"This year, novel coronavirus pneumonia suddenly comes, and the majority of medical workers are wearing white jacket and retrograde March to become the most shining heroes in the new era. As an educator of medicine and pharmacy, I have been thinking about how to raise the awareness of the whole society about the importance of medicine, attract more excellent people to learn medicine, and improve the level of Chinese medicine education in the face of endless global health challenges. " Laimaode is one of the first five Chinese academicians of the German Academy of Sciences. He was the youngest vice president of Zhejiang Medical University and Zhejiang University. He became the president of China Pharmaceutical University in 2013. He has a deep understanding of Chinese medical education.
The importance of medicine in society
Laimaode said that there are great doctors in the so-called "great epidemic". Since ancient times, any country has experienced a tenacious struggle with infectious diseases. Take China for example, from the plague in Northeast China more than 100 years ago, to the SARS in 2003, and to the new coronavirus this year, all the medical staff are fighting at the forefront. In this epidemic, the biggest harvest of medical and health care is that the whole society has a good understanding of the important role of medicine in social development and health care. Zhong Nanshan, Li Lanjuan, Zhang Wenhong, etc. have become "national idols", and those medical workers who have come to the forefront of Hubei Province have become the most lovely people in the people's mind in the new era.
According to laimaode, only when medicine is stronger can the country be able to better serve the people. Why do you say that? First, the novel coronavirus pneumonia took place in the country, which took more than two months to control Wuhan. This is precisely because the state has trained a large number of medical workers. These people have been charging ahead of the country when they need it, which fully reflects the advantages of our country and the occupation ethics of medical staff. In addition, the first case of SARS was diagnosed on November 14, 2002, but it was not until April 16, 2003 that the pathogen was identified as a new virus, which took more than five months. In this novel coronavirus pneumonia, the pathogen was identified in 7 days. The genome sequencing was completed in 9 days. The diagnostic kit could be released on the 19 day, which cannot do without the rapid development of Chinese medicine in 18 years.
Attract the best to study medicine
Laimaode has many years of experience in studying and working abroad. He believes that no matter in developed countries in Europe and America or in China, higher education has been popularized. Even so, medical education is always an elite education, which needs to attract the best people to learn medicine. But our country has not achieved this at this stage, for example, the overall attraction of medicine and pharmacy in enrollment is not very strong. According to media reports, there was a school in the North last year, and the medical admission score line was not as high as that of the veterinarian.
How to attract? According to laimaude, this requires the joint efforts of the society and the state. From the social level, there are many contradictions between doctors and patients in recent years. We need to use the law to regulate everyone's behavior, which includes two aspects, one is to regulate the behavior of patients, the other is to regulate the behavior of doctors. Doctors should respect patients and accept legal treatment if they have bad behaviors. Patients have opinions on doctors, and the right measure is to choose to "complain" rather than "make trouble". If a patient commits an illegal act, he will also be punished by law. Only when the law of usage is standardized can doctors feel the sense of occupational gain and security.
At the national level, we should first increase the number of doctors. According to the data of the National Health Commission, by 2018, the number of doctors and nurses per thousand people in China was 2.59 and 2.94, which exceeded the average level of middle-income countries. But compared with four doctors per thousand in Germany and Austria, we still have some room for improvement. With the development of China's economy and society, and the transformation of the main social contradictions, the number of thousands of doctors should also adapt to this to meet the needs of the people.
At the same time, the structure of medical staff needs to be adjusted. One is to adjust the structure of medical staff in urban and rural areas, and the other is to adjust the structure of internal department staff. In China, the number of doctors per thousand people in rural areas is 1.8, about 45% of that in urban areas. Even less than half of them are doctors. High level doctors are concentrated in the top three hospitals in urban areas. This difference is related to the unbalanced social structure of urban and rural development in our country. The imbalance of the structure of the staff in the internal departments of the hospital is mainly reflected in the imbalance of the structure proportion of the doctors in various specialties. We lack doctors in pediatrics, psychiatry, pathology, rehabilitation and other aspects, and doctors in infection department are also insufficient. In addition, the number of public health doctors is small and the loss is serious, which is related to the social environment, occupational treatment and sense of access.
How to solve the problem of few doctors and unbalanced structure? Laimaode has two suggestions: first, expand the enrollment of medical students in comprehensive universities, especially those universities that have merged many excellent medical colleges under the influence of the previous university merger; second, in view of the lack of doctors in some disciplines, the state can guide students through policies and adopt the way of "large medical junior college", and medical students first receive systematic clinical medicine Study major, and then choose specialized department to engage in medical work after graduation.
How to make medical education better
Lai Maode said that the novel coronavirus pneumonia epidemic will never be the last challenge for mankind. Therefore, we need to think more about how to make medical education better. He made the following five suggestions:
1. School system. The length of schooling of medical students is long and not uniform, for example, there are three years of junior college, five years of undergraduate, a few years ago, there were seven years of master's degree, now there are eight years of doctor's degree and so on. It is hoped that the length of schooling of medical students can be unified from the national level. At present, the consensus reached by the medical community is that based on the five-year system, three years of standardized resident training and three years of specialist training will be added after graduation.
2. The pertinence of training. Medical treatment is a system, which can be divided into two categories, one is medical specialty, the other is medical related specialty, such as nurses, respiratory therapists, radiologists, etc. We need to train not only doctors to see doctors, but also technicians to operate all kinds of medical instruments. For example, the ECMO (extracorporeal membrane oxygenation), which is often heard during the epidemic, can be operated by special technicians to assist doctors.
3. Scope of knowledge. Strictly speaking, medicine is "human science" and "human science" has high requirements for humanistic care. In addition to the knowledge of medicine itself, medical students also need to learn sociology, art, economics, hygiene and law, medical development history and medical ethics, and know the ethical boundaries and laws and regulations of gene therapy, gene editing, big data, artificial intelligence and other cutting-edge technologies.
4. Practice. Medicine is a very practical subject, but now medical students can't go to the operating table soon after graduation, so we must invest a lot of money to provide training base for students. Not only that, when ordinary patients go to the hospital, they are psychologically unwilling to let a fledgling medical student "check the pulse" for themselves. It is not easy to cultivate a doctor, but more investment is needed to cultivate medical students.
5. Famous doctors. The most basic thing to be a doctor is to see a doctor for a patient. If you want to become a famous doctor, you need to do more research and publish papers, but not everyone can give consideration to both. Most of the doctors we train should be doctors who see a doctor for the common people. Therefore, the evaluation and promotion conditions of doctors must match with them.
(Zheng Jinming, reporter of our newspaper)
Source: Guangming Daily Co ordinator: Zhou Shixiang