| Summary: | 碩士 === 國立陽明大學 === 公共衛生研究所 === 99 === Vietnam’s economic reforms have brought about remarkable achievements in socio-economic development. However, there are concerns about the health care system in response to the high demand of services and changing disease patterns. This thesis consists of three reviews and one cross-sectional study in Vietnam referring to those issues.
The first review study presented the current medical education in Vietnam. Medical training lasts either four or six years, with competitive graduates attending residency programs following graduation. While examinations are required to graduate, the lack of a national licensing exam makes it difficult to ensure that a nation-wide standard of quality exists, both at the medical universities themselves as well as amongst the doctors graduating from them. The development and institution of a national exam would introduce a standard of training throughout Vietnam’s medical education system. It is expected that increase the competence of doctor as important measure to decrease the volume overload at big hospitals.
The second review explored physician scientists training and proposed the best way which might be adopted to develop and strengthen future research manpower in Vietnam. Medical Scientist Training Programs are successful models for the training of physician scientists with 83% of graduates pursuing academic careers and 78% obtaining National Institute of Health grants. Training at the postgraduate level also shows promising outcomes, with lower costs in terms of both time and money.
The third review showcases the burden of changing disease patterns through tobacco prevalence as lifestyle disease. In adults, medical students, and students from 13-15 years old, the prevalence of smoking cigarettes was markedly higher than the prevalence of using tobacco products other than cigarettes. The prevalence of second hand smoking at home and work place was significantly high. More robust and integrated programs in terms of tax, health care, and health education should be implemented to protect current smokers and non-smokers alike from the devastating effects of tobacco.
Finally, the cross-sectional study displays a delayed response to the transforming morbidity pattern in Vietnam. Discussed are the levels of diabetes knowledge in parents of diabetic children and how it relates to the treatment patterns of patients. Creating educational interventions is an urgent need to improve diabetes care for those children.
In conclusion, this thesis suggests that multi and comprehensive strategies should be developed and implemented in order to improve health for Vietnamese citizens. Creating more education programs requires immediate action. To physicians, National Examination Program to standardize and upgrade the quality of training is a prospective short term approach. Long term strategies should include adopting new training frameworks to solve the health problems of Vietnam.
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