Medical education should not be reduced to manufacturing "noble doctors"

The reason is still the academic problem. This is the third time he has participated in a special medical recruitment meeting since he was a senior. The vast majority of the participants were small hospitals in county towns, and only two of the top three hospitals. Even so, if the recruitment position involves clinical work, the qualification requirements are at least a master's degree.

The academic threshold has made many students in He Wei choose to "escape employment". The job fair on that day also seemed relatively deserted: in a job fair with more than 30 hospitals, there were less than 200 students. Most medical undergraduates have shifted their focus to the battlefield of postgraduate entrance examination.

Among medical students, there is a saying that if undergraduates do not take the postgraduate study, they can only work as temporary workers in the hospital; if the graduate students do not go abroad to study, it is equivalent to studying for three more years in vain, because the graduate students can not find An ideal clinical job.

Difficulties in employment and recruitment

This argument is not without basis. According to a survey conducted by Max in 2010, the unemployment rate of graduates of clinical medicine after half a year is 23.1%, which is a high level in many majors.

A deputy dean of a public health school in Yunnan also confirmed this to a reporter from China Youth Daily. Nearly 95% of the undergraduates in the medical school where he works choose to take the postgraduate examination, half of them are admitted to the school, and a few more excellent candidates are admitted to famous schools such as Peking University School of Medicine and Tongji University. The vast majority of students choose to take the exam next year. In the end, only a small percentage of students choose to work directly in the community or county and township hospitals in the city.

At the same time, it is difficult for some primary medical units to recruit people.

Ju Honghua, a member of the National Committee of the Chinese People's Political Consultative Conference and vice president of Mongolian Hospital in Wulan County, Qinghai Province, told a reporter from China Youth Daily that their hospital had recently recruited a newcomer 10 years ago, and the largest department of their hospital, internal medicine, 3 doctors.

Wulan County Mongolian Hospital belongs to the second-class second-class hospital, with 50 beds. According to the regulations of the Ministry of Health, at least 65 health professionals are required. However, so far, with the support staff, the Mongolian hospital has only 42 people. In 2008, Juhonghua went to a province in the east with the National Committee of the Chinese People's Political Consultative Conference. If he didn't envy others, he envyed many doctors. She found that there are many people, and even the topics covered can cover the three age groups of the old, middle-aged and young: some talk about how the granddaughter is good, some talk about how the son is scouring, and how to talk about the blind date. Unlike the Mongolian hospital, even the topic of a young man can't talk about it.

Ju Honghua said that in recent years, the hardware conditions of grass-roots health institutions have gradually improved, the house is bigger, and the equipment is available, but the software has not changed greatly. One of the consequences of this is that X-ray machine, B ultrasound There are both mechanical and biochemical analyzers, but they haven't been opened. "No one will make it open. It will cost a lot of electricity to open up." Ju Honghua looks forward to the newcomer. "We don't need a doctorate or a master's degree, not even an undergraduate, as long as you have formal medical education and clinical experience. . "

Feng Shiliang, president of the Liaoning Diabetes Treatment Center who has been a member of the National Committee of the Chinese People's Political Consultative Conference for 15 years, was deeply touched by this. Every year, he has to visit various cities and counties in China. His team found in the survey that there is currently a shortage of qualified general practitioners in urgent need at the grassroots level in China. There are only more than 80,000 registered general practitioners, accounting for the total number of practicing physicians 4.3%. In countries and regions that value primary health, general practitioners can generally account for 1/3 or more than 1/2 of the total number of physicians.

Feng Shiliang lamented that the employment of medical students has entered a situation where the employment of large hospitals is difficult to coexist with the recruitment of small hospitals. The result can only be that young doctors cannot get real exercise, and the development of small hospitals can hardly be improved. .

Medical education reduced to a machine for training "noble doctors"

Some people attributed this dilemma to the "realm" of medical students, saying that they had misunderstandings in their career choices and were unwilling to go down to the grassroots and enter the community.

There is indeed a big difference in salary between the top three hospitals and community hospitals. Feng Shiliang told the China Youth Daily that in Shenyang, the average salary of medical graduates employed in the top three hospitals was about 3,300 yuan in the first year, while undergraduates in small hospitals only had about 1,800 yuan.

But this is not the whole reason. "Even if we want to go to the community hospital, we can't do it." He Wei complained to reporters that the current medical students still learn how to overcome certain diseases in the school, while working as a general practitioner in the community, the main job is to manage chronic diseases, and The relationship between the teaching in the school is not big, and there is a deviation from the original intention of the students to study medicine, so the general medical students are reluctant to choose and it is difficult to be qualified for the work of community medical institutions.

There is also an unavoidable fact that the current medical education based on specialties has gradually become a machine for training "noble doctors". An old professor who has worked in Peking University ’s medical department for nearly 30 years told reporters that on the wheel of this machine, if students want to get ahead, they only have to keep running forward, from undergraduate to master, and then to doctor. Until it is possible to obtain a doctor ’s qualification certificate and become a “prospective master” of a specific subject; however, it is difficult to train a decent general practitioner.

"The actual medical needs have undergone major changes, but medical education has not kept up." Feng Shiliang said.

He gave an example. Some leaders came from the county, and a deputy township chief put on a banquet to entertain him. During this time, the deputy township chief drank a lot of wine, his blushing neck rose, and his breathing was quickened. The dermatology specialist in the hospital failed to see why. In the end, the township chief died on the way to the county hospital.

Feng Shiliang told reporters that this is a very common disease, but the primary medical staff did not have a correct understanding and timely rescue. This phenomenon also exacerbated the difficulty of seeing a doctor on another level. He said that after the Cultural Revolution, the state began to pay attention to specialization in the training of doctors, which greatly strengthened the professionalism of doctors ’professions, which brought doctors many conveniences in scientific research and high-end medical research. But on the other hand, it objectively neglected the need for "small" people at the grassroots level.

In 2010, the internationally renowned medical journal "The Lancet" published the "Cultivation of Medical and Health Talents in the New Century: Reforming Medical Education to Strengthen the Health System in an Interdependent World" jointly written by 20 internationally renowned medical educators. The article summarizes the medical education experience of the past one hundred years and looks forward to the reform of medical education in the next one hundred years. The article mentions that at present, medicine is brewing a new revolution, and its leading reform is mainly based on community health promotion. The establishment and implementation of the general practitioner training system has become the core of this new change.

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