外國醫學生（包括波蘭醫學生）是教育部總額管制下的一個漏洞，開放外國醫學生來台行醫，是否違背教育部「總額管制」的目的？這些外國醫學畢業生，他們的學習場所並無接受國家的監督（醫學院評鑑、教學醫院評鑑），國我如何保證這些國外醫學畢業生的學習成果和國內的醫學畢業生水平相當(亦即須符合「大學辦理國外學歷採認辦法」第八條規定:「國外學歷…修業期限、修習課程，應與國內同級同類學校規定相當。」之要求)？除了學歷的採認之外，「實習期滿成績及格」的認定在本案中是關鍵，因為由前述的爭執歷史過程中，皆未有相關外國醫學學歷的爭執，大家的爭議之處都是「實習問題」。 所以，選擇「國外醫學畢業生應國家醫師考試法律問題之研究—以國人取得波蘭醫學院畢業證書為例」這個題目作為研究的對象，將使吾人學習到： 1. 什麼職業算是「專門職業及技術人員」，「醫師」這個職業算是「專門職業及技術人員」之一種嗎?「醫師專技」的工作權和一般的工作權有何不同? 2. 我國針對「本國」、「外國」、「大陸地區」的醫學學歷的審查和採認有不同的標準嗎? 我國負責學歷採認的政府機關和其法源依據是甚麼? 如果有不同的採認標準，則對持外國醫學學歷的應國家醫師考試的應考人而言，會有甚麼影響? 3. 考選部據「考選部醫師牙醫師審議委員會」之決議做成的「暫准報名，緩發及格證書」的行政行為，其法律性質為何? 因為有部份應考人在簽完此份行政契約之後，卻又在考試過後向台灣高等法院聲請假處分，所以有關「實習期滿成績及格」之認定所產生的爭議，在本文中會隨同「信賴保護原則」，「不確定法律概念之適用」等相關議題一起討論。 4. 從比較法的觀點，我們會思考國內現有的國家醫師考照制度，和美國、日本、韓國的國家醫師考照制度，以及美國、日本、韓國對於持外國醫學學歷者到他們國家去參加國家醫師考試的時候，外國人需準備何種學歷證件去做學歷審查，將會面對何種考試去採認他們的學歷、資格。 由以上的研究，我們發現：「實習期滿成績及格」的認定隨著考選部醫審會的調查結果，在不同時期有不同的認定標準，本文肯定最終提出凡「以國外學歷報考者，須繳驗國內醫療機構出具之實習期滿成績及格證明」的決定，而非僅適用在波蘭醫學畢業生。醫學生招生總額管制本文也肯任有其存在的必要性，但是對於管制的醫學生招生總數和法源依據有再檢討的必要。

本研究旨在探討「健康、性格、習慣量表(HPH)」的臨床效度。HPH最初是由柯永河教授(民84)編製，後來廣泛使用在國內臨床場域中。發展至今已有中上程度的信效度支持，但過去較缺乏臨床上區辨與構念效度的研究，因此本研究旨在探討HPH區辨不同疾患的能力，以及以臨床疾患為受試時量尺之構念效度。 本研究回顧國內外類似測驗─MMPI、KMHQ、MCMI─的發展軌跡，並參照前人作法來進行HPH的臨床區辨效度研究。初步以臨床場域中常見的精神分裂症、重鬱症、低落型情感疾患、焦慮疾患，共257名患者為受試。先以共變數分析(ANCOVA)探討控制人口與臨床變項後，不同疾患組別在HPH的A、B、D類量尺的影響。再進一步使用羅吉斯迴歸(logistic regression)探討哪些量尺及其組合可以區辨兩兩疾患間的差異。最後，本研究也進行HPH的探索性因素分析(exploratory factor analysis)，以檢驗其臨床上的因素結構。 本研究發現，精神分裂症(A1)、躁症傾向(A2)、憂鬱自殺類(A3、B4、A4)、心理功能與健康(D1、D3、D4、D5、D6)量尺在共變數分析上的差異情形與假設大致相符，後續討論分析也支持強迫症(B5)量尺效度。羅吉斯迴歸中，A1、A3、B4、B5能在兩兩疾患間區辨有顯著預測力。其中A1能在精神分裂症與其他三組疾患的兩兩區辨中預測，A3能在重鬱症與另外兩組(精神分裂症、焦慮症)的兩兩區辨中預測，B4能在低落型情感與精神分裂症的兩兩區辨中預測，B5能在強迫症與其他疾患間的兩兩區辨中預測。但是在重鬱症與低落型情感疾患間，以及低落型情感與焦慮疾患間，沒有量尺能在兩者的區辨中有顯著預測力。而各兩兩疾患間整體區辨效果有中至高度的關聯性，分類正確率也多有七成以上，顯示HPH量表在臨床上的區辨效度獲得支持。 構念效度部分，A、D類量尺因素結構與當初編製的每個量尺構念相近，B類量尺構念雖與原量尺略有不同，但仍不違背原量尺編製架構，因此構念效度亦獲得支持。不過各量尺仍有值得編修之處，討論一節中針對結果提出HPH後續編修之建議。 最後，本研究也將此結果之臨床實務應用於討論一節中詳述，以供後續研究與實務者參考。 / The purpose of this study is to examine the clinical validity of the Health, Personality, and Habit Test (HPH). The HPH was developed by Dr. Yung-Ho Ko in 1995, and has been widely used in clinical settings. The HPH has demonstrated appropriate reliability and validity, but little research has been done on its differential and construct validity in the clinical settings. Therefore, the aim of this study is to explore the HPH’s ability to differentiate between disorders and its construct validity in clinical context. This research reviewed the developments of similar tests, such as MMPI, KMHQ, and MCMI, and examined validity of the HPH with the same methods. Subjects were 257 patients who suffered from common disorders in clinical settings, including schizophrenia, major depression, dysthymia, and anxiety disorders. ANCOVA was first used to explore whether different disorders have an effect on category A, B, and D scales after controlling demographic and clinical variables. Next, logistic regression was used to clarify which scales and combinations can differentiate between two of four disorders. Finally, exploratory factor analysis was conducted to examine the structure of HPH in clinical setting. The results of ANCOVA showed that the differences of schizophrenia scale (A1), manic scale (A2), depression/suicide scales (A3, B4, & A4), obsessive-compulsive disorder (OCD) scale (B5), and psychological function and health scales (D1, D3, D4, D5, D6) were partly consistent with assumptions, supporting the differential validity of HPH. The results of logistic regression analysis also supported the validity of A1, A3, B4, and B5 scales. More specifically, A1 was able to differentiate schizophrenia from any other three disorders, A3 was able to differentiate MDD from schizophrenia and anxiety disorders, B4 was able to differentiate dysthymia from schizophrenia, and B5 was able to differentiate OCD from other disorders. However, none of the scales was able to differentiate MDD from dysthymia, nor were they able to differentiate dysthymia from anxiety disorders. Moreover, each of the logistic regression functions showed moderate to high correlations, and most of them achieved high overall hit rates (above 70%), providing support for the clinical differential validity of the HPH. As for construct validity, these factors in category A and D scales were essentially similar to original scales. Similarly, factors in category B scales were compatible to original scales though difference was found. In sum, these results lent support to the construct validity of the HPH in the clinical settings. However, refining of the scales is needed and suggestions are discussed. Finally, the practical uses of the findings were also discussed.