1 exam introduction
In order to implement the spirit of the Ministry of Personnel and the Ministry of Health's Notice on Strengthening the Evaluation and Employment of Health Professional and Technical Posts and other related documents, since 200 1, the national primary and intermediate technical qualifications of health professional and technical posts have been formally implemented by examination and employment. The qualification obtained through the examination represents the level and ability required by the corresponding technical post, which is the necessary basis for the unit to hire the corresponding technical post.
A, internal medicine attending physician qualification examination scope
(1) Scope of applicable personnel: personnel engaged in internal medicine in medical and health institutions approved by the state or relevant departments.
(2) Specialty setting: The specialties of internal medicine inspection include internal medicine, cardiovascular medicine, respiratory medicine, gastroenterology, nephrology, neurology, endocrinology, hematology, tuberculosis, infectious diseases, rheumatism and clinical immunology, and occupational diseases *** 12.
(3) Examination subject setting: What is the score of the examination? Basic knowledge? 、? Related professional knowledge? 、? Professional knowledge? 、? Professional practice ability? Test four subjects, such as man-machine dialogue.
Second, the way to obtain the qualification of internal medicine attending physician
In principle, the qualification examination for internal medicine attending physicians is conducted once a year, and the national unified organization, unified examination time, unified examination outline, unified examination proposition and unified qualification standard.
All majors included in the national examination will no longer carry out qualification identification and evaluation of junior and intermediate health professional and technical positions, and will no longer organize junior and intermediate health technical series professional examinations.
Three, internal medicine attending physician qualification certificate management
Those who have passed the qualification examination for the attending physician of internal medicine shall be awarded the professional and technical qualification certificate uniformly printed by the Ministry of Personnel and the Ministry of Health. The certificate is valid nationwide.
In any of the following circumstances, the Health Bureau shall revoke its corresponding professional and technical qualification, and the Personnel Bureau shall withdraw its professional and technical qualification certificate, and shall not participate in the physician qualification examination within 2 years:
(a) forged academic qualifications or professional and technical qualifications;
(two) there is a violation of discipline during the examination;
(three) other circumstances stipulated by the administrative department of health and personnel of the State Council.
2 exam outline
The examination syllabus for general internal medicine attending physicians will be published from June 65438+February of the year before the examination to June 65438+ 10 of the year of the examination.
3 Registration conditions
Anyone who meets the registration conditions in the Interim Provisions on the Examination of Clinical Medical Professional and Technical Qualification issued by the Ministry of Health and the Ministry of Personnel (Ren Weifa [2000] No.462) can sign up for the examination of the corresponding level and professional category.
Internal medicine major:
1, to participate in the physician qualification examination personnel, should meet the following basic conditions:
(1) Abide by the Constitution and laws of People's Republic of China (PRC);
(2) Abide by the Law of People's Republic of China (PRC) Municipality on Medical Practitioners and obtain the qualification of medical practitioners;
(3) Have good medical ethics and professionalism;
(4) Doctors in medical institutions who implement standardized training for residents must obtain training certificates.
2, to participate in the physician qualification examination personnel, in addition to the above conditions, but also must meet one of the following conditions:
(1) Obtained medical secondary school education and worked as a doctor for 7 years.
(2) obtain a medical college degree and have worked as a doctor for 6 years.
(3) obtain a bachelor's degree in medicine and have worked as a doctor for 4 years.
(4) obtain a master's degree in medicine and have worked as a doctor for 2 years.
(5) Obtaining a professional degree of doctor of clinical medicine.
3, one of the following circumstances shall not apply to participate in the internal medicine professional and technical qualification examination:
(1) The person responsible for medical accident is less than 3 years old.
(2) The person responsible for medical errors is dissatisfied with 1 year.
(3) If an administrative sanction is imposed, during the disciplinary period.
(4) Forgery of academic qualifications or violation of discipline during the examination for less than 2 years.
(5) Other circumstances stipulated by the provincial health administrative department.
Those who take the examination for the qualification of internal medicine attending physician must first obtain the qualification of practicing physician, and submit the qualification certificate of corresponding professional practicing physician when registering. Due to job changes, people who need to apply for the professional category of their current posts must be engaged in professional work for two years.
The academic qualifications or degrees specified in the registration conditions refer to the academic qualifications or degrees of regular institutions of higher learning recognized by the administrative departments of education and health of the state. The deadline for calculating the working years is the end of the year of examination registration. The date of obtaining academic qualifications and working years in this major of those who signed up for the 20 14-year qualification examination for internal medicine doctors are as of 20 13, 12 and 3 1.
Those who meet the registration requirements, regardless of the nature of the unit and household registration, can choose the professional category to take the exam according to the needs of their work.
Description:
1, applicants must engage in internal medicine work in medical and health institutions approved by relevant departments; Those who apply for the doctor in charge of internal medicine shall have the qualification of practicing doctor and submit the qualification certificate of practicing doctor at the time of registration. For the majors with entry qualification requirements, the entry qualification documents should also be submitted when registering.
2. The relevant qualifications required in the registration conditions for those who sign up for the qualification examination of internal medicine doctors refer to the national education qualifications recognized by the state; The requirement of working years refers to the sum of working time in this major before and after obtaining the above education. The calculation of working years ends at the end of the year of examination registration.
3. Anyone who meets the conditions of the above-mentioned physician in charge of internal medicine can take the examination of physician in charge of internal medicine, regardless of the nature of the unit and household registration, and apply for related subjects according to the department.
Your major must correspond to (or be similar to) the major you are applying for. For example, those who study pharmacy can only apply for pharmacy qualification, not nursing qualification and so on.
4, the "Interim Provisions" in the provisions of the medical accident liability, etc. shall not take the exam.
4 Registration time
The examination registration of internal medicine attending physician is divided into online registration and on-site confirmation.
The registration time for the national health professional and technical qualification examination is generally from February 65438 to1October 65438 at the beginning of the following year.
The registration time of 20 14 health professional technical qualification examination is: online registration time is 20 14 1.8 to 20 14 1.25, and on-site confirmation time is 2014/kloc-0.
First, the online registration time
Online registration time: generally in 65438+February of that year, please consult the test center office where the registration is located for details.
The online registration time for 20 14 physician examination is: 20 14 1.8 to 20 14 1.25.
Online registration steps:
Step 1: Candidates check the registration statement on China Health Talents Online, read it and agree, then click to enter the registration process.
Step 2: Check the registration process: After knowing the registration order and precautions, click Start Registration to enter the registration page.
The third step is to enter the online newspaper system, register and fill in the online registration declaration form. Candidates can register in 65438+February. Personal ID number? And login to the website to inquire and modify personal registration information. Fill in personal registration information. After the candidate confirms and saves the registration information, the system prompts? Registration successful? .
Step 4: After the candidates confirm that the information provided is correct, they can print the Application Form for Registration of Health Professional and Technical Qualification Examination.
Second, the on-site confirmation time
On-site registration time: generally from the end of February to the beginning of the following year, subject to the notice of the test center.
On-site confirmation time of 20 14 internal medicine attending physician examination is: 20 14 1.9 to 1.28, and each region can arrange the confirmation time by itself according to the specific situation.
Candidates hold the printed "Registration Form for Health Professional and Technical Qualification Examination" and conduct on-site registration and qualification examination according to the specific requirements of the test center. Stamp the declaration form: candidates should bring the declaration form to their unit or file storage unit for review and stamp. Submit written application materials (such as ID card, original and copy of graduation certificate, etc.). ), and confirm the personal registration information signature and payment.
Documents and related materials required for on-site audit and confirmation: (subject to local registration notice)
1, Application Form for 20 14 Annual Health Professional Technical Qualification Examination (A4 specification);
2. My valid identity certificate and photocopy;
3. Original graduation certificate and degree certificate;
4 professional and technical post qualification certificate, letter of appointment or original certificate;
5. Original relevant qualification certificate;
6. Applicants who have changed jobs need to submit relevant certificates in order to be transferred to their current positions;
7. Those who have participated in the health professional and technical qualification examination must submit the original and photocopy of the previous examination transcripts or admission tickets.
Note: Candidates are not allowed to modify the registration information after signing the confirmation form. Anyone who fails to go to the selected test center or its registration point on time for on-site confirmation and payment will be deemed to have given up the exam automatically.
5 Examination time
The examination time for attending physicians in internal medicine is generally from May to June each year.
The time of the 20 15-year health professional technical qualification examination has been determined as: May 20 16, May 20 17, May 23 and May 24, in which the specific time schedule of the 20 15-year examination for internal medicine doctors is as follows:
Examination subject examination date and time
Basic knowledge 201May16th 8: 30- 10: 00
Relevant professional knowledge11:00-12: 30
Professional knowledge 14: 00- 15: 30
Professional practical ability 16: 30- 18: 00
6 exam subjects
Internal medicine attending physician qualification examination subjects are divided into:? Basic knowledge? 、? Related professional knowledge? 、? Professional knowledge? 、? Professional practice ability? Wait for 4 subjects.
Among them? Basic knowledge? With what? Related professional knowledge? The examination contents of internal medicine and its sub-majors are the same. ? Professional knowledge? With what? Professional practice ability? The examination content of each sub-major of this subject is required by the examination outline of this sub-major.
7 test questions
Attending physician of internal medicine in 20 14 annual health professional technical qualification examination? Basic knowledge? 、? Related professional knowledge? 、? Professional knowledge? And then what? Professional practice ability? All four subjects are man-machine conversation tests. The examination time for each major and subject is 90 minutes.
The examination questions for attending physicians in internal medicine are as follows:
Examination categories, examination subjects and examination questions
internal medicine
Attending physician basic knowledge multiple choice questions
* * * Use the stem to do multiple-choice questions and case analysis questions.
Related professional knowledge
professional knowledge
Professional practical ability
First, multiple choice questions
It consists of 1 stem and 5 options, with the stem in front and the options behind. There are only 1 correct options in each question, and the rest are interference options.
1. The high concentration of estrogen and progesterone in the blood in the third trimester comes from
A. Adrenal cortex
B. Follicles
C. corpus luteum of pregnancy
D. placenta
E. ovary
Second, * * * dry multiple-choice questions with questions.
The topic is case summary, and on this basis, 2 ~ 6 independent questions are put forward to test candidates' simple application ability of the knowledge and skills they have learned. There are only 1 correct options in each question, and the rest are interference options. The answering process of this type of question is irreversible in the computer test, that is, you can't go back and modify the finished questions after entering the next question.
Example: The patient is a 40-year-old male. 1 year progressive palpitation, shortness of breath, abdominal distension and edema of lower limbs. Physical examination: The overall situation is good. Blood pressure130/90mmhg (17.3/12kpa). When the heart is percussion, the voiced boundary expands to both sides, the apical beat and the first heart sound are weakened, and there are 3/6 systolic murmurs at the apical part, and the heart rate 100 beats/min is regular. Wet rales at the bottom of both lungs. The jugular vein is dilated, 4cm below the liver rib, and the spleen is not up. Edema of both lower limbs (+). Electrocardiogram showed complete right bundle branch block.
1. The most likely diagnosis of patients is
A. rheumatic heart disease, mitral insufficiency
B. Hypertensive heart disease
C. Coronary heart disease with papillary muscle insufficiency
D. dilated cardiomyopathy
E. constrictive pericarditis
2. Among the following diseases, what is different from this one is that
A. Pericardial effusion
B. coronary heart disease
C. restrictive cardiomyopathy
D. constrictive pericarditis
E. Hypertrophic cardiomyopathy
3. In order to make further diagnosis, the following tests should be carried out.
A. dynamic electrocardiogram
X-ray chest film
C. echocardiography
D. myocardial enzyme spectrum
E. erythrocyte sedimentation rate
4. The following treatment measures are not suitable for this patient.
A. calcium antagonists
B. diuretics
C. Nitrate preparation
D.？ Receptor blocker
E. angiotensin converting enzyme inhibitors
Third, case analysis questions
Case analysis questions are currently only used for? Professional practice ability? Subject, in the form of man-machine dialogue.
This is a series of indefinite multiple-choice questions that simulate clinical situations. It is used to examine the knowledge, skills, thinking mode and comprehensive application ability of knowledge that candidates should have in clinical work, and also involves the understanding of evidence-based medicine. The examination contents include medical history collection, physical examination, selection of auxiliary examination items and explanation of examination results, possible diagnosis, differential diagnosis, evaluation of severity of illness, analysis of etiology and pathogenesis, treatment of disease, evaluation of prognosis and ethical and legal issues running through medical activities.
The topic of case analysis is to simulate clinical cases, and put forward some questions according to the thinking mode and content of clinical practical work. Questions can have a certain logical relationship according to the information provided. With the progress of the disease course, new information is constantly provided, and then corresponding problems are put forward. Candidates should choose all the correct options for each question according to the description and prompt information of the question type. The correct option may be 1 or above, and the score varies according to the importance of the option. Choose the right score and the wrong score until the score of this question is 0. In the man-machine dialogue exam, the process of answering case analysis questions is irreversible, that is, you can't go back and modify the answered questions after entering the next question.
Example: The patient is a 66-year-old male. I was unconscious for 4 hours due to lethargy, and was unconscious after two convulsions. I came to the hospital for emergency treatment. Recently 1 week, due to fever and cough after a cold, I went to the local health center for intravenous infusion of glucose solution and intramuscular injection of gentamicin. After 3 days, symptoms such as fatigue, dry mouth, polydipsia and polyuria became more and more serious. I came to the hospital for treatment. Physical examination: T 38.8℃, P 108 times/minute, blood pressure150/75 mmhg (20/10 kpa). Fat figure, dry lips, poor skin elasticity, no facial paralysis signs, no neck resistance. Wet rales can be heard in the lower left lung.
Question 1: The items that should be checked first in an emergency include
1. Serum potassium, sodium, chlorine and calcium
2. Lumbar puncture cerebrospinal fluid examination
3. Blood gas analysis
Urinary sugar
5. Blood lipids
6. Blood sugar
It is suggested that blood potassium is 3.7mmol/L, blood sodium 156mmol/L, blood chlorine10/0 mmol/L, blood calcium is 2.5mmol/L, blood sugar is 38.8mmol/L, and urine sugar is++. Blood ketone (-), urine ketone. AB 23mmol/L, Tco26mmol/L, BE -2, 8mmol/L, SaO2 0.92, plasma osmotic pressure 358 mmol/L. 。
Question 2: The current emergency diagnosis is
1. Severe coma
2. Cerebral vascular accident
3. Diabetic ketoacidosis coma
4. Diabetic lactic acidosis coma
5. Diabetic hyperosmolar ketosis coma
6. Non-insulin dependent (type II) diabetes mellitus
Question 3: Emergency measures include
1. Intravenous infusion of 5% glucose solution
2. Intravenous infusion of 5% sodium bicarbonate solution
3. Intravenous infusion of 0.45% sodium chloride solution or 0.9% sodium chloride solution
4. Intravenous infusion of 1.87% sodium lactate.
5. Dehydrate with 20% mannitol.
6. subcutaneous injection of routine insulin
It is suggested that 8 units of normal insulin, 3.0mmol/L of blood potassium, 65,438 0.50 mmol/L of blood sodium, 32.4mmol/L of blood sugar, 328 mmol/L of plasma osmotic pressure, 65,438 0 hours of intravenous injection of 0.45% sodium chloride solution and 0.9% sodium chloride solution, 65,438 000 ml of blood pressure.
Question 4: At present, the correct measures include
1. Intravenous potassium supplementation
2. Continue to drop 0.45% sodium chloride solution.
3. Intravenous infusion of 5% glucose solution
4. Plasma or whole blood can be infused intravenously.
5.25% human albumin can be injected intravenously.
6. Continue intravenous infusion of routine insulin, 4 ~ 6 units per hour.
Tip: After the above treatment 12 hours, the patient's dehydration is reduced and his consciousness is restored. Body temperature is 37.3℃. Blood potassium was 3.4mmol/L, blood sodium 144mmol/L, blood sugar 14.2mmol/L, blood urea nitrogen 10.8mmol/L, blood creatinine 133 mmol/L, and chest radiograph showed left lung infection.
Question 5: The measures that should be taken at present include
1. Use antibiotics
2. Continue intravenous potassium supplementation.
3. Intravenous infusion 10% glucose solution
4. Continue to drop 0.9% sodium chloride solution.
5. Encourage patients to drink water and eat.
6. Continue intravenous infusion of insulin to reduce blood sugar to the normal range.
Tip: After the above two days of treatment, the patient has been able to eat a semi-liquid diet, and still has a cough with yellow and sticky sputum. Body temperature is 37℃ ~ 38.2℃. The fasting blood glucose was 65438 04.8 mmol/L.
Question 6: The adjustments that should be made in the next treatment include
1. subcutaneous injection of routine insulin to control blood sugar
2. Subcutaneous injection of appropriate amount of insulin to control blood sugar.
3. Control diet according to diabetes requirements
4. Give sulfonylurea oral hypoglycemic agents for treatment.
5. Give biguanides oral hypoglycemic agents.
6. Continue intravenous infusion of routine insulin.
7. Continue to use antibiotics
8 performance management
The examination results of attending physicians in internal medicine can be found on the only official website, China Health Talent Network, with my admission ticket number and certificate number (ID card, military officer's card, passport, etc.). ) It is filled in at the time of registration, usually around July every year.
The two-year cycle rolling management method is implemented for the scores of the corresponding majors in the examination of internal medicine attending physicians. You can get a vocational qualification certificate if you pass the examination of four subjects in the same major for two consecutive examination years. Different majors (including majors and sub-majors), the qualified scores of each subject shall not be calculated as the same major. Those who have participated in the examination of attending physicians in internal medicine shall use the original file number when signing up for the examination of other subjects within the prescribed time limit. For those who pass the single-subject examination within the validity period and pass the examination in the field due to job changes, the local personnel department will issue a vocational qualification certificate.
Example:
1.In 2003, candidate A applied for four subjects: basic knowledge, related professional knowledge, professional knowledge and professional practice ability of internal medicine attending physicians, and passed the basic knowledge and professional knowledge after the examination. In 2004, the report assessed the relevant professional knowledge and professional practice ability of internal medicine attending physicians. If both subjects pass, the attending physician exam will pass. If the relevant professional knowledge passes, but the professional practice ability fails, the score of candidate A in 2003 has been invalidated, so candidate A needs to pass at least three subjects of basic knowledge, professional knowledge and professional practice ability of internal medicine attending physician in 2005 to pass the examination of internal medicine attending physician.
2. Candidates from different places In 2003, candidate B applied for the basic knowledge, relevant professional knowledge, professional knowledge and professional practice ability of the attending physician of internal medicine in Beijing, and passed the examination. Due to job transfer, I applied for the relevant professional knowledge and professional practice ability of Tianjin internal medicine attending physician in 2004. If he passes both subjects, he will pass the examination of attending physician in internal medicine, and the data will be synthesized and counted by the local personnel department in Tianjin. If the relevant professional knowledge passes and the professional practice ability fails, the results of candidate B in 2003 have been invalidated, so candidate B needs to pass at least three subjects of basic knowledge, professional knowledge and professional practice ability of attending physician in 2005 before he can pass the examination of attending physician in internal medicine.
9 pass the standard
The test score is calculated with 100 as the full score of each subject. A score of 60 in each subject is qualified, and the test results are valid for 2 years. Those who have passed all 4 subjects within 2 years may apply for professional and technical qualifications of this level.
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