本文的目的在探討全民健康保險制度實施後，對於教學醫院專科醫師培養之影響，以及臨床教學所面臨的問題以及其如何造成困擾。方法學上，作者以焦點團體的方式，針對某醫學中心之臨床教師進行訪談，以為資料收集的方法，再以內容分析的方法，將所得的資料進行分析。結果顯示，在目前健保體制下臨床醫學教育之影響主要內容包括：營運與教學無法兼顧以致影響教學品質，教學成本無法獲得合理給付以致學無以印證，教學醫院評鑑制度之精神無法落實以致教學品質無法達到要求，給付領導醫療以致醫學教育受到影響。有鑑於專科醫師培養深受醫院之營運，以及保險制度之影響。作者建議，應考慮結合醫療保險制度與國家社會的需要，規劃適當的專科醫師培養計畫；至於進一步的發現、討論、與可能的因應辦法將於文中提出，以為台灣醫學教育之參考。

　　　　　They purpose of this paper is to explore the difficulties in training physicians after the implementation of the national health insurance system in Taiwan. The data were collected by focus group interview and then analyzed using content analysis. Faculty members from a medical center in southern Taiwan were recruited for this study. The results showed that under the current insurance system there were four areas that have had negative impact on clinical medical education. These include conflict between the managing of hospitals and the training of physicians, insufficient reimbursement to cover the cost of teaching, exploitation of teaching hospitals accreditation system which then affect the quality of clinical teaching, and more emphasis on profits than on medical care. Since the training of physicians is greatly affected by the management of hospitals and the national insurance system, we suggest that the nation's medical insurance policy be integrated and accredited to adopt an appropriate plan for medical training in order to meet the needs of the public. As a reference for future medical education in Taiwan, details of our discoveries, analyses, and a possible solution discussed.