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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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Society

Debt Trap: Why South Korean Economics Explains Squid Game

Crunching the numbers of South Korea's personal and household debt offers a glimpse into what drives the win-or-die plot of the Netflix hit produced in the Asian country.

In the Netflix series, losers of the game face death

Yip Wing Sum

-Analysis-

SEOUL — The South Korean series Squid Game has become the most viewed series on Netflix, watched by over 111 million viewers and counting. It has also generated a wave of debate online and off about its provocative message about contemporary life.

The plot follows the story of a desperate man in debt, who receives a mysterious invitation to play a game in which the contestants gamble their lives on six childhood games, with the winner awarded a prize of 45.6 billion won ($38 million)... while the losers face death.


It's a plot that many have noted is not quite as surreal as it sounds, a reflection of the reality of Korean society today mired in personal debt.

Seoul housing prices top London and New York

In the polished streets of downtown Seoul, one sees endless cards and coupons advertising loans scattered on the ground. Since the outbreak of the pandemic, as the demand for loans in South Korea has exploded, lax lending policies have led to a rapid increase in personal debt.

According to the South Korean Central Bank's "Monetary Credit Policy Report," household debt reached 105% of GDP in the first quarter of this year, equivalent to approximately $1.5 trillion at the end of March, with a major share tied up in home mortgages.

Average home loans are equivalent to 270% of annual income.

One reason behind the debts is the soaring housing prices. In Seoul, home to nearly half of the country's population, housing prices are now among the highest in the world. The price to income ratio (PIR), which weighs the average price of a home to the average annual household income, is 12.04 in Seoul, compared to 8.4 in San Francisco, 8.2 in London and 5.4 in New York.

According to the Korea Real Estate Commission, 42.1% of all home purchases in January 2021 were by young Koreans in their 20s and 30s. For those in their 30s, the average amount borrowed is equivalent to 270% of their annual income.

Playing the stock market

At the same time, the South Korean stock market is booming. The increased demand to buy stocks has led to an increase in other loans such as credit. The ratio for Korean shareholders conducting credit financing, i.e. borrowing from securities companies to secure stock holdings, had reached 21.4 trillion won ($17.7 billion), further increasing the indebtedness of households.

A 30-year-old Seoul office worker who bought stocks through various forms of borrowing was interviewed by Reuters this year, and said he was "very foolish not to take advantage of the rebound."

In addition to his 100 million won ($84,000) overdraft account, he also took out a 100 million won loan against his house in Seoul, and a 50 million won stock pledge. All of these demands on the stock market have further exacerbated the problem of household debt.

42.1% of all home purchases in January 2021 were by young Koreans in their 20s and 30s

Simon Shin/SOPA Images/ZUMA

Game of survival

In response to the accumulating financial risks, the Bank of Korea has restricted the release of loans and has announced its first interest rate hike in three years at the end of August.

But experts believe that even if banks cut loans or raise interest rates, those who need money will look for other ways to borrow, often turning to more costly institutions and mechanisms.

This all risks leading to what one can call a "debt trap," one loan piling on top of another. That brings us back to the plot of Squid Game, "Either you live or I do." South Korean society has turned into a game of survival.

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