Greater focus on clinical practice and nursing to plug gaps in healthcare system exposed by pandemic

The State Council has adopted a host of measures to boost the training of medical workers, with steps to expand enrollment in postgraduate programs and boost the number of nurses at hospitals as the country moves to address weaknesses in the healthcare sector exposed by the COVID-19 pandemic.

The Cabinet said after its executive meeting on Wednesday that China's shortage of medical workers, especially in public health, the treatment of severe cases and nursing, was brought to light by the pandemic, and more efforts must be made to reform and innovate the country's medical education system.

In addressing the shortage, the government will refine the structure of talent training and cultivate more medical workers with expertise in both disease prevention and treatment, a statement released after the meeting said.

Medical schools must offer education in general practice to all their students and gradually expand enrollment in free GP programs tailored to provide services at the grassroots level, the Cabinet said.

It added that central finances will continue to support the training of undergraduate students for posts in township clinics in central and western regions.

Enrollment in postgraduate programs in fields including anesthesiology, infectious diseases, severe illnesses and pediatrics will be increased, and vocational training in nursing will be bolstered.

The meeting underlined the need to accelerate the training of top public health talent, with heightened measures to promote cooperation between medical colleges, disease prevention centers and infectious disease hospitals.

"A stark problem we are facing right now is the shortage of nursing talent. Nursing is a key part of healthcare, and the work of nurses requires dedication and hard work," Premier Li Keqiang said at the meeting, adding that the government will make the training of nurses a policy priority.

Li recalled his trip to Jinyintan Hospital in Wuhan, Hubei province, in late January, when the city was the epicenter of the novel coronavirus outbreak and a shortage of nurses was among the most immediate challenges faced by hospitals.

The meeting on Wednesday also highlighted the need to improve the quality of education for medical workers. The government will establish a mechanism to ensure that students in medical majors obtain adequate clinical practice, the statement said.

University-affiliated hospitals must step up clinical teaching so that those pursuing medical majors can obtain more clinical experience as early as possible.

The evaluation of professional titles for medical workers will focus more on clinical practice, and authorities will refine the standardized training mechanism for resident physicians to improve their clinical practice skills.

The Cabinet added that eligible clinicians with undergraduate degrees will be treated the same as those with postgraduate degrees.

In explaining the decisions, the premier said many doctors expend a great deal of energy writing papers, which reduces the time they can spend in clinical practice, adding that clinical medicine is different from other disciplines in that experience from actual practice and the treatment of cases is crucial.

Guo Dong, a gastrointestinal surgeon at the Affiliated Hospital of Qingdao University in Shandong province, said giving medical students clinical experience in the early stages of their education will allow them to have a better understanding of their future jobs.

"It will shorten the training period of doctors and help them shift focus to accumulating clinical experience," he said, adding that in most hospitals three years of clinical experience are needed for a physician with a PhD to become an attending doctor.

Guo said he welcomed the Cabinet's decision to put more focus on clinical experience in the evaluation of professional titles for medical workers.

The current evaluation mechanism stipulates that a doctor must write papers that include experimental data from laboratories during applications for more senior titles, meaning surgeons like him had to bear an extra burden in addition to their routine duties at hospitals.

"Some hospitals are not equipped with good laboratories, which makes conducting experiments very difficult," he said. Guo also said he was barely able to find any time for experiments and writing papers as he performed as many as four operations a day.

"We need a scientific and objective evaluation mechanism of our expertise as doctors, rather than of our capabilities to write research papers," he said.