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Why Becoming A Doctor In China Is No Longer A Dream Job

Dr Lu, in Shanghai
Dr Lu, in Shanghai
Shen Nianzu and Sun Li

BEIJING - In many countries, being a doctor is regarded as a highly prestigious job. So why are so many Chinese medical students dropping out in the middle of their studies?

According to Li Ling, a professor at the National Development Research Institute of Beijing University who is also China’s medical reform expert, “China trains about 600,000 medical students each year, but only about 100,000 of them actually become doctors.”

Dr. Zhang Jingxiu, from the MyCOS Research Institute, a Beijing-based education consultancy, believes that the situation is not as serious as it looks, because the 600,000 include students in every medical and health-related field, including those whose specialty doesn’t require a medical degree.

However, he agrees that fewer and fewer students regard becoming a doctor as their dream career. Even doctors who have worked in hospitals for years are starting to leave, for various reasons.

The Lilac Garden (DXY.cn), an online community for Chinese health care professionals, doctors and pharmacies, conducted a survey recently and found out that as many as 89% of doctors have entertained the idea of quitting the profession.

Although medical practitioners will only resign as a last resort, undergraduate junior doctors are the most likely to change their mind.

Another survey conducted by Wang Hong Man, professor at the Institute of Medical Humanities at Beijing University, supports the statement. According to the investigation, half of the medical students are not confident about future employment prospects.

Long studies, low salaries, long hours, intense psychological pressure and patient-doctor tensions eventually bring home the realization that this is not what they want to do in life. These are the major factors causing the flight of these “white-coated angels.”

Chutian, who graduated in 2006 from the prestigious Beijing University Medical School, quit his hospital job after only four years to become a researcher. He rather enjoys a life which doesn’t involve emergency calls and in which he is guaranteed summer and winter vacations.

Qin Xiao only just started to be a physician two months ago. He earns less than $400 a month and is already feeling bitter, in particular because it was his parents who pushed him into medical study, believing it would “guarantee a good income.”

Better salaries as medical reps

Many others have decided to leave their hospital jobs to become drug or medical equipment representatives for large multi-internationals like Bayer, Johnson & Johnson, or General Motors. “The income is definitely better than being a doctor while one’s medical knowledge is still very useful,” explains Zhao Hui who chose to leave.

Chutian says some of his classmates make up to $80,000 a year working as pharmaceutical company representatives, although he talks about their career choice scornfully.

In contrast with the decline in the supply of doctors is the rising need of China’s patients. According to China’s Health Statistics Yearbook 2012, the number of patients visiting Chinese hospitals increased from 4 billion in 2005 to 6.2 billion in 2011, whereas inpatient admissions soared from 71 million in 2005 to more than double – 152 million in 2011. Meanwhile, the increase in the numbers of practicing physicians is far lower than necessary. Between 2008 and 2011, the number of doctors only increased by 170,000.

China has the biggest number of medical practictioners in the world, according to the World Health Organization (WHO): 2,466,000. It also has the world’s biggest population: 1.3 billion. In comparison, America has 0.3 billion people with approximately 750,000 doctors.

Cui Xiaobo, professor at the Capital University of Medical Sciences, says that five years ago China’s Ministry of Health had already been alerted to the growing problem of qualified medical graduates refusing to become medical practitioners. The government has not found a way yet to attract doctors back to the medical profession.

Lin Hui, an undergraduate at the China and Beijing Union Medical College, was chosen a year ago to study at the University of California, San Francisco School of Medicine (UCSF). “In the U.S., doctors are considered as the elite. After four years of university, students have to pass very competitive exams to go into medical school. Therefore the ones who have chosen this path have given it careful consideration, it is not the result of a temporary enthusiasm, or some shallow or one-sided understanding of the profession like some Chinese students. Under such circumstances, it’s unlikely they’d ever give up their career as a doctor,” Lin Hui pointed out.

Even if the phenomenon of a brain drain of doctors is not immediately obvious, and China’s top medical schools still attract a sufficient number of intelligent students, according to a survey of 61 major medical schools conducted by the Economic Observer, overall national admission scores for medical students have decreased in recent years.

“Originally, it was the most intelligent, most generous and most moral who chose to become doctors. Doctors were the rulers of social morality and social welfare. When such people do not wish to become doctors, it’s a great sadness for medical education and a country’s health system,” Cui Xiaobo remarked with great concern.

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FOCUS: Russia-Ukraine War

How Vulnerable Are The Russians In Crimea?

Ukraine has stepped up attacks on the occupied Crimean peninsula, and Russia is doing all within its power to deny how vulnerable it has become.

Photograph of the Russian Black Sea Fleet headquarters with smoke rising above it after a Ukrainian missile strike.

September 22, 2023, Sevastopol, Crimea, Russia: Smoke rises over the Russian Black Sea Fleet headquarters after a Ukrainian missile strike.

Kyrylo Danylchenko

This article was updated Sept. 26, 2023 at 6:00 p.m.

Russian authorities are making a concerted effort to downplay and even deny the recent missile strikes in Russia-occupied Crimea.

Stay up-to-date with the latest on the Russia-Ukraine war, with our exclusive international coverage.

Sign up to our free daily newsletter.

Media coverage in Russia of these events has been intentionally subdued, with top military spokesperson Igor Konashenkov offering no response to an attack on Russian Black Sea Fleet headquarters in the Crimean city of Sevastopol, or the alleged downing last week of Russian Su-24 aircraft by Ukrainian Air Defense.

The response from this and other strikes on the Crimean peninsula and surrounding waters of the Black Sea has alternated between complete silence and propagating falsehoods. One notable example of the latter was the claim that the Russian headquarters building of the Black Sea fleet that was hit Friday was empty and that the multiple explosions were mere routine training exercises.

Ukraine claimed on Monday that the attack killed Admiral Viktor Sokolov, the commander of Russia's Black Sea Fleet. "After the strike on the headquarters of the Russian Black Sea Fleet, 34 officers died, including the commander of the Russian Black Sea Fleet. Another 105 occupiers were wounded. The headquarters building cannot be restored," the Ukrainian special forces said via Telegram.

But Sokolov was seen on state television on Tuesday, just one day after Ukraine claimed he'd been killed. The Russian Defense Ministry released footage of the admiral partaking in a video conference with top admirals and chiefs, including Defense Minister Sergei Shoigu, though there was no verification of the date of the event.

Moscow has been similarly obtuse following other reports of missiles strikes this month on Crimea. Russian authorities have declared that all missiles have been intercepted by a submarine and a structure called "VDK Minsk", which itself was severely damaged following a Ukrainian airstrike on Sept. 13. The Russians likewise dismissed reports of a fire at the headquarters of the Black Sea Fleet, attributing it to a mundane explosion caused by swamp gas.

Kremlin spokesman Dmitry Peskov has refrained from commenting on the military situation in Crimea and elsewhere, continuing to repeat that everything is “proceeding as planned.”

Why is Crimea such a touchy topic? And why is it proving to be so hard to defend?

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