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.

Support Worldcrunch
We are grateful for reader support to continue our unique mission of delivering in English the best international journalism, regardless of language or geography. Click here to contribute whatever you can. Merci!

Cancel Tintin? Spotting Racist Imagery In Comics Around The World

Some of the world's most beloved comics and graphic novels contain depictions that are antiquated at best and downright racist at worst.

Tintin has been criticized for its depictions of people of color

PARIS — From the anti-Semitic children's books of Nazi Germany to the many racist caricatures of Asian, African or Indigenous people in the 20th century, comics have long contained prejudiced, sexist and xenophobic stereotypes.

These publications have been rightfully criticized and, in some cases, replaced with more diverse and accurate narratives created by a broader range of artists and writers. Earlier this year, the publisher of beloved American author Dr. Seuss announced it would no longer distribute six of his books due to racist and offensive imagery of Black people, Asians and Arabs.

Still, some are pushing back, saying that this kind of unwarranted "cancelling" threatens freedom of expression and the sanctity of beloved, and often nostalgic, imagery.

Here are examples from three countries around the world about how people are handling the debate and sketching the future of comics.

In Canada, Torching Tintin & Astérix

Still image of an Asterix movie showing Obelix with a stereotypical North American Indigenous woman

A scene from the 1994 film "Asterix Conquers America" — Photo: Extrafilm

  • The Adventures of Tintin and The Adventures of Asterix both emerged in French-speaking Europe during the 20th century and quickly developed global audiences. Tintin has been translated into over 70 languages and Asterix into 111, and both were adapted to different media including television, film and even a theme park.
  • But the comic books have also been called out for controversial depictions of certain groups, including North American Indigenous peoples. And as Radio-Canada recently reported, one group of French-speaking schools in Ontario found the texts so offensive that — in a show of solidarity with the country's First Nations — they decided to go ahead and burn the books.
  • The report, not surprisingly, stirred up a pretty fiery debate on the issues of free speech and what some refer to as "cancel culture."
  • Suzy Kies, co-chair of the Indigenous Peoples Commission of Prime Minister Justin Trudeau's Liberal Party, was involved in the burning and said in a video, "We bury the ashes of racism, discrimination and stereotypes in the hope that we will grow up in an inclusive country where everyone can live in prosperity and security."
  • She and others fault the Tintin and Asterix books for depictions that oversexualize Indigenous peoples and paint them as lazy, alcoholic and "savage."
  • But now, Kies's identity as being of Abenaki and Montagnais-Naskape descent is under question and she has resigned from her chair position. For his part, Prime Minister Trudeau said he is "never in favor of burning books," but added the importance of reconciliation with First Nations, particularly with the recent discoveries of unmarked mass graves at residential schools that Indigenous children were forced to attend.
  • Maybe instead of fighting over these comics (which are rarely historically accurate), attention should be focused on projects like This Place, a graphic novel anthology telling Canadian history through the perspectives of Indigenous people from around the country.

France's Favorite Cowboy Shoots For More Diversity

Cover of Lucky Luke's 81st album, A Cowboy in High Cotton
The latest Lucky Luke includes the perspective of Black Americans in the Wild West — Photo: Cinebook
  • In a more progressive model for rethinking cartoons with long — and complicated — legacies, Lucky Luke in France is taking a different direction. Telling the story of a cowboy in the Wild West, Lucky Luke was and continues to be a staple for many French children. And yet, despite being in print since the 1940s, the series is notably lacking in terms of diversity. The only edition featuring Black characters — Going up the Mississippi — was filled with racial stereotypes.
  • But in 2020, well-known French cartoonists Julien Berjeaut (known as Jul) and Hervé Darmenton (known as Achdé) took on the challenge of a more inclusive Lucky Luke. With its 81st album, Un Cow-Boy Dans Le Coton (A Cowboy in High Cotton), they changed the perspective to focus on recently freed Black slaves.
  • The plot begins like a typical Lucky Luke narrative. He inherits a Southern plantation, but then decides to redistribute the land to Black farmers. The other main character is inspired by Bass Reeves, who was the first Black deputy U.S. marshal west of the Mississippi. And Lucky Luke must rely on Reeves to go up against the real enemy: the Ku Klux Klan.
  • Berjeaut interviewed French activists and scholars to better understand the representation of Black people in popular culture. Despite facing criticism in some conservative media, Un Cow-Boy Dans le Coton ended up being the best selling comic book in France last year.

Japan Gets A Manga Makeover

Cover of Unrivaled NAOMI Tenkaichi, a manga featuring tennis star Naomi Osaka
The cover of Unrivaled NAOMI Tenkaichi — Photo: @nakayosi_manga/Twitter
  • Outside of France and Belgium, Japan arguably has the largest market for graphic novels, or manga, which first developed in the late 19th century. And like their European counterparts, certain manga titles have been accused of using racist tropes.
  • One example is the character Mr. Popo, a genie from the popular Dragon Ball series who has been cited for having offensive features. But as author and Japan Times columnist Baye McNeil told the Christian Science Monitor, "Though these characters are inaccurate, I don't think they are necessarily intended to be offensive. It's also true that those comics are not supposed to be consumed by non-Japanese."
  • In the meantime, more and more mangaka (creators of manga) are expanding beyond these traditional representations, including in their depictions of women, who are over-sexualized in many manga. The majority of mangaka have historically been men, but this is shifting, leading to a broader exploration of themes around gender, sexuality and equality.
  • One interesting case involves the tennis star Naomi Osaka, who is of Japanese and Haitian descent and has often been portayed in Japanense media as having lighter-colored skin and hair than she actually does.
  • That's why, for a comic about the athlete called Unrivaled NAOMI Tenkaichi (tenkaichi means "best of earth"), her sister worked with the publisher directly to make sure Osaka is more accurately depicted — even if the story itself is quite fantastical. In it, Osaka travels the universe playing "space tennis." Kazam!
Support Worldcrunch
We are grateful for reader support to continue our unique mission of delivering in English the best international journalism, regardless of language or geography. Click here to contribute whatever you can. Merci!