3周：均在病房，实习医师在上级医师指导下分管至少6张床。

一、呼吸科对实习医师具体需掌握疾病如下：慢性支气管炎、肺气肿、肺心病、支气管哮喘、支气管扩张、大叶性肺炎、肺化脓症、胸膜炎、肺栓塞。二、基础技能训练要求：

1. 病历书写：实习医师应于24小时内完成完整病历的采集、书写，内容要求完整、准确、

重点深入、条理分明、字迹清楚整齐，不能随意涂改。呼吸科实习结束前上交中文病历2份、英文病历1份，英文班交英文病历2份，需有上级医师修改及签字。 2. 体格检查：熟练掌握系统检查方法，手法要规范，各种手法要做到位。

3. 病程记录，出院记录，死亡记录：要求写全各种记录，能正确反映病程变化和三级查房

上级医师的意见，不能把病程记录写成流水帐，作好阶段总结，并练习写出院记录、死亡记录等，要有上级医师签字，不能随意涂改。

4. 实验室检查：掌握血、尿、便三大常规正常值、临床意义，并掌握血沉、出凝血时间、

网织红细胞计数、胸水常规生化检查，掌握肝、肾功能检查，血液流变学检查，免疫全项，风湿抗体检查，血、痰培养等临床意义，了解一些特殊实验室检查结果及临床意义。 5. X线检查：掌握正确系统的阅片方法，全面有层次的阅片，不遗漏应观察的任何部位，

能写出X光报告。掌握心、肺、骨正常X线表现。肺部渗出，纤维化、钙化、空洞，肿块性病变，心脏、大血管影像特殊检查： 6. 心电图：能掌握肺心病的心电图变化。

7. 肺功能：了解支气管哮喘和慢性喘息性支气管的肺功能表现 8. 基本掌握特殊检查如支气管的适应症、禁忌症 9. 基本诊疗技能操作：

（1）掌握皮下注射、肌肉注射、皮内注射、静脉穿刺、取血、输血、输液。（2）掌握胸腔穿刺技术。

（3）掌握吸氧、吸痰、人工呼吸、体外心脏按压等方法。

10. 正确开医嘱及处方，掌握呼吸科内科常用药物剂量、给药途径及给药时间，掌握药物的

作用，了解副作用。

二、呼吸内科常见危重症抢救及一些新技术了解。

1. 呼吸衰竭、肺梗塞、大咯血的抢救。 2. 了解又创及无创机械通气技术

心脏科实习大纲

选择实习心脏监护病房或心脏普通病房，实习时间均为3周。实习医师在上级医师指导下分管至少6张床。

一、对实习医师具体需掌握疾病如下：心力衰竭、心源性休克、风湿热、风湿性心瓣膜病、感染

性心内膜炎、高血压、冠心病、心肌炎、心肌病、心包炎、心律失常（室上性心律失常、房颤、房扑、室性心律失常、传导阻滞、病窦综合征）二、基础技能训练要求：

1. 病历书写：实习医师应于24小时内完成完整病历的采集、书写，内容要求完整、准确、

重点深入、条理分明、字迹清楚整齐，不能随意涂改。心脏科实习结束前上交中文病历2份、英文病历1份，英文班交英文病历2份，需有上级医师修改及签字。同时要求每周至少写住院志1份并附医嘱。

2. 体格检查：熟练掌握系统检查方法，手法要规范，各种手法要做到位。掌握心脏的望、

触、叩、听，重点掌握心脏的听诊。

3. 病程记录，出院记录，死亡记录：要求写全各种记录，能正确反映病程变化和三级查房

上级医师的意见，不能把病程记录写成流水帐，作好阶段总结，并练习写出院记录、死亡记录等，要有上级医师签字，不能随意涂改。

4. 实验室检查：掌握血、尿、便三大常规正常值、临床意义，并掌握血沉、出凝血时间、心

肌酶升高的意义和鉴别诊断。

5. X线检查：掌握正确系统的阅片方法，全面有层次的阅片，不遗漏应观察的任何部位，

能写出X光报告。掌握心脏、大血管影像。 6. 特殊检查：

（1）心电图：能掌握正常心电图和典型的心律失常、传导阻滞及心室、心房肥大、冠心病、心绞痛、心肌梗死的心电图变化。

（2）基本了解超声心动图、24小时心电监护（HOLTOR）、冠脉造影、心脏ECT等检查的方法，掌握其报告的临床意义。

7. 基本诊疗技能操作：

(1) 掌握皮下注射、肌肉注射、皮内注射、静脉穿刺、取血、输血、输液、动脉血气取

血。

(2) 了解心包穿刺的方法。

(3) 掌握吸氧、吸痰、人工呼吸、体外心脏按压等方法。

8. 正确开医嘱及处方，掌握心脏科常用药物剂量、给药途径及给药时间，掌握药物的作用，

了解副作用。

二、内科常见危重症抢救及一些新技术了解。

参加急性左心衰、急性心肌梗死，严重室性心律失常，参加心肺复苏的抢救，会使用除颤器，了解起搏器的安装，心脏介入治疗情况等。

消化科实习大纲

实习时间3周

一、对实习医师具体需掌握疾病如下：胃炎、消化性溃疡、肝硬化及其并发症（腹水、食道静

脉曲张出血、肝昏迷）、原发性肝癌、肠结核、结核性腹膜炎、炎性肠病、黄疸的鉴别诊断。

二、基础技能训练要求：

1. 病历书写：实习医师应于24小时内完成完整病历的采集、书写，内容要求完整、准确、

重点深入、条理分明、字迹清楚整齐，不能随意涂改。本科要求书写中文病历2份、英文病历1份，英文班交英文病历2份，需有上级医师修改及签字。

2. 体格检查：熟练掌握腹部查体的方法，手法要规范，各种手法要做到位。

3. 病程记录，出院记录，死亡记录：要求写全各种记录，能正确反映病程变化和三级查房

上级医师的意见，不能把病程记录写成流水帐，作好阶段总结，并练习写出院记录、死亡记录等，要有上级医师签字，不能随意涂改。

4. 实验室检查：掌握血、尿、便三大常规正常值、临床意义，并掌握血沉、出凝血时间、

网织红细胞计数、体腔液（胸腹水）常规生化检查，脑脊液常规生化检查，掌握肝、肾功能检查，血液流变学检查，免疫全项，风湿抗体检查，血、尿、便培养等临床意义，了解一些特殊实验室检查结果及临床意义。

5. X线检查：掌握正确系统的阅片方法，全面有层次的阅片，不遗漏应观察的任何部位，

能写出X光报告。掌握胃、十二指肠溃疡、消化道肿物等疾病。

6. 特殊检查：基本掌握一些特殊检查的适应症、禁忌症。如胃镜、肠镜等的方法及报告的

辨认。

7. 基本诊疗技能操作：

掌握胸穿、腹穿穿刺。掌握胃肠减压、下胃管等方法。

8. 正确开医嘱及处方，掌握内科常用药物剂量、给药途径及给药时间，掌握药物的作用，

了解副作用。

三、了解消化道大出血的抢救，了解食管静脉曲张结扎及硬化剂注射的过程。

肾科实习大纲

实习病房3周，实习医师在上级医师指导下分管至少6张床。

一、实习医师具体需掌握疾病如下：要求基本掌握诊断、诊断依据、鉴别诊断、处理原则及急症

危重病人抢救。急慢性肾小球肾炎、急进性肾小球肾炎、隐匿性肾炎（IgA肾病）、泌尿系统感染、肾病综合征、急慢性肾功能不全。二、基础技能训练要求：

1. 病历书写：实习医师应于24小时内完成完整病历的采集、书写，内容要求完整、准确、重点深入、条理分明、字迹清楚整齐，不能随意涂改。在3周病房期间完成住院病历2份、英文病历1份，英文班交英文病历2份，需有上级医师修改及签字。 2.体格检查：熟练掌握系统检查方法，手法要规范，各种手法要做到位。

3.病程记录，出院记录，死亡记录：要求写全各种记录，能正确反映病程变化和三级查房上级医师的意见，不能把病程记录写成流水帐，作好阶段总结，并练习写出院记录、死亡记录等，要有上级医师签字，不能随意涂改。

4.实验室检查：掌握血、尿、便三大常规正常值、临床意义，掌握肾功能、免疫功能检查临床意义，主要了解肾科一些特殊实验室检查结果及临床意义。 5.基本诊疗技能操作：

皮下注射、肌肉注射、皮内注射、静脉穿刺、取血、输血、输液。 6.掌握胸穿、骨穿、腹穿等穿刺。

7.掌握吸氧、吸痰、洗胃、人工呼吸、体外心脏按压等方法。

8.正确开医嘱及处方，掌握肾内科常用药物剂量、给药途径及给药时间，掌握药物的作用，了解副作用。

三、常见危重症抢救及一些新技术了解。 1.掌握急性、慢性肾衰透析治疗的指征。 2.掌握肾脏活检的适应症。

内分泌科实习大纲

实习3周，实习医师在上级医师指导下分管至少6张床。一、具体需掌握疾病如下：

甲状腺机能亢进症、原发性慢性肾上腺皮质功能减退症、糖尿病、尿崩症皮质醇增多症、垂体前叶功能低下二、基础技能训练要求：

1. 病历书写：实习医师应于24小时内完成完整病历的采集、书写，内容要求完整、准确、重点深入、条理分明、字迹清楚整齐，不能随意涂改。内分泌科实习结束前上交中文病历2份，英文病历1份，英文班交英文病历2份，需有上级医师修改及签字。 2. 体格检查：熟练掌握系统检查方法，手法要规范，各种手法要做到位。

3. 病程记录，出院记录，死亡记录：要求写全各种记录，能正确反映病程变化和三级查房上级医师的意见，不能把病程记录写成流水帐，作好阶段总结，并练习写出院记录、死亡记录等，要有上级医师签字，不能随意涂改。

4. 实验室检查：掌握甲状腺功能、OGTT检查结果正常值、临床意义，并了解肾上腺皮质功能、垂体激素和性激素检查结果及临床意义。 5. X线检查：掌握心、肺、骨正常X线表现。 6. 特殊检查：

ECT；能基本掌握甲状腺、甲状旁腺和骨扫描等特殊检查的适应症。骨密度；能基本掌握检查结果的临床意义。 7. 基本诊疗技能操作：

掌握皮下注射、肌肉注射、皮内注射、静脉穿刺、取血、输血、输液。掌握胸穿、骨穿、腹穿等穿刺。掌握人工呼吸、体外心脏按压等方法。

8. 正确开医嘱及处方，掌握内分泌科常用药物剂量、给药途径及给药时间，掌握药物的作用，了解副作用。

三、内分泌科常见危重症抢救及一些新技术了解。

1. 掌握糖尿病酮症酸中毒、高渗昏迷的处理。 2. 了解甲亢危象、高钙危象的处理原则。

血液科实习大纲

血液科实习共3周，实习医师在上级医师指导下分管至少6张床。

一、血液科对实习医师具体需掌握的疾病如下：各种贫血，包括：缺铁性贫血、再生障碍性贫血、

巨幼细胞性贫血、溶血性贫血、急、慢性白血病、淋巴瘤、多发性骨髓瘤、出血性疾病、特发性血小板减少性紫癜、DIC等。二、基础技能训练要求：

1. 病历书写：实习医师应于24小时内完成完整病历的采集、书写，内容要求完整、准确、重点深入、条理分明、字迹清楚整齐，不能随意涂改。实习结束前上交中文病历2份、英文病历1份，英文班交英文病历2份，需有上级医师修改及签字。 2. 体格检查：熟练掌握系统检查方法，手法要规范，各种手法要做到位。

3. 病程记录，出院记录，死亡记录：要求写全各种记录，能正确反映病程变化和三级查房上级医师的意见，不能把病程记录写成流水帐，作好阶段总结，并练习写出院记录、死亡记录等，要有上级医师签字，不能随意涂改。

4. 实验室检查：掌握血、尿、便三大常规正常值、临床意义，并掌握血沉、出凝血时间、网织红细胞计数。胸、腹水常规生化检查，脑脊液常规生化检查，掌握肝、肾功能检查。 5. 特殊检查：骨髓；能掌握正常骨髓像。急慢性白血病骨髓像，常见缺铁性贫血，巨幼细胞贫血，再生障碍性贫血的骨髓特点。了解细胞化学染色的临床意义，急性白血病、淋巴病等免疫分型。 6. 基本诊疗技能操作：

掌握骨穿、腰穿及椎管注射等操作。

7. 正确开医嘱及处方，掌握血液科常用药物剂量、给药途径及给药时间，掌握药物的作用，了解副作用。

三、重症抢救及一些新技术了解。 1. 掌握DIC的诊断及治疗。

2. 对输血反应能及时判断并正确处理。 3. 了解骨髓移植的进展。

感染免疫科实习大纲

实习共3周：均在病房，实习医师在上级医师指导下分管至少6张病床。一、感染免疫科对实习医师需掌握疾病的具体要求

掌握一般病毒感染、流行性出血热、败血症、临床常见的脑膜炎等感染性疾病以及系统性红斑狼疮、类风湿关节炎、成人still’s病、干燥综合征、炎性肌病、系统性血管炎、血清阴性脊柱关节病等常见风湿免疫性疾病的诊断与鉴别诊断、临床正确处理和基本治疗原则，了解疾病的研究进展和前沿热点问题。掌握发热待查的诊断思维方法。此外通过实习还应掌握医院感染的概念、抗菌药物的临床正确应用、常见耐药细菌的耐药机制及其在治疗中应掌握的原则。二、基础技能训练要求：

1、病历书写：实习医师应独立完成住院病历内所有内容的采集书写，包括入院志、首次病程记录、病程记录、会诊记录、各项化验检查记录和出院记录等内容，要求完整、准确、重点深入、条理分明、字迹清楚整齐，不能随意涂改。

2、体格检查：熟练掌握系统检查方法，手法要规范，各种检查要做到位。

3、实验室检查：正确掌握血、尿、便常规、血沉、出凝血时间、网织红细胞计数、肝肾功能检查等基本实验室检查的正常值和在临床诊断中的正确应用；对胸腹水、脑脊液常规、生化的结果应能正确分析病熟悉其临床意义；掌握血液、骨髓及其他体液、分泌物培养阳性结果及其临床意义，能够正确读懂及运用细菌药物敏感试验指导临床合理用药；掌握免疫全项，常见自身抗体检查在风湿免疫病诊断中的价值，了解一些特殊实验室检查结果及临床意义。

4、特殊检查：

心电图：能熟练操作心电图机，掌握正常心电图和典型的心律失常、传导阻滞及心室、心房肥大、冠心病、心绞痛、心肌梗死的心电图变化。

X线检查：掌握正确的阅片方法，能识别心、肺、骨的常见异常X线表现。掌握胃镜、肠镜和各种穿刺的适应症和禁忌症。 5、基本诊疗技能操作：

掌握皮下注射、肌肉注射、静脉穿刺、取血、输血、输液。掌握胸穿、腰穿、骨穿、腹穿等穿刺。

掌握吸氧、吸痰、人工呼吸、体外心脏按压等方法。

6、正确开医嘱，掌握常用药物剂量、给药途径及给药时间，掌握药物的适应症、禁忌症和副

作用。

7、掌握内科常见危重症的抢救技术，如呼吸衰竭、大咯血、急性左心衰、急性心肌梗死，严重心律失常，消化道大出血、糖尿病酮症酸中毒、高渗昏迷、DIC的诊断及和处理，参加心肺复苏的抢救，会使用除颤器。

三、了解感染免疫科常见危重症抢救及一些新技术。

暴发性狼疮、重症流行性出血热、颅内压增高的抢救。鞘内注射MTX治疗狼疮脑病。

基本要求

外科实习大纲

实习生外科轮转共12周。实习科室有普通外科6周、心胸外科3周、骨科3周、泌尿外科3周、外科急诊1周，麻醉1周。

通过上级医师的传、帮、带以及实习医师提问、自学等方式，理论联系实践，熟悉外科常见病、多发病的诊断和治疗。学会阅读胃肠道造影、腹平片、CT、MR、BU-s，及其在疾病诊断中的价值。掌握外科无菌术，换药、手术基本操作等技能。

在外科实习过程中，要求实习生参加住院医生24小时值班，对“医师法”进行了解。书写中文病历8份，英文2份。在上级医师指导下分管≥6张床病人。

实习期间，每周安排实习小讲课一次，教学查房一次，要求应用双语教学和学习，安排主治医师带教。安排英文翻译一次。实习结束时进行口试、理论考试、病例分析及操作考试。实习医生实习期间，要求参加学科组织的学术讲座，病例讨论等学术活动。各学科具体要求

普外科

普通外科轮转6周，对实习医师要求如下：

1. 通过临床诊治工作，熟悉外科病人常见症状、体征及其意义，掌握初步诊断疾病的轻重缓急

及病态大致部位。

2. 熟悉普外病人术前常规准备方法以及术后饮食、抗菌素、胃肠减压、腹腔引流的处理及补液

原则。

3. 了解B超、X线检查结果、内窥镜检查、同位素检查以及各项常规化验结果在临床外科的诊

断意义。

4. 通过病房及急诊实践、掌握抽血、换药、脓肿切开、导尿、胃肠减压、掌握外科无菌概念。

在上级医师指导帮助下，学会外科手术的基本操作。

5. 对阑尾炎、疝、大隐静脉曲张、甲状腺瘤、肛门疾病从诊断、术前准备、手术治疗原则到术

后处理要求较全面的掌握,并参加这一类手术。

6. 对一般胆囊炎、胆石症、消化道溃疡、消化道肿瘤，甲状腺肿大、甲亢，乳腺等疾病，要求

掌握临床表现、体征，辅助检查方法选择，特殊术前准备以及手术原则。

7. 对直肠癌，门脉高压，胰腺疾病，复杂胆道疾病等复杂的外科病，要求了解临床表现和诊断

方法的选择，掌握治疗原则。

8. 对抢救工作，尤其是外科较多见的出血及中毒性休克，了解补充血容量，纠正水电解质紊乱

和酸碱平衡失调的原则。

9. 熟悉外科营养的目的、途径、需要量的计算、并发症的预防和处理。

10. 书写中文病历3份，英文1份，英文班书写英文病历3份，熟悉普外科常见病术前、术后的医嘱处理。

骨科

骨科轮转3周，对实习医师要求如下：

1. 通过骨科实习后，熟悉掌握骨科物理学诊断方法，尤其掌握上、下肢的肌力检查方法、脊柱

及骨关节的检查方法，并应了解一些特殊的骨科物理诊断方法。

2. 初步掌握骨科常见病的诊断及处理原则，如：创伤（骨折、脱位）、骨关节感染、结核、关节

炎等常见病的诊断和处理方法。初步掌握一些常见的骨折、脱位（如股骨颈骨折、COLLes骨折、锁骨骨折、肩关节脱位等）的诊断和治疗原则。

3. 了解骨科的一些基本操作技术方法，如：皮牵引、骨牵引固定、小夹板应用、关节穿刺、各

种造影技术、局部封闭等技术。

4. 了解严格的无菌概念对骨科的特殊重要性，必须掌握要求更高的无菌操作及消毒、灭菌原则。 5. 熟悉骨科常见病多发病，腰椎间盘突出症的诊断及鉴别诊断，脊柱结核的临床表现，治疗原则及手术指征，慢性化脓性骨髓炎的成因、诊断及治疗原则，骨肿瘤的分类、良恶性骨肿瘤的鉴别和治疗原则。了解腰腿痛及颈肩痛的病因、发病机理、诊断、鉴别诊断及治疗原则，髋及膝关节结核的临床表现和治疗原则。

6. 正确开医嘱，掌握骨科常见病术前准备及术后处理；常用药物剂量、给药途径及方法，掌握药物的适应症、禁忌症和副作用。

7. 掌握骨外科常见急重症的抢救技术，如手外伤、多发伤、多发骨折、创伤性失血性休克、高位颈髓损伤等，参加心肺复苏的抢救。

8. 书写中文病历2份，英文1份，英文班书写英文病历2份，熟悉骨外科常见病术前、术后的医嘱处理。

心胸外科

心胸外科轮转3周，对实习医师要求如下：

1. 对一般胸部创伤能作出正确诊断及初步处理。

2. 了解食管疾病，肺部疾病的检查方法，能对食管癌、肺癌做出诊断。 3. 了解胸透、胸穿操作方法及观察胸腔引流在疾病诊治中的作用。 4. 了解低温、体外循环的机理。

5. 根据心前区杂音能判断出先天性心脏病，二尖瓣病变。 6. 了解冠状动脉性心脏病的外科治疗；

7. 了解常见先天性心脏病：继发孔型房间隔缺损、室间隔缺损的外科治疗；

8. 了解常见心脏瓣膜病：二尖瓣狭窄/关闭不全、主动脉瓣狭窄/关闭不全的外科治疗。 9. 书写中文病历2份，英文1份，英文班书写英文病历2份，

泌尿外科

泌尿外科轮转3周，对实习医师要求如下：

1. 初步掌握泌尿科常见病多发病包括泌尿系感染，前列腺炎，泌尿系结石，尿路梗阻及泌尿系

损伤的诊断及处理原则，尤其对泌尿系统诊断方法，如：膀胱镜、泌尿系造影、肾功能检查血管造影等的选择及适应症有初步认识，并能阅读影象学资料。

2. 了解泌尿科的一些基本操作技术，前列腺按摩、导尿技术、包皮环切术、鞘膜积液及膀胱造

瘘等手术操作。

3. 了解泌尿外科的一些特殊检查：体外冲击破碎石，尿流率．膀胱镜．尿道扩张术适应症。 4. 熟悉门诊常见病的诊治方法（前列腺、附睾、泌尿结石）、泌尿系统外科常见病的临床表现、

诊断、治疗原则及手术指征。

5. 书写中文病历2份，英文1份，英文班书写英文病历2份，熟悉泌外科常见病术前、术后的医嘱处理。

妇产科实习大纲

共实习6周，其中妇科2周，产科2周，计划生育1周，门诊1周。通过临床实习,掌握妇产科病史的采集、病历的书写和体格检查，尤其是妇产科专科检查及特殊检查。掌握妇产科常见病、多发病的诊断、鉴别诊断、治疗及其预防措施。学会住院病人的病情观察，并熟练书写病程记录、各种医疗文件。初步掌握妇产科急症病人的急救方法。实习期间，每周安排实习小讲课一次，教学查房一次，要求应用双语教学和学习，安排主治医师带教。安排英文翻译一次。实习结束时进行口试、理论考试、病例分析及操作考试。实习医生实习期间，要求参加学科组织的学术讲座，病例讨论等学术活动。

产科

产科实习２周，通过产科实习，掌握产科病历书写、基本操作及常规检查技术。

１．了解产前检查的意义，掌握产科普通病历的书写及产科入院记录的书写。熟练掌握产科四步触诊法、骨盆外测量。要求实习生所分配的所有病理产科患者均书写普通病历2份，书写英文病历1份，英文班交英文病历2份，正常孕妇写产科入院记录。每日参加主治医师查房、整理病历，记录病程，填写医疗文件，抄写并张贴化验报告，发现异常情况及时向上级医师汇报。２．学会观察产程，在上级医师的指导下初步掌握正常分娩接生的方法及步骤。要求在助产士的带领下上台接平产1~2次。

３．了解产钳助娩的适应症、条件和操作步骤。

４．了解病理产科常见病与多发病的诊断、鉴别诊断和处理原则，如：妊娠高血压综合征、胎盘早剥、前置胎盘、妊娠合并心脏病、糖尿病、贫血、产后出血、胎儿窘迫、胎膜早破和异常分娩等。认识围产期保健及母乳喂养的重要意义。每周组织教学查房１次。

５．了解胎儿电子监测仪在预测胎儿宫内储备力的应用，掌握ＮＳＴ、ＯＣＴ、ＣＳＴ及远程胎心监护的操作及其临床意义。

６．了解正常及异常产褥的诊断和处理。７．掌握新生儿窒息的抢救。

８．参加剖宫产术，掌握刷手、消毒、穿手术衣、切皮、打结、剪线及缝皮等操作，熟悉剖宫产术的适应症和手术步骤。

9.学会引产的适应症及方法，掌握异常情况的处理。

妇科

妇科实习２周。通过妇科实习，掌握妇科病历书写、基本操作及常规检查技术。

１．熟悉妇科病历的书写特点，要求实习生书写中文病历2份，英文病历1份，英文班交英文病历2份。掌握妇科检查方法（包括双合诊、三合诊及肛查）。掌握妇科常用特殊检查方法，如宫颈刮片、吸片。掌握阴道镜、宫腔镜、腹腔镜的适应症，初步学会阅读Ｂ超片。２．每周参加主任教学查房，报告病历，参与讨论。

３．学会妇科常见病的诊断、鉴别诊断与处理原则，如子宫肌瘤、卵巢肿瘤、异位妊娠、女

性生殖系统炎症、子宫内膜异症、妊娠滋养细胞疾患、宫颈癌等。４．掌握化疗的适应症，熟悉化疗方案的制定。５．熟悉妇科手术前后病人的处理原则。

６．参加妇科手术，掌握刷手、消毒、穿手术衣、切皮、打结、剪线及缝皮等操作，熟悉子宫切除术、附件切除术的适应症和手术步骤。

计划生育

１．掌握早孕的诊断，掌握人工流产、药物流产的适应症、禁忌症。

２．学会口服避孕药、避孕工具（避孕套、宫内节育器）的适应征、用法及副作用的处理。３．在上级医师的指导下，参加人工流产、上环、取环、中期引产几输卵管绝育术的操作。学习药物流产的方法。

妇产科门诊

１．门诊实习包括产科门诊、妇科门诊与Ｂ超室。在上级医师指导下诊治门诊病人，书写门诊病历，做产前检查、妇科检查、刮片及吸片。学习妇产科超声检查。２．学会门诊常见病，如流产、炎症、不孕症等诊治。

３．熟悉诊断性刮宫、输卵管通气、宫颈活检、宫腔镜的指征和步骤。４．学习宣传母乳喂养的重要性。

儿科学实习大纲

一、目的与要求

1、不断强化学生全心全意为患儿服务的医疗意识和良好的医德医风，培养严格严谨的工作

作风。

2、逐步理解和掌握儿科常见疾病的基本理论知识。 3、基本掌握儿科临床基本技能。二、实习时间与安排

1、儿科实习时间共6周，其中病房4周（包括普通病房2周，新生儿病房2周），门诊、急

诊2周。

2、每周三下午安排实习讲座，讲课任务由科内主治医师或高年住院医师承担。讲课内容为：（1）儿科药物应用原则（2）儿科常见症状鉴别诊断（3）儿科急症处理

（4）儿科常见病毒感染性疾病的诊治

3、结合临床典型病例，定期（一般每两周一次）组织实习医师分析讨论。

4、改革实习医师出科考试形式，以督促和促进学生把所学理论知识与临床实际紧密结合，

重视临床实习机会，将平时查房提问评分计入出科口试分数；出科笔试内容增加一份典型病历分析。

5、加强实习医师的外语查房（不拘形式）。

6、要求实习医师参加每周二科内业务学习小讲课（内容包括疑难病历分析，传达国内外学

术会议精神，及医学最新进展动态等）。

7、定期由科内老专家教授进行教学查房（或疑难病历讨论）。三、基本技能训练要求

1、掌握病历的采集、书写，病程观察，病程志、交、接班志、出院志的书写，以及病历的

整理。

2、掌握儿科体格检查特点及系统的检查方法（包括体格及智力发育的测量方法）。 3、基本掌握小儿的喂养（清洁、保温、消毒、隔离、具体喂养方法、营养量的计算），小儿

的护理。

4、掌握儿科液体疗法及常用药物剂量。

5、基本掌握儿科心电图的操作和诊断，儿科物理降温，超声雾化等方法。了解常用诊疗技

术（如：小儿头皮、肘、股静脉穿刺、小儿肌肉注射、小儿皮下注射、小儿皮内注射、小儿腰椎穿刺、等）。

四、掌握下列疾病的诊断、治疗。

1、生长发育

（1）掌握小儿年龄分期，各期特点。

（2）掌握体重、身长计算公式，头围，前囟大小，骨化中心出现年龄及牙齿发育。 2、营养及营养障碍性疾病

（1）婴儿喂养：掌握小儿物质代谢特点及营养需要量，母乳喂养优点和喂养方法，了解牛

奶配制、添加辅食顺序。

（2）掌握蛋白质-能量营养不良的病因，临床表现，诊断，治疗及预防措施。（3）维生素D缺乏性佝偻病：掌握病因，临床表现，诊断，治疗及预防。（4）维生素D缺乏性手足搐搦症：掌握临床表现，诊断及治疗。

3、新生儿疾病

（1）新生儿基本概念及分类：掌握新生儿分类，了解新生儿病房的分级。

（2）足月儿和早产儿特点及护理：掌握足月儿和早产儿的生理特点和外观特点以及护理。（3）新生儿窒息：掌握临床表现、Apgar评分，并发症及处理。（4）新生儿缺氧缺血性脑病：掌握临床表现，诊断，鉴别诊断及预后。（5）呼吸窘迫综合征：掌握临床表现，实验室检查，诊断，鉴别诊断及治疗。（6）新生儿黄疸：掌握生理性和病理性黄疸的鉴别诊断及治疗。（7）新生儿寒冷损伤综合征：掌握临床表现，诊断和治疗。 4、免疫缺陷病：掌握临床表现，诊断及治疗原则。 5、消化系统疾病

（1）掌握小儿腹泻的病因，临床表现，诊断及治疗。（2）掌握婴儿腹泻的病因、脱水程度、性质及液体疗法。 6、呼吸系统疾病

（1）掌握小儿呼吸系统解剖生理特点。掌握小儿上呼吸道感染的临床表现及治疗。（2）掌握一般肺炎和重症肺炎的临床表现和处理，掌握肺内各种异常呼吸音及各种罗音

的听诊，四种特殊肺炎的临床特征。

（3）掌握支气管哮喘的临床表现，儿童哮喘的诊断标准及治疗。

7、循环系统疾病

先天性心脏病：了解胎儿血循环特点及出生后血液动力学变化，掌握四种常见先心病的临床表现，杂音特点及常见并发症。 8、泌尿系统疾病

（1）急性肾小球肾炎：掌握一般病例和重症病例的临床表现，及处理。

（2）肾病综合征：掌握其主要临床表现，单纯性肾病和肾炎性肾病的鉴别诊断，及治疗

原则。

9、血液系统疾病

（1）营养性缺铁性贫血；掌握其分期及各期主要实验室检查。

（2）营养性巨幼红细胞性贫血：掌握其特殊临床表现，实验室检查，预防及治疗。 10、神经肌肉系统疾病

（1）化脓性脑膜炎：掌握临床表现，几种疾病脑脊液的鉴别诊断，及治疗。（2）急性病毒性脑炎：掌握其特殊临床表现，实验室检查，及治疗。

11、内分泌疾病：掌握先天性甲状腺功能减低症的临床表现，实验室检查，诊断及治疗。 12、结核：掌握结核的病原体、结核的临床表现、结核菌素试验及治疗

神经内科实习大纲

实习时间为6周，其中5周在病房，1周在门急诊。实习期间，每周安排实习小讲课一次，教学查房一次，要求应用双语教学和学习，安排主治医师带教。安排英文翻译一次。实习结束时进行口试、理论考试、病例分析及操作考试。实习医生实习期间，要求参加学科组织的学术讲座，病例讨论等学术活动。基本技能的训练

1．掌握神经科病例的问诊、神经科查体的步骤和方法、病例分析要点和查房记录等。要求书

写神经内科中文病历3份及英文病历1份，英文班交英文病历2份，。 2．认识神经科各种常见的阳性体征。

3．掌握腰椎穿刺及该项检查的适应症和禁忌症。

4．了解脑电图、肌电图、诱发电位、经颅多普勒超声检查的临床用途及意义。

5．了解格林-巴利综合征呼吸衰竭、重症肌无力危象等气管切开的护理和呼吸机使用方法。实习病种一、脑血管病 1. 脑血管病的分类

2. 短暂脑缺血发作颈内动脉系统TIA和椎-基底动脉系统TIA发作的临床表现，CT、MRI、TCD、PET、DSA等检查特点和治疗

3. 动脉血栓性脑梗死颈内动脉系统：包括大脑中动脉的皮层支和深穿支，大脑前动脉的皮层支和深穿支梗死的临床表现，CT、MRI、DSA、TCD、等改变特点。椎-基底动脉系统：①椎-基底动脉血栓形成其中应见到的病种有：基底动脉主干的梗塞：大脑脚综合症；闭锁综合症；延髓背外侧综合症；基底动脉尖综合症；桥脑内侧综合症；②大脑后动脉血栓形成；③小脑梗死小脑上动脉、小脑前下动脉和小脑后下动脉动脉梗塞的CT特点 4. 脑栓塞心源性脑栓塞临床特点和治疗原则

5. 腔隙性脑梗塞各型腔隙性脑梗塞的临床表现和头颅CT的变化

6. 脑出血壳核出血、丘脑出血、脑叶出血、脑干出血、小脑出血、脑室出血等临床和CT的表现及治疗

7. 蛛网膜下腔出血 CT和DSA的表现

8. 脑血管性痴呆临床表现和诊断方法及治疗。

二、脊髓病

1. 脊髓病的临床表现、各段脊髓损害的定位诊断

2. 急性脊髓炎此病应作为重点，掌握其临床表现、体征、辅助检查（包括CSF变化特点、MRI的改变）以及治疗原则，并与脊髓压迫症等相鉴别。 3. 脊髓亚急性联合变性应掌握其临床表现、辅助检查和治疗 4. 脊髓蛛网膜炎应掌握其临床表现、辅助检查和治疗三．癫痫

1. 掌握脑部不同的病变部位造成相应的临床表现和体征

2. 部分性发作分为①单纯部分性发作应实习到单纯运动型发作；单纯感觉型发作； ②复杂部分性发作应实习到颞叶单纯意识障碍性发作；情感障碍性发作；精神感觉型发作；精神运动型发作

3. 全身性发作 ①癫痫大发作应作为重点，掌握其临床表现、脑电图改变特征；②失神发作；③肌阵挛性发作

4. 癫痫持续状态要掌握一般处理；控制发作；维持治疗的三项处理原则。 5. 各型癫痫的用药原则

四、运动紊乱疾病（锥体外系疾病）

1. 锥体外系疾病的临床表现静止性震颤、舞蹈样动作、肌强直、手足徐动症、抽动症、扭

转痉挛、半身投掷运动

2. 帕金森病临床表现即震颤、肌僵直、运动减少和姿势反射减退，药物治疗原则。了解帕

金森病、特发性震颤、帕金森综合征、帕金森附加征等疾病的诊断与鉴别。 3. Huntingtons disease 临床表现特点、诊断和治疗 4. Wilson 病临床表现特点、诊断和治疗五、脱髓鞘疾病

1. 多发性硬化掌握多发性硬化视神经炎、感觉障碍、脑干功能障碍、小脑症状、自主神经异常等各种临床表现，诊断标准，尤其是辅助检查如头颅MRI和CT检查脑白质多灶损害的形态和部位，以及诱发电位等方面的变化等。 2. 视神经脊髓炎应掌握临床表现、辅助检查和治疗

3. 急性播散性脑脊髓炎临床表现特点是脑实质和脊髓广泛损害而出现多种临床表现、辅助检查：CSF的变化应成为重点六、神经-肌肉接头病与肌病

1. 重症肌无力 ①根据 Osserman分型的各型临床表现； ②MG的诊断标准，学习做疲劳试验和新斯的明试验；③治疗原则，④了解重症肌无力危象、胆碱能危象和反拗危象、三种危象的临床表现及抢救性治疗措施。

2. 肌营养不良了解其分类，以Duchine 肌营养不良为例，熟悉肌营养不良的肌肉假肥大、特殊步态以及肌电图和血清肌酶的变化特点。 3. 强直性肌营养不良症掌握临床表现和治疗原则

4. 多发性肌炎此病在皮肤科或免疫科也能见到，故把临床表现与其他肌病的鉴别作为重点七、周围神经病

1. 应掌握周围神经病共性的临床表现

2. 急性感染性多发性神经根神经炎此病应为重点，其临床表现是以近端为主的四肢无力，感觉特点是主观感觉重，客观检查感觉体征轻，脑脊液检查的最佳时间是2-3周，并发呼吸衰竭时的临床表现、观察指标以及抢救原则和措施

3. 面神经炎能够识别周围面瘫的临床特点，并与中枢面瘫相鉴别及治疗原则八、神经系统变性病

1. Alzhermer disease 检查方法和诊断标准，与其他类型的痴呆的鉴别，以及治疗原则 2. 运动神经元病了解其分类，主要是肌萎缩侧索硬化的上下运动神经元同时损害的临床特点，辅助检查的变化，以及与其他类型之间的鉴别诊断。九、中枢神经系统感染

1. 病毒性脑炎主要是单纯疱疹性脑炎其临床特点和常见的实验室检查，并与其它病毒性脑炎如带状疱疹病毒性脑炎、肠道病毒性脑炎、呼吸道病毒性脑炎、进行性多灶性白质脑病、亚急性硬化性全脑炎相鉴别，也要与结核性脑膜脑炎，细菌性脑炎，霉菌性脑炎，AIDS等相鉴别。要掌握病毒性脑炎的治疗原则。

医学影像学实习大纲

一、实习目的

要求在实习期间参加科内病例会诊，诊断报告书写，掌握呼吸系统常见病、多发病在胸片中表现，熟悉骨与关节系统、消化系统、泌尿生殖系统和神经系统常见病、多发病的影像表现，了解循环系统、头颈部疾病表现和胃肠道造影初步检查方法。二、实习时间及安排

共两周，分为胸部、腹部、头颈部及骨关节系统四部分实习。

三、基本技能训练要求

初步了解X光机、CT、MR机的工作原理，检查步骤及临床应用，熟悉胸腹部透视，消化道钡剂造影的检查方法。

四、初步掌握常见病、多发病的诊断

1. 呼吸系统：肺部炎症；肺结核；肺部肿瘤，纵隔肿瘤

2. 循环系统：高血压性心脏病；肺心病；风湿性心脏病；肺动脉栓塞；房间隔缺损；心包疾病

3. 骨与关节系统：骨与关节外伤；骨与关节炎症；常见骨肿瘤；代谢性骨病；骨关节退行性疾病

4. 消化系统：食管静脉曲张；胃、十二指肠溃疡；胃肠道穿孔；胃癌；结肠癌；肝癌；胆道结石；胆囊炎；胰腺炎

5. 泌尿生殖系统：泌尿系结石；结核；泌尿系统肿瘤

6. 神经系统及头颈部：脑出血；脑梗死；常见脑肿瘤；颅面骨折

麻醉学实习大纲

一、实习目的

了解麻醉学专业的范围和任务，熟悉麻醉科工作常规，以及麻醉学科的基础理论知识和基本操作技能，为毕业后的工作打好坚实的基础。

二、实习要求

根据教学计划的安排，在2周的实习阶段，在分管主治医师的指导下参加临床麻醉工作，了解麻醉科的工作常规，熟悉常见手术的麻醉，以及临床麻醉基本操作技能。

实习期间应遵守医院和科室的各项规章制度，服从科室工作安排，不迟到、不早退。尊敬上级医师，虚心学习，关心患者疾苦，积极参加科室日常工作，具体要求如下：

1. 麻醉前对病情的评估

了解麻醉前访视的重要性及目的，掌握ASA分级和心功能分级，了解对患者全身情况，包括心血管系统、呼吸系统、中枢神经系统、内分泌系统、肝肾功能的评估。 2. 麻醉前准备和麻醉前用药

了解麻醉前准备的目的和麻醉选择的原则，了解麻醉前用药的基本原则，并熟悉常用的术前药物。了解术前麻醉用品和麻醉设备的准备。

3. 全麻的诱导、维持和苏醒

了解全身麻醉的注意事项。初步了解麻醉诱导、维持和苏醒的基础知识。 4. 气管和支气管内插管

了解困难气道的分级，以及全身麻醉药品和器械的准备工作；了解气管内插管的并发症情况。 5. 椎管内麻醉

了解蛛网膜下腔阻滞和硬膜外阻滞的适应症、禁忌症和并发症情况，了解其对机体生理机能的影响和常见不良反应的防治。

6. 麻醉期间的监测和输血、输液

了解麻醉期间监测的目的与重要性，熟悉麻醉、手术期间和手术前病人体液改变的原因，以及麻醉手术期间的输血、输液原则。

三、实习达标要求

1.参加病人的术前访视和科室病例讨论次数≥3次/周。 2.参加手术麻醉例数≥6例。

3.在经管主治医师的指导下，基本能够完成全身麻醉的准备工作。 4.参加椎管内阻滞的穿刺技术。 5.独立书写麻醉计划单和记录单2份。

Internal Medicine Practice Outline

General requirements

Time and arrangement：

The total time of practice in internal medicine amounts to 18 weeks（including 2 weeks in the department of radiology）. The period of practice must include more than 5 departments（hemotology，endocrinology，nephrology，cardiology，pulmonary medicine，infectious diseases，out-patient clinic，and emergency medicine）. The time of practice in each department amounts to 3 weeks, and each intern is in charge of at least 6 beds under the instruction of senior staff. There must be teaching rounds once a week, which should be documented during the rounds, and rounds (should be in Chinese and English while student studying in China).

Diseases to be mastered

Interns should develop clinical reasoning, diagnosis, differential diagnosis, treatment, long term follow-up, and prevention of the following diseases:

1.Respiratory medicine: chronic bronchitis, pulmonary emphysema, cor pulmonale, asthma, bronchiectasis, lobar pneumonia, lung abscess, pleurisy, pulmonary embolism.

2.Circulatory system: heart failure、cardiac shock、rheumatic fever、rheumatic valvular heart disease、infective endocarditis、hypertension、coronary atherosclerotic heart disease、myocarditis、cardiomyopathies、pericarditis、cardiac arrhythmias (supraventricular arrhythmia、atrial fibrillation、atrial flutter、 ventricular arrhythmia、 conduction blocks、sick sinus syndrome)

3.Gastroenterology: gastritis, peptic ulcer, liver cirrhosis and its complications (ascites, esophageal variceal hemorrhage, hepatic encephalopathy), primary carcinoma of the liver, tuberculosis of the intestine, tuberculous peritonitis, inflammtory bowel disease, distinctive diagnosis of jaundice.

4.Renal diseases: Acute and chronic glomerulonephritis, rapidly progressive glomerulonephritis, latent glomerulonephritis(IgA nephropathy), urinary tract infection, nephrotic syndrome, acute and chronic renal insufficiency.

5.Hematology: anemia, including: iron deficiency anemia, aplastic anemia, megaloblastic anemia, hemolytic anemia, acute and chronic leukemia, lymphoma , multiple myeloma, bleeding diseases, idiopathic thrombocytopenic purpura, DIC etc.

6.Endocrinology: hyperthyroidism, primary hypocortisolism , diabetes mellitus , diabetes insipidus, hypercortisolism, hypo-pituitary states.

Requirements for basic skill training

1.Medical record writing: Within 24 hours, medical record should be finished with complete content, clear points and good handwriting. Ten medical records ( 8 case records in English) must be complete, which should be revised by supervising doctors with their signatures.

2.Physical examination: Interns should know the performance of the physical examination skillfully, systematically, and competently.

3.Course record, discharge record, and death record: Course record writing must reflect changes of diseases and physician’s assessments. The discharge record and death record should be also done with the supervising physician’s signature.

4.Laboratory tests: Normal reference data and clinical implications and indications of blood, urine, and stool tests should be well known. Clinical implications and indications for performance of other tests

should be understood , for example: ESR, BT, clotting time, reticulocyte count, biochemical examination of serous fluid and cerebrospinal fluid, liver function, renal function, immunological examination, rheumatic antibody, bacterial cultures of blood, urine and stool.

5.Radiology: Analyze the parts of the X-ray correctly and systematically. Do not omit any suspicious areas seen. Try to write an X-ray report. Grasp the normal X-ray appearance of the heart, lungs, and bones. Identify infiltration, fibrosis, calcification, cavity, air containing spaces, and tumor-like pathological changes of the lungs and features of the heart and large blood vessels, gastric ulcers, duodenol ulcers, and digestive tract tumors. 6.Special tests:

(1)EKG: Interpret normal EKG findings and representative changes of the EKG with arrhythmias、conduction blocks, atrial ventricular hypertrophy、coronary atherosclerotic heart disease、angina pectoris、and myocardial infarction.

(2)Bone marrow: understand the characteristic of normal bone marrow, and bone marrow findings in acute and chronic leukemia. Also know the bone marrow characteristics of iron deficiency anemia, aplastic anemia, and megaloblastic anemia. Also know the clinical meaning of coloration of cytochemistry and the immunophenotype of acute leukemia and lymphoma etc.

(3)It is necessary to know indications and contraindications of special examinations such as gastric endoscopy and colon endoscopy, echocardiography, and lung function examination. 7.Basic medical procedural skills

(1)Learn hypodermic, intramuscular , intracutaneous, and intravenous penetration, and the performance of drawing blood and transfusions.

(2)Interns should learn methods of thoracentesis and abdominal paracentesis , and bone marrow aspiration.

(3)Understand how to administer oxygen, suction sputum, perform artificial respiration, chest compressions in vitro, and gastric lavage etc.

8.Write medical orders and precriptions correctly. Pay attention to use of medicines commonly in use ( dosage , route, etc) , especially their effects and side-effects .

Know several common emergency treatments and some new technologies that are used:

1.Respiratory failure, lung infarction, severe hemoptysis.

2.To attend the treatment of acute left heart failure, acute myocardial infarction, severe ventricular arrhythmia and cardio-pulmonary resuscitation, use of defibrillator, to understand the installation of pacemakers and the interventional treatment of cardiovascular diseases.

3.To understand the emergency treatment of gastrointestinal bleeding, including esophageal variceal ligation and sclerosant injection.

4.Understand the diagnosis and therapy of DIC (disseminated intravascular coagulation). Understand potential reactions to transfusions, and managing these issues correctly.

5.Understand the indication for dialysis treatment of acute and chronic renal failure

6.Understand how to deal with diabetic ketoacidosis and hyperosmolar coma; understand principles of treatment of hyperthyroidism and hypercalcemia.

Individual Department Requirements:

Respirdatory Medicine Practice Outline

During 3 weeks in the hospital ward, each intern is in charge of at least 6 beds under the instruction of the supervising physician.

1.Diseases that should be understand well: chronic bronchitis, pulmonary emphysema, cor pulmonale, asthma, bronchiectasis, lobar pneumonia, lung abscesses, pleurisy, pulmonary embolism. 2.Basic requirements for skill training:

(1) Case history writing: You should finish a complete medical record history within 24 hours. It should be accurate, integrated and in fine clear writing without alterations. During the period of instruction, at least 2 cases in English should be submitted. All revised cases should have a signature from the senior staff.

(2) Physical examination: Intern should be skilled in the systemic PE method, using a standardized and competent performance.

(3) Disease progress notes, discharge notes, and death notes: These should correctly reflect the serial changes of the patient, and should include “ward round notes” of the senior staff (including consultant doctors, chief physicians, professors, or department directors). Pay attention not to be wasteful with what you write, and record only relevant information. Summarize what you have seen and understood. Try to make discharge notes, death notes, and so on under the instruction of the senior staff.

(4) Laboratory Data: Grasp normal values and clinical significance of the three conventional tests (blood, urine and stool), master clinical significance of erythrocyte sedimentation rate(ESR), bleeding/coagulation time, reticulocyte count, routine and biochemical tests of pleural effusions, liver and renal function tests, hematology tests, rheumatoid antibody, immunology tests, and blood and sputum cultures. Understand some special laboratory findings and their respective clinical significances.. (5) Chest X-ray examination : Go over the parts correctly and systemically. Do not omit any suspicious area . Try to write an X-ray report. Grasp the normal X-ray appearance of the heart, lungs, and bones. Identify infiltration, fibrosis, calcification, cavity, air containing spaces, and tumor-like pathological changes of the lungs and the appearance of the heart and large blood vessels. (6) Electrocardiogram: Grasp the characteristic changes of cor pulmonale.

(7) Lung function examination: Understand the characteristic manifestations of asthma and chronic asthmatic bronchitis.

(8) Grasp basically the indications and contraindications of bronchoscopy. (9) Technological procedures and routines for respiratory diseases:

①learn hypodermic, intramuscular, intracutaneous, intravenous penetration, and the performance of

drawing blood and giving transfusions. ②understand the technology of thoracentesis.

③understand principles of oxygen administration, sputum suctioning, artificial respiration, and

chest compression in vitro etc.

(10) Write a prescription correctly and gain knowledge of drugs commonly used in respiratory medicine.Try to remember dosages, route and time of the medicine administered. Understand the effects and side effects of the drugs.

3.Have knowledge of the common emergencies and some new technologies used: (1)Respiratory failure, lung infarction, severe hemoptysis.

(2)The understanding of invasive and non-invasive mechanical ventilation.

Cardiac Department Practice Outline

Choose to practice in the CCU or normal sickroom, the time is 3 weeks. The intern should manage at least 6 sickbeds with the guidance of a supervising doctor.

1.The intern should gain mastery of the following diseases: heart failure、cardiac shock、rheumatic fever、rheumatic valvular heart disease、infective endocarditis、hypertension、coronary atherosclerotic heart disease、myocarditis、cardiomyopathies、pericarditis、cardiac arrhythmias: supraventricular arrhythmias、atrial fibrillation、atrial flutter、ventricular arrhythmias、conduction blocks and sick sinus syndrome.

2.Basic requirements for skill training:

(2) Physical examination: Intern should be skilled in the systemic PE method, using a standardized and competent performance. Master inspection, palpation, percussion and auscultation of the heart, specially auscultation.

(5)X-ray examination: Go over the parts correctly and systemically. Do not omit any suspicious area.Try to write an X-ray report. Grasp the normal X-ray appearance of the heart and large blood vessels.

(6) Special aspects of the clinical examination:

①EKG: interpret a normal EKG and characteristic changes of the EKG with arrhythmias、conduction blocks and atrial ventricular hypertrophy、coronary atherosclerotic heart disease、angina pectoris、and myocardial infarction.

②Basic understanding the examination of UCG、 HOLTER、coronary arteriongraphy、 cardio ECT、manage the clinical meaning of the report. (7)Basic diagnostic and procedural skills:

①Ability to perform a complete and accurate cardiac physical examination ②Comprehend the method of paracentesis of the pericardium and indications

③Manage the method of aspiration of oxygen、aspiration of sputum、artificial respiration、and external cardiac pressure.

(8). To write medical orders and prescriptions correctly, to master the dose of general drugs, the pathway and time for giving drugs of cardiology, and to master the effect of these drugs and understand the adverse effects.

3．To understand the treatment of some of the critical cases of internal medicine and some new technologies that are used:

To participate in the treatment of acute left heart failure, acute myocardial infarction, severe ventricular arrhythmias, and cardio-pulmonary resuscitation, ability to use a defibrillator , to understand the installation and use of pacemakers, and the interventional treatment of cardiovascular diseases.

Gastroenterology Department Practice Outline

The total time of practice in the Gastroenterology Department amounts to 3 weeks.

1.Interns should understand several kinds of diseases, such as gastritis, peptic ulcers, liver cirrhosis and its complications ( ascites , esophageal variceal hemorrhage , hepatic encephalopathy ), primary carcinoma of the liver, tuberculosis of intestine , tuberculous peritonitis, inflammtory bowel disease , and the distinctive diagnosis of jaundice.

2.Basic requirements for skill training:

(1)Medical record writing: Within 24 hours, the medical record should be finished with complete content, clear points, and good handwriting.Three medical records ( at least 2 in English) must be completed which should be revised by superior doctors with their signatures.

(2)Physical examination: Interns should know how to perform the abdominal physical examination skillfully and correctly.

(3)Course record, hospital discharge record and death record: Course record writing must reflect changes of diseases and doctor’s opinions. Hospital discharge record and death record also should be done with superior doctors’ signatures.

(4)Laboratory test. Normal reference data and clinical implication of blood, urine, and stool, should be understood. Clinical implication of other tests should be grasped, for example, ESR, BT, clotting time, reticulocyte count, biochemical examination of serous membrane fluid and cerebrospinal fluid, liver function, renal function, immunological examination, rheumatic antibody, and bacterial culture of blood, urine and stool.

(5)X-Ray: Interns should learn how to analyze X-Ray images and complete reports without omitting important points. The X-Ray features of gastric ulcers, duodenol ulcers, and digestive tract tumors must be learned.

(6)Special examination. It is necessary to know indications and contraindications of special examination such as gastric endoscopy and colon endoscopy.

(7)Basic medical procedural skill. Interns should learn methods of thorcentesis and abdominal paracentesis .

(8)Write doctor’s orders and prescriptions correctly. Pay attention to usage of medicine most in use ( dosage , route, etc) , especially their effects and side-effects.

3.To understand the emergency treatment of gastrointestinal bleeding, including esophageal variceal ligation and sclerosant injection.

Renal Department Practice Outline

Each practice student must be responsible for at least 6 beds under the direction of a superior doctor and should be in the medical ward of the renal department for 3 weeks 1.Diseases that must be mastered include

Acute and chronic glomerulonephritis, rapidly progressive glomerulonephritis, latent glomerulonephritis(Ig A nephropathy), urinary tract infection, nephrotic syndrome, acute and chronic

renal function insufficiency.

2.Requirement of basic training skills

(1)Writing of the case history : the collection and writing of a whole case history must be finished within 24 hours. The case history should have complete content, obvious emphasis, clear classification and good handwriting. Case histories of 3 different patients with the signature of the superior doctor must be finished during the duration of 3 weeks when you are in the kidney department

(2)Medical examination: skillfully master the systemic examination method, especially the standard manipulation.

(3)Record the course of disease, hospital discharge of the patient and death of the patient: All of these records must be finished. The record of the course of the disease should be able to reflect the changes of the state of an illness and the analysis and advice of the superior doctors of 3 different grades. Summarize the illneses in the Renal Department during the period of intership. Practice writing the records of discharge history and death of a patient. Such records must be signed by your supervisor and cannot be altered.

(4)Laboratory test: understand the normal values and the clinical significance of blood, urine, and stool routine examination. Understand the clinical significance of renal function and immune function tests. Know some results of special tests of the renal department and their clinical significance.

(5)Basic manipulation of diagnosis and treatment skills: hypodermic injection, intramuscular injection, venipuncture, drawing of the blood, blood and other liquid transfusion

(6)Master the methods of thoracic puncture, bone puncture and ventral puncture

(7)Master the methods of oxygen inhalation, sputum suctioning, gastric lavage, artificial respiration, and cardiac compression

(8)Prescribe for the patients according to the superior doctor’s advice correctly. Understand the common medicine dosage, administration approach and time, the role and side effect of the medicine 3.Common emergency treatments and some new technique

(1)Understand the indication of dialysis treatment of acute and chronic renal failure (2)Understand the indication of renal biopsy

Endocrinology Department Practice Outline

Practice for 3 weeks . Each intern should be in charge of 6 hospital patients guided by a supervising physician.

1.Diseases to be understood:

Hyperthyroidism, primary hypocortisolism, diabetes mellitus, diabetes insipidus, hypercortisolism , hypo-pituitarium anterius 2.Basic skill to learn:

(1)Case writing : Interns should complete collection and writing of the case in 24 hours. The contents of the case should be concise and accurate. The points should be clear . Handwriting should be neat. 2 cases written in English, should be submitted during the practice time in the endocrinology department . The resident doctor should sign on the case . (2)Physical examination :

Systemic examination should be completed proficiently . (3)Progress note, discharge note and death note.

All the notes should be written. The progress notes should reflect the changes of the disease and the perspectives from the clinical rounds with supervising doctors. Do not just write a day to day account, but rather also make a summary of the medical problems and treatment. Try to write discharge and death notes. Don’t recondition ad libitum. A higher level doctor should sign on the case . (4)Laboratory examination

Understand the normal values and clinical significance of thyroid function tests and OGTT . Understand the function of the adrenal cortex and pituitary hormones. (5)X-ray examination

Grasp the normal manifestations of the heart , lungs, and bone . (6)Special examinations

ECT : indications for thyroid , parathyroid and bone scan Bone density: clinical significance of examination

(7)Basic procedures of diagnosis and treatment

subcutaneous injection , intramuscular injection , intradermal injection , venipuncture , blood transfusion , thoracentesis , bone marrow aspiration , abdominal paracentesis , artificial respiration , external cardiac pressure

(8)Practice writing doctor's orders and prescriptions correctly, grasp the dosage of drugs commonly used , the route of administration, the time, and understand the drug action and its side effect .

3.Understand how to treat the common severe cases of endocrinology and understand new skills .

(1)understand how to deal with diabetes melltitus ketoacidosis and hyperosmolar coma. (2) understand the principles of treatment of hyperthyroidism and hypercalcemia .

Hematology Department Practice Outline

There are 3 weeks spent in the hematology department, and the intern doctor manages at least 6 patients with senior direction.

1.Diseases that must be understood: anemia, including: iron deficiency anemia, aplastic anemia , megaloblastic anemia, hemolytic anemia, acute and chronic leukemia, lymphoma, multiple myeloma, bleeding diseases, idiopathic thrombocytopenic purpura, DIC etc. 2.Basic skills to know:

(1)Case history writing: intern doctor should collect and write the case history within 24 hours. The content should integrated, correct, and clear. There should be orderliness in handwriting, with no alterations. Before the end of the rotation, 2 complete medical histories in English, should be submitted, with the signature and modifications of the physician in charge.

(2)Physical examination: understand how to perform the examination proficiently.

(3)Report courses of diseases, report of hospital discharge, report of death: can write the reports above, reflect the changes of the diseases and the opinion of the supervising doctors, make summaries, and exercise writing reports of hospital discharges, and reports of death, signed with the supervising doctor’s signature.

(4)Lab examination: understand the normal ranges, clinic meaning of the blood, urine, and stool routine tests, understand the ESR, PT, APTT, RET tests. Routine and biochemical examination of fluid of thorax, and spinal fluid. Understand the tests for function of the liver and kidney.

(5)Special examination: understand the characteristics of normal bone marrow, acute and chronic

leukemia bone marrow. Also know the bone marrow characteristics of iron deficiency anemia, aplastic anemia, and megaloblastic anemia. The clinical meaning of coloration of cytochemistry and the immunophenotype of acute leukemia and lymphoma etc.

(6)Basic procedures of diagnosis: understand the bone marrow aspiration, lumbar puncture, and injection of vertebra duct.

(7)Write the doctor’s orders and the prescriptions correctly. Understand the dosage, route, and time of the drugs in common use, and know the clinical uses and side effects. 3.Intensive care and some new technology: (1)Understand the diagnosis and therapy of DIC.

(2)Transfusion reactions, understanding and dealing with it correctly. (3)Know about the development of bone marrow transplantation.

Immunologic and Infectious Disease Department Practice

Outline

There are 3 weeks spent in the department, and the intern doctor manages at least 6 patients under the instruction of the supervising physician. 1.Diseases to be understood:

(1)Comprehend the diagnosis, differential diagnosis and the management principles of the infectious diseases such as non-specific virus infection, epidemic hemorrhagic fever, sepsis, pneumonia and the rheumatic disease such as systemic lupus erythematosus (SLE), rheumatoid arthritis, adult onset Still’s disease, sicca syndrome ( sjögren syndrome), inflammatory myopathy, systemic vasculitis, seronegative spondyloarthropathy.

(2)Learn the newest developments of clinical immunology and anti-infectious therapy. (3)comprehend the diagnostic algorithm for Fever of Unknown Origin (FUO)

(4)comprehend the conception of nosocomial infection, the principle of appropriate use of antibiotics and the antibiotic resistant mechanism. 2. Laboratory examination

(1)know the normal values and the clinical meaning of blood, urine and stool routine tests; erythrocyte sedimentation rate (ESR); bleeding and clotting time; reticulocyte count and serum biochemical tests. (2)know the normal values and analyze the result of routine and biochemical tests of pleural fluid and ascitic fluid.

(3)The interns should be able to analyze the positive results of blood, marrow and other body fluid cultures, and to select proper antibiotics based on the antibiotic sensitivity test.

(4)Understand the results of immunologic examinations, making a rheumatic disease diagnosis based on the results of autoantibody test.

3.Learn about the new achievements in the domain of infectious diseases and rheumatic diseases, knowing how to treat the severe cases of the infectious and rheumatic disease, such as: fulminate form SLE, severe hemorrhagic fever with renal syndrome，increased intracranial pressure and the treatment of lupus encephalopathy.

Surgery Practice Outline

Basic requirements:

There are 18 weeks for the interns to accomplish the surgical rotation. The arrangements are as follows: department of general surgery for 6 weeks, department of cardiothoracic surgery for 3 weeks, department of orthopedic for 3 weeks, department of urinary surgery for 3 weeks, surgical emergency for 1 week and department of anesthesiology for 2 weeks.

Through the senior doctor’s teaching and self-study by the intern, the student should integrate theory with practice and become acquainted with the diagnosis and treatment of common surgical diseases. The intern should learn how to read gastrointestinal contrast films, abdominal plain films, CT, MR, B-ultrasound, and know their use in the diagnosis of various diseases. The procedures of surgical asepsis, dressing changes, and some basic operation skills should be mastered.

The intern should be engaged in 24-hour duty during the internship, and learn the basic principles of medical care. The intern should finish 8 medical records and manage at least 6 inpatients under the senior doctor’s instruction. There will be a small lecture once a week and instructional teaching rounds with the attending physican, once a week. There will be an attending physician serving as a teacher, and teaching will be both in English and Chinese. At the end of the internship, the intern will receive an oral examination, a written examination paper, a case analysis and a test of procedural skills. You are also required to take part in academic activities organized by the department, such as lectures and case discussions.

Individual Department Requirements

General Surgery Practice Outline

The intern should work in the department of general surgery for 6 weeks and the requirements are as follows:

1. Become acquainted with common symptoms and signs of patients with general surgical diseases and know their significance by clinical work. Learn how to approximate the extent and location of the diseases.

2. Be acquainted with routine preparation for preoperative patients and basic postoperative management, such as diet, antibiotic treatment, principles of fluid replacement, nasogastric suction, and abdominal drainage.

3. Understand the diagnostic significance of B-ultrasound, X-ray films, endoscopy, isotopic examination and routine laboratory reports.

4. Master some procedures such as venipuncture for blood draws, dressing changes, abscess incision, urethral catheterization, nasogastric suction, and understand surgical aseptic technique. Master basic operation skills under the senior doctor’s instruction.

5. Master the diagnosis, preoperative preparation, and operative principles for appendicitis, hernia, varicose vein of the great saphenous vein, thyroid tumor, and diseases of the anus. Participate in these operations.

6. Master the clinical presentation, selection of accessory examinations, special prepoerative

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preparations, and operative principles for cholecystitis, cholecystolithiasis, peptic ulcers, digestive tract tumors, thyromegaly, hyperthyroidism, and diseases of the breast.

7. Understand the clinical presentation and selection of diagnostic methods, and master the treatment principles for some complicated surgical diseases, such as rectal cancer, portal hypertension, diseases of the pancreas and complicated diseases of the biliary tract.

8.Understand the principles of blood volume replacement, correction of water-electrolyte disturbances, and acid-base imbalance during emergencies, especially in hemorrhagic shock and toxic shock.

9.Be acquainted with the purpose, route, calculation of requirements, and prevention and management of complications of surgical nutrition.

10.Finish 3 English medical records and be acquainted with preoperative and postoperative physician orders for common diseases in general surgery.

Orthopedic Surgery Practice Outline

Guidelines for 3 weeks of clinical practice in the Orthopedics Department

1.To master the basic physical examination techniques required to make a diagnosis of diseases of the musculoskeletal system, for example the examination of muscle strength and motion of the spine or joints. Also try to obtain knowledge of some special physical examination techniques.

2. To acquire an intimate knowledge of the principles of diagnosis and treatment for some common disorders of the bones and joints. Such as traumatic surgery (fracture and dislocation), infectious diseases, and aseptic arthritis, etc.

3. To learn some basic therapeutic techniques, such as traction, fixation with splint or cast, arthrocentesis, arthrography, and local injection techniques to treat joint pain.

4. To understand the special importance of aseptic technique during orthopedic surgery, and to learn more strict sterile techniques for this area.

5. To learn the basic knowledge of key points for some common disorders such as the diagnosis and differential diagnosis for lumbar disc herniation, the clinical manifestations and principles of treatment of tuberculosis of the spine, the classification, differential diagnosis, and principles of treatment of bone tumors.

6. To learn how to write the correct medical documentation and physician orders, to give a proper plan for preoperative and postoperative treatment, and to know the correct medications to prescribe, and their effects and side effects.

7. To take part in procedures for the management of some emergency and critical cases, such as multiple injuries, compound fractures, traumatic and hemorrhagic shock, and cervical spinal cord injury. 8. To complete at least 2 case records in English.

Cardiothoracic Surgery Practice Outline

The intern should work in the department of cardiothoracic surgery for 3 weeks and the requirements are as follows:

1. Be able to give the correct diagnosis and initial management for general chest trauma.

2. Understand the examination methods for diseases of the oesophagus and lung. Be able to determine the diagnosis for oesophageal cancer and lung cancer.

3. Understand the procedures of chest fluoroscopy and thoracic puncture, and observe the effects of

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thoracic drainage in diagnosis and treatment.

4. Understand the mechanism of hypothermia and extracorporeal circulation.

5. Be able to diagnose congenital heart diseases and bicuspid valve lesions according to the precordial region murmur.

6. Understand surgical treatment of coronary heart disease.

7. Understand surgical treatment of common congenital heart diseases, atrial septal defect, and ventricular septal defect.

8. Understand surgical treatment of common heart valve diseases, such as mitral valve stenosis, mitral valve incompetence, aortic valve stenosis, and aortic valve incompetence. 9. Complete 2 English medical records.

Urologic Surgery Practice Outline

Practice in urology will be for 3 weeks, with the requirements as follows:

1.Master the diagnosis and management principles of some common diseases in urology, including urinary tract infection, prostatitis, urinary stones, obstruction of the urinary system and urologic injury. Student should especially know the methods of diagnosis, for instance: cystoscopy, urography, renal function examination, and angiography. Understand the information of radiology.

2.Understand some basic procedures, for instance: prostatic massage、phimosiectomy、the operative procedures for hydrocele、tunica vaginalis, and cystis stoma.

3.Understand the indications of some special examinations: extracorporeal shock wave lithotripsy, urine flow rate measurement, cystoscopy, and dilation of the urethra.

4.To know the diagnosis and treatment of common diseases (diseases of the prostate gland、

epididymis、urinary calculus)、and to know the clinical manifestation, diagnosis, therapeutic principles, and operative indications of common diseases in urology.

5.Complete 2 clinical records in English, and to know the physician orders for preoperative and postoperative care for the common diseases in urology .

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Obstetrics and Gynecology Practice Outline

The practice in the department of obstetrics and gynecology includes two weeks in the obstetrics department, two weeks in the gynecology department, one week in the family planning department, and one week in the outpatient department. Through clinical practice, students should master how to obtain the case history, write case files, and carry out the physical examinations, especially the pelvic examination. In addition, the diagnosis, differential diagnosis, treatment and preventive measures of the common and frequently-occurring diseases should be understood. The student should learn how to survey the patient’s condition, and proficiently write the progress note and the various required medical documents. The student should also master the preliminary emergency treatment of acute patients. During the time of practice, there will be weekly small-scale practice lectures and clinical rounds for teaching. Students will be taught bilingually, and physicians will be provided to teach students. At the end of the rotation, the students will have an oral examination、written examination、case analysis, and a procedural exam. During the period of practice, the trainees are asked to take part in the science lectures, case discussions, and other learning activities organized by the department.

Individual Department Requirements:

Obstetric Department Practice Outline

Students should master obstetric case documentation, some basic operation procedures, and routine examination techniques, during the two weeks in the obstetric department. The following will be expected of the students:

1. To understand the aspects of antenatal care, understand how to write routine obstetric case notes, and resident admission notes. To proficiently master the four maneuvers of Leopold and external pelvic measurements. An intern must write two ordinary case files, including 2 English cases of all the arranged pathological obstetric patients and admit notes of normal gravidas. Every day the intern must participate in physician clinical rounds, write the case files they are responsible for, write the progress notes, and report unusual conditions to the supervising doctor in a timely manner.

2. To learn how to follow the patient during labor, preliminarily master the method and procedure of the normal pregnancy delivery, supervised by a higher level physician, and deliver the normal parturition guided by midwives, one or two times during the rotation.

3. To understand the indication, and manipulation steps of using obstetrical forceps.

4.To understand the diagnosis, differential diagnosis, and treatment principles of the common and frequently-occurring pathological obstetric diseases, for example pregnancy induced hypertension syndrome, placental abruption, placenta previa, pregnancy complicated with cardiac disease, diabetes during pregnancy, anemia, postpartum hemorrhage, fetal distress, premature rupture of memberanes, abnormal labor, and so on. To know the significance of peripartum care and breast feeding. Every week a teaching clinical rounds lecture will be organized.

5. To understand how to apply a fetal electronic monitor, to forecast fetal reserve capability. To master NST, OCT, CST, and the manipulation and clinical meaning of long range fetal heart monitoring. 6. To understand the diagnosis and treatment of normal and abnormal puerperium. 7. To understand the emergency treatment of neonatal asphyxia.

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8. To participate in a caesarean section, master the procedure of scrubbing, sterilization, wearing the operating gown, cutting the skin, ligature, shearing thread and making skin sutures, and to be familiar with the indication and the operative procedure of a caesarean section.

9. To learn the indication and methods of induced abortion, and master the treatment of abnormal conditions.

Gynecology Department Practice Outline

Students should master gynecologic case documentation, basic procedures and routine examination techniques, during the two weeks in the gynecologic department practice.

1. To be familiar with the documentation of gynecologic cases, the trainees are asked to write two Chinese case files and one in English. To master gynecologic examination methods (including the bimanual examination, vagino-recto-abdominal examination and anus examination). To understand specific gynecologic examinations that are frequently used, such as cervical scraping smear (PAP smear), and a cavitary uterine aspiration smear. To understand the indications for use of the colposcope, hysteroscope and laparoscope, and to learn how to read type-B ultrasonic pictures.

2. To participate in the consultant teaching clinical rounds every week, report the case files, and participate in the discussion.

3. To learn the diagnosis, differential diagnosis, and treatment principles of common gynecologic diseases, such as hysteromyomas, ovarian tumors, ectopic pregnancy, genital system inflammation, endometriosis, gestational trophoblastic disease, cervical cancer, and so on.

4. To master the indication for chemotherapy, and to be familiar with the institution of chemotherapy programs.

5. To be familiar with pre-operative and post-operative treatment principles in gynecologic patients. 6. To participate in gynecologic operations, master the procedure of scrubbing, sterilization, wearing the operating gown, cutting skin, ligature, shearing thread, skin sutures, and so on, and to be familiar with the indication and the operative procedure of uterectomy and adnexectomy .

Family Planning Department Practice Outline

The following will be expected of students:

1.To master the diagnosis of early pregnancy, and understand the indications, and contraindications of artificial and medical abortion.

2.To learn the indications, usage, and the adverse reactions to treatment with oral contraceptives, and contraceptive devices (condom, intrauterine contraceptive device (IUD)).

3.To take part in the procedure of artificial abortion, placement and displacement of an IUD, induction of labour in the second trimester, and tubal sterilization procedures, guided by higher level supervising doctor, and to learn the method of medical induced abortion.

Outpatient Department Practice Outline

The following will be expected of students:

1. The practice in the outpatient department includes the obstetrical service, gynecologic service, and the type-B ultrasound office. Students will be expected to diagnose and treat outpatients, directed by a higher

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level doctor, to write outpatient case reports, carry out antenatal examinations, gynecologic examinations, cervical scraping smear (PAP smear), and a cavitas uterine aspiration smear, and to learn about the obstetric and gynecologic ultrasonic examination.

2. To learn how to treat the common problems in the outpatient department, for example abortion, inflammation, infertility and so on.

3. To be familiar with diagnostic curettage, cervical biopsy, and the indication and procedure of hysteroscopy.

4. To publicize the importance of breast feeding.

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Pediatric Clinical Practice Outline

1.Purposes and requirements:

（1）Enhance students medical knowledge and skills to serve needs of children with compassionate hearts, self-discipline and professional conduct continuously.

（2）Understand and master basic theory and knowledge of common pediatric diseases.

（3）Master pediatric basic clinical techniques and general good procedures of manipulations. 2.Clinical practice time and arrangement:

（1）It is six weeks for clinical practice, four weeks in the ward (including two weeks in the general ward and two weeks in the neonatal ward) and two weeks in clinics and emergency.

（2）Arrange clinical practice lectures every Wednesday afternoon. This is taught by the attending or senior resident. The content is:

①Principles for pediatric drug use.

②Differential diagnosis for symptoms of common pediatric diseases. ③Treatment for pediatric emergencies.

④Diagnosis and treatment for pediatric common viral infections diseases.

（3）Organize clinical practice doctor to analyze and discuss typical clinical cases regularly (usually once per two weeks)

（4）Design examination method for the clinical practice doctor, so that it is encouraged for students to combine theory with clinical practice tightly, attaching importance to opportunity for clinical practice, and combine the score which is obtained by questions in clinical rounds with the oral test score obtained when leaving the department and add one typical case analysis as part of the written examination.

（5）Require clinical practice doctor to participate in a professional lecture every Tuesday afternoon (including analysis for difficult cases, conveying information from science meetings both at home and overseas, and new medical developments.

（6）Didactical clinical rounds by experienced Professors periodically. (or difficult case discussions) 3.Basic technique and manipulation requirements.

（1）Master the ability to obtain and write information about the patient, observe the change of the diseases, write daily progress note, sign out summery, acceptance note and discharge summery and organize paperwork of case at time of discharge store in medical records department. Two pieces of cases should be written when leaving department.

（2）Master characteristics of pediatric physical examination. And examination methods for various systems (including physical examination and measurement for intelligence development).

（3）Master finding of children(cleanliness, heart preservation, disinfection, isolation method of feeding ,calculation for nutrition amount) and nursing children generally. （4）Master pediatric fluid therapeutics and common drug dosages.

（5）Master manipulation and diagnosis for pediatric electrocardiogram, method of pediatric lowering of temperature using physical methods, pediatric inhaler pulverization treatments etc, generally, Understand common manipulations (eg. Children venipuncture for scalp, elbow, femoral sites, children intramuscular injection, children subcutaneous injection, children intradermic injection, children lumbar puncture etc.

6.Master diagnosis and treatment of diseases below （1）Growth and development

①Master the characteristics of the different stages of children’s development.

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②Master the calculation using the fomula for weight and height, circumference of head , fontanel size, age of ossific center of the bone and teeth development. （2）Nutrition & its disorders

①Infant feeding: master character of metabolism and nutrition requirements, merit and method for breast feeding, understand how to mix milk and sequence of the additive supplement to the diet.

②Protein-energy malnutrition: master etiology, clinical manifestation, diagnosis, treatment and prevention

③Rickets of vitamin d deficiency: master clinical manifestation, diagnosis, treatment, and prev （3）the newborn disease:

①Basic concept and category for newborn: master newborn category, understand degree of ward neonatal

②Characteristics nursing for full term infant and preterm infant: master physical and appearance characteristics nursing for full term infant and preterm infant

③Asphyxia of newborn: master clinical manifestation, apgar score, complication and treatment

④Hypoxic-ischemic encephalopathy of newborn: master clinical manifeststion, diagnosis, differential diagnosis and prognosis

⑤Respiratory distress syndrome: master clinical manifestation, laboratory findings, diagnosis, differential diagnosis and treatment

⑥Newborn jaundice: master differential diagnosis and treatment for physiological and pathologic jaundice

⑦Neonatal cold injury syndrome: master clinical manifestation , diagnosis , and treatment （4）Immunodeficiency: master clinical manifestation, diagnosis and principle of treatment （5）Digestive diseases

①Infantile diarrhea: master etiology, clinical manifestation, diagnosis and treatment

②Infantile diarrhea: master etiology, degree of dehydration, type of dehydration, fluid and electrolyte management

（6）Respiratory tract disease

①Master anatomic and physiologic characteristics of the respiratory system for children, master clinical manifestions and treatment of severe upper respiratory infections.

②Master clinical manifestation and treatment for general pneumonia and serious pneumonia, master auscultation for all kinds of abnormal respiratory sound and rale in the lung and clinical characteristic of the four kinds of special pneumonia

③Master clinical manifestation of bronchial asthma, criteria for diagnosis and treatment of children asthma

（7）Cardiovascular disease

Congenital heart disease: understand characteristics of fetal circulation and charge of the blood dynamics after birth, master clinical manifestation, murmur characteristics and common complications of four kinds of common congenital heart diseases （8）Kidney & urinary tract

①Acute glomerulonephiritis: master clinical manifestation and treatment of general case and severe cases.

②Nephrotic syndrome: master main clinical manifestation ,differential diagnosis of the simple type nephrotic syndrome and the nephritis type nephrotic syndrome and principles of treatment （9）Hematologic disorders

①Nutritional iron deficiency anemia: master stages of disease and main laboratory findings

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②Nutritional megaloblastic anemia: master special clinical manifestation, laboratory findings, prevention and treatment

（10）Neurologic & muscular disorders

①Purulent meningitis: master clinical manifestations, differential diagnosis of celebrospinal fluid findings and treatment

②Acute viral encephalitis: master its special clinical manifestations, laboratory findings and treatment (11) Endocrine disorders: master clinical manifestations, laboratory findings, diagnosis and treatment of congenital hypothyroidism.

(12) Tuberculosis: Master pathogen clinical manifestations, tuberculin test and treatment.

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Neurology Practice Outline

Interns will spend six weeks in this department , with five weeks on the wards and one week in the clinic and neurology emergency clinic. There will be a lecture and also clinical rounds for teaching, in Chinese and English, once a week. The bilingual teaching will be performed by an attending physician. Interns are requested to participate in the professional lectures and case discussions. Interns will take an oral test, a written test, case analysis testing, and a test of procedural skills.

The training of fundamental skills must include:

1. Medical history taking, physical examination, analysis of a neurological case, and documentation during clinical rounds. Three case files written in Chinese and one in English are required for all students.

2. Recognize common presenting symptoms of neurologic diseases.

3. Be able to perform a lumbar puncture, and understand the indications and contraindications of this procedure.

4. Understand the usage and significance of the electroencephalogram, evoked potentials, and transcranial Doppler.

5. Understand the nursing care of a tracheostomy which would develop in respiratory failure caused by Guillain-Barré Syndrome or Myasthenic Crisis, as well as utilization of an artificial ventilator.

The neurologic diseases that must be covered are: 1. Cerebrovascular diseases (CVD) （1）The classification of CVD

（2）Transient ischemic attack (TIA). The clinical findings of TIA in the internal carotid artery system and the vertebrobasilar artery system, the investigative studies of CT, MRI, TCD, PET and DSA, and the treatments of TIA that are required.

（3） Atherosclerotic thrombosis: The internal carotid artery system included with the anterior cerebral artery, which is divided into cortical and penetrating branches. When they occlude, the clinical findings and features of CT, MRI, DSA and TCD should be understood. The interns should also be familiar with clinical findings of vertebrobasilar artery occlusion.①When atherosclerotic thrombosis has developed, such diseases could be encountered, including the occlusion of the vertebrobasilar artery trunk, the cerebral peduncle syndrome, the locked-in syndrome, Wallenberg syndrome, top of the basilar syndrome and internal pontine syndrome .

1)Atherosclerotic thrombosis of posterior cerebral artery should be understood. 2)cerebeller infarction should be understood. The CT scan features of thrombosis of the superior cerebellar artery, the anterior inferior cerebellar artery, and the posterior inferior cerebellar artery should be understood.

（4） Embolism: The clinical findings and principles of treatment of cardiogenic embolism should be understood.

（5）The clinical findings and changes on the CT scan for each type of lucunar infarction should be understood.

（6）Intracerebral hemorrhage: The clinical findings, CT scan presentations and treatments of hemorrhage in different locations within the putamen, lobe of the brain, brain stem, cerebellum and cerebral ventricles should be understood.

（7） The features of CT scan and DSA in subarachnoid hemorrhage should be understood. （8） The clinical findings, diagnosis, and treatment of vascular dementia should be understood.

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2. Myelopathy:

（1） The clinical findings of myelopathy and location of the lesion should be understood.

（2）Acute myelitis is emphasized in our curriculum : The clinical findings, investigative studies including changes of the CSF and MRI, and the therapeutic principles, and the differential diagnosis with compressive myelopathy need to be understood.

(3)The clinical findings, investigative studies, and treatments of subacute combined degeneration should be understood.

(4)The clinical findings, investigative studies, and treatments of arachnoiditis of the spinal cord should be understood. 3. Epilepsy:

(1)The clinical findings of seizures within different locations should be understood.

(2)Partial seizures include simple partial seizures and complex partial seizures should be understood. We will deal with simple partial seizures with motor or sensory findings, as well as the simple temporal lobe seizures with conscious disturbance, affective disturbances during psychomotor seizures, and psychosensory seizures.

(3)Generalized seizures: The clinical findings and the changes of the EEG of tonic – clonic seizures(Grand mal) are emphasized.

Understand absence seizures and myoclonic seizures.

(4)Status epilepticus. The interns are requested to master the principles of general management, control of the seizures, and ongoing treatments.

(5)Principles of antiepileptic drugs for different types of seizures. 4. Movement disorders (sometimes called extrapyramidal disorders)

(1)The clinical findings of Movement disorders including static tremor, choric movement, rigidity, athetosis, torsion spasm and hemiballismus should be understood.

(2)Parkinsons disease. The clinical findings of tremor, rigidity, hypokinesia and abnormal posture are required, as well as principles of drug usage for this disease. Interns should understand the diagnosis and differential diagnosis of idiopathic tremor, Parkinsonism.

(3)The clinical features, diagnosis and treatments of Huntington’s disease should be understood. (4)The clinical features, diagnosis and treatments of Wilson’s disease should be understood. 5. Demyelinating disease

(1)Multiple sclerosis. The clinical findings such as optic neuritis, sensory disorders, dysfunction of the brain stem, symptoms related to the cerebellum and abnormalities of the autonomic nervous system, as well as the criteria for diagnosis, especially the investigative studies of MRI and CT which can show the shape and location of the impairment in brain white matter should be understood.

(2)The clinical findings, investigative studies, and treatments of ophthalmoneuromyelitis should be understood.

(3) The clinical findings caused by extensive impairments of the brain parenchyma, and the spinal cord, and the investigative studies, especially the changes in CSF findings that are required in acute disseminated encephalomyelitis should be understood.

6. Diseases of the neuromuscular junction and muscular diseases

(1) Myasthenia gravis: ① The clinical findings of each type according to Osserman’s classification. ② The criteria for diagnosis, performance of the Jolly’s test, and neostigmine test. ③ The principles of treatment. ④Understand the clinical findings, and emergency management of myasthenia crisis, cholinergic crisis, and brisple crisis.

(2)Understand the classification of muscular dystrophy, and be familiar with the features of muscular

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pseudo-hypertrophy, gait, alterations of the EMG and the serum CK in cases of Duchenne muscular dystrophy.

(3)The clinical findings and treatment principles of myotonic dystrophy should be understood. (4)The clinical findings of polymyositis which can be seen in the departments of dermatology and immunology, as well as the differential diagnosis with other myopathies should be understood. 7. Peripheral neuropathy

(1)The common clinical findings of Peripheral neuropathy

(2)Acute inflammatory polyradiculoneuropathy is emphasized in our curriculum. Patients generally present with weakness of all limbs usually more proximally than distally. The clinical findings are subjective sensory complaints, although objective sensory disturbance are usually far less than motor deficits. The CSF often shows a characteristic abnormality at 2-3weeks after onset.

(3)Facial neuritis: recognize the clinical features of peripheral facial palsy and the differential with central facial palsy. The principles of treatment should also be understood. 8. Neurological degenerative diseases

(1)The examination and criteria of diagnosis of Alzheimer’s disease, as well as the differential diagnosis with other forms of dementia, and principles of treatment should be understood.

(2)Understand the classification of motor neuron diseases. The clinical findings, investigative studies and differential diagnosis with other types, when upper and lower motor neurons impair simultaneously in amyotrophic lateral sclerosis are emphasized. 9. Infections of the central nervous system

Herpes simplex virus encephalitis is emphasized in viral encephalitis. The clinical findings, common investigative studies and differential diagnosis with other viral encephalitis such as herpes zoster virus encephalitis, enterovirus encephalitis, respiratory viral encephalitis, progressive multifocal leucoencephalopathy, and subacute sclerosing panencephalitis, as well as the tuberculosis related meningitis and encephalitis, bacterial encephalitis, mycotic encephalitis, and AIDS should be understood. The principles of treatment in viral encephalitis should also be understood.

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Radiology Practice Outline

1.Objectives during rotation

The student should attend consultation of daily cases, should practice writing diagnostic reports, gain some mastery of the appearance on X-ray of common respiratory diseases, and the student should be familiar with the appearance of frequently encountered diseases of the digestive system、bone and articulur system、urologic and reproduction system、nervous system, have some understanding of the appearance of diseases affecting the circulatory system、brain-neck imaging, and the method of gastrointestinal tract barium radiography . 2.Total time and arrangement

Two weeks, include thoracic part、abdominal part、brain-neck part, and bone –articulur part. 3.Training of basic technical skill

The student should have understanding of principles of X-ray imaging、and beginning principles of CT and MR imaging, should have understanding of the initial procedures of examination and clinical applications, and be familiar with methods of thoracic imaging、abdominal imaging, and digestive tract barium radiography.

4.Mastering diagnosis of commonly encountered diseases

(1)respiratory system: pneumonia, pulmonary tuberculosis, pulmonary tumors, mediastinal tumors. (2)circulatory system: hypertensive heart disease, cor pulmonale, rheumatic heart disease, atrial septal defect, pulmonary embolism, pericardial disease.

(3)bone and articulur system: surgical trauma, inflammation, common bone tumors, metabolic bone disease, degenerative osteoarthritis.

(4)digestive system: esophageal varices, gastric ulcer, duodenal ulcer, gastrointestinal perforation, gastric cancer, colon carcinoma, liver cancer, biliary calculi, cholecystitis, and pancreatitis. (5)urologic and reproduction system: urinary calculi, tuberculosis, tumors.

(6)nervous system and brain-neck: cerebral hemorrhage, cerebral infarction, common cerebral tumors, fracture of facies cranii.

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Anesthetic Practice Outline

Purpose of practice

To know the scope and task of anesthesiology, to get familiar with the routine work in the anesthesiology department, as well as the basic theory and operation, in order to lay the solid foundation for the future. Demands of practice

In terms of the teaching schedule, to take part in the clinical practice under the guidance of a superior, to know the routine work, to be familiar with common anesthetic methods, and basic manipulation of anesthesia.

To follow the rules of the hospital and department during the internship, to obey the arrangement of work, and never to come late or leave early, to respect superiors, learn open-mindedly, to care for the pains of the patients, to take part actively in routine work.

Demands in detail as follows:

1. Evaluation of the patient pre-operatively

To know the importance and purpose of visiting patient pre-operatively, to grasp the ASA classification and heart function grade, to know the evaluation of general conditions of patients, including the vascular system, respiratory system, central nervous system, endocrine system, and hepatic function and renal function.

2. Preparation and medication pre-operatively

To know the purpose of preparation pre-operatively and the principles of choosing anesthetic methods, and to be familiar with the pre-medication, to know the preparation of anesthetic appliances and devices. 3. Induction, maintenance and resuscitation of general anesthesia

To know the basic aspects of general anesthesia, to know the elementary knowledge of induction, maintenance and resuscitation.

4. endotracheal and bronchial intubations

To know the grade of difficult airways and the preparation of drugs and devices in total intravenous anesthesia, to know the complications of endotracheal intubations. 5. Intrathecal block

To know the indication, contraindication, complication of spinal anesthesia and epidural block, to know the influence on the physiology, and the prevention and treatment of adverse reactions. 6. Monitoring and transfusion during the anesthesia

To know the significance and purpose of monitoring during the anesthesia, to get familiar with variation of body fluids through the complete process, and the general principle of blood infusion and liquid transfusion during the anesthesia. Qualification of practice

1. to visit the patient pre-operatively and to join the discussion more than 3 times per week. 2. to take part in detailed anesthesia for more than 6 cases.

3. to accomplish the total intravenous anesthesia under the guide of a superior anesthetist. 4. to fulfill the puncture of intrathecal block.

5. to write 2 cases of the plan list and record list independently.

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