CPPCC Member and Vice President of the Chinese Stomatological Association Wang Songling Proposes Reconstructing the Professional Degree Education System by Learning from International Practices
Mar 13, 2018 16:45
CST Updated
16:45
During the Two Sessions, Professor Wang Songling, a member of the National Committee of the Chinese People's Political Consultative Conference (CPPCC), Vice President of the Chinese Stomatological Association, and Vice President of Capital Medical University, offered recommendations for current medical education reform. He proposed drawing on international experience to reconstruct the professional degree education system, simplifying the structure of clinical medicine professional degrees, expanding the scope and scale of enrollment for the integrated “5+3” medical student program, and rationally planning and implementing financial investment in clinical teaching.
Following the 2014 joint issuance by seven national ministries and commissions to vigorously advance medical education reform, in July 2017, the state once again promulgated the “Opinions of the General Office of the State Council on Deepening Medical-Educational Collaboration and Further Advancing the Reform and Development of Medical Education” (hereinafter referred to as the “Opinions”). This document further clarified the goals for medical education reform over the next decade or more: by 2020, breakthroughs would be achieved in reforming the management systems and mechanisms of medical education; incentives for the utilization of medical talent would be improved; and a clinical medical talent training system with the “5+3” model as the mainstay and the “3+2” model as a supplement would be basically established.
By 2030, the policy environment for the reform and development of medical education will be further improved, a standardized and regulated system for cultivating medical professionals with Chinese characteristics will be more sound, and the medical workforce will basically meet the needs of building a Healthy China.
It should be said that,Establishing a comprehensive medical education and training system that integrates undergraduate medical education, postgraduate education, and continuing medical education is an internationally recognized fundamental principle for cultivating medical professionals.。
China’s establishment of a medical education system dominated by the “5+3” model as the focal point of medical education reform is an epoch-making measure that aligns with the principles of medical education and enhances the quality of clinical medicine talent training.
In the development of the postgraduate medical education system, degree policies serve as crucial incentives and support mechanisms. Therefore, the state has proposed a framework that integrates standardized residency training with professional master’s degree programs in clinical medicine. This approach represents the correct direction, aligning with the existing foundation of China’s medical education system and the future needs of physician workforce development.
The current overall framework design for medical education reform still faces the following major issues in practical implementation.
Poor articulation between undergraduate education and postgraduate education. The "Opinions" clarify that the "5+3" model constitutes the mainstay of a comprehensive medical education system, meaning that medical students must undergo three years of professional degree graduate training or residency training after completing their five-year undergraduate studies to become qualified physicians capable of practicing independently.
Under the current admissions policy, most five-year undergraduate students must still pass the national unified examination to enter professional degree postgraduate programs. This rigorous examination system compels medical students to devote their valuable internship period in the fifth year to exam preparation, severely undermining the quality of undergraduate education.
Although some universities can recruit medical students for the “5+3” integrated long-term program, allowing these students to be exempt from the master’s entrance examination, this group constitutes a small proportion, accounting for less than one-fifth of all professional degree master’s students.
The construction of the medical education system lacks supporting financial resources. The clinical faculty and clinical teaching system are important components of the medical talent training system, while in China's current medical education investment mechanism,Insufficient consideration has been given to the funding support for clinical teaching mentorship and the financial backing required during the clinical training phase of medical students.。
This has resulted in contradictions such as the current reliance on clinical instructors’ sense of responsibility and dedication for clinical teaching, and the disparity in compensation between professional master’s students in clinical medicine and resident physicians despite performing identical work. These issues are highly detrimental to the effective implementation and quality assurance of clinical training and education.
The hierarchical alignment between professional degree programs and industry training is unreasonable. The "Opinions" link the two stages of postgraduate medical education (residency training and fellowship training) separately with the two levels of clinical medicine professional degree education (master’s and doctoral degrees). This approach is incompatible with the long-term needs of building China’s physician workforce and fails to meet the inherent coordination requirements of the current medical education degree system.
For instance, dividing the professional degree education in clinical medicine into two stages—a three-year master’s program and a three-to-five-year doctoral program—and positioning it as a key pathway for training qualified physicians has resulted in excessive time and financial costs for clinical practitioners to obtain doctoral degrees. This situation is inconsistent with the urgent need in China to optimize the educational qualification structure of its physician workforce by increasing the proportion of doctorate holders.
1. To this end, we call for drawing on international experience to rebuild the professional degree education system.Medical education and medical degree systems vary across countries, yet they all adhere to the fundamental principles of long-cycle elite education and are aligned with each nation’s needs for cultivating medical talent and developing its healthcare service system. In light of this, we call for further liberalization in the design of China’s professional master’s degrees in clinical medicine, breaking away from the entrenched framework of academic degree education:
2. Call for simplifying the setup of professional degree programs in clinical medicine.Establish a single-tier doctoral degree system: After completing the five-year undergraduate program in clinical medicine, students enter a three-year professional degree program in clinical medicine that is integrated with standardized residency training. Those who successfully complete the program are awarded the Doctor of Clinical Medicine degree.
Upon completion of the “5+3” training program, some physicians proceed to further complete specialist physician training. To establish a medical workforce with a rational structural composition, the number of specialists undergoing training should be capped at no more than one-third of the total physician population. It is recommended that individuals who successfully complete specialist physician training be awarded a professional doctorate in their specialty, or alternatively, that such training be decoupled from academic degree education.
3. Expand the scope and scale of enrollment for the "5+3" integrated medical student program.It is recommended to gradually expand the “5+3” integrated program to all eligible medical schools. For universities that currently enroll students in this program, enrollment quotas should be increased, with the aim of establishing the “5+3” integrated model as the primary pathway for training clinical medicine doctoral candidates in the future.
4. Rational Planning and Implementation of Financial Investment in Clinical Teaching. It is recommended that the national education and health administrative authorities clarify fiscal investment policies for undergraduate clinical medicine and professional degree programs, designating teaching allowances for clinical instructors and clinical work stipends for graduate students in clinical professional degrees as separate budgetary categories within fiscal allocations.
Local education and health administrative departments shall collaboratively formulate budgets and policies for fund utilization, reasonably address financial support for clinical teaching and training, effectively advance the development of the clinical teaching faculty, and ensure the normal operation of clinical teaching.
Source: Today's Dentistry, China Medical Tribune