Yesterday, Rao Yi, president of Capital Medical University, said in a personal public post that Capital Medical University had taken the lead in establishing a “clinical professor system” last year.
The series does not require the issuance of papers, “as long as they are good doctors, plus do teaching work for the university, they can meet the basic qualifications.
The news immediately caused a lively discussion among the doctor community.
However, this new system seems to be so ‘new’ that neither the admissions office nor the publicity section of Capital Medical University can give detailed answers at the moment. Doctors at the Capital Medical University told Clove: “The hospital didn’t advertise too much, in fact, we don’t really understand the details.
What kind of system is this when you can become a professor without publishing a paper?
In fact, this is not the first Time that the concept of “clinical professorship” has been proposed.
In December last year, Peking Union Medical College (PUMC) held a meeting on the first batch of clinical Medicine faculty positions, proposing the establishment of a system of faculty management by series and appointment by classification evaluation, while announcing the recruitment of 33 renowned clinical experts from the front line to become the first batch of clinical medicine professors in China.
Although we did not see the relevant appointment details on the Peking Union Medical College website, the information provided by the officials indicates that the purpose of this new appointment system is to “reform the construction of the teaching staff” and to match the special nature of the combination of clinical and teaching in medical Education.
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Source: The official website of Union Medical College
It is easy to see that this is not the same thing as the “clinical professor system” proposed by Rao Yi.
If we look carefully at Rao Yi’s article, the system was established by the first medical school to correct the “institutional mechanism problem” of physician promotion.
What is this “institutional mechanism” that needs to be corrected? To summarize, doctors want to be professors and professors demand research, so the research circle is in chaos.
In the existing promotion channel of doctors’ titles, the requirements are similar from region to region and from hospital to hospital. In each promotion, there are several points that cannot be avoided, such as examinations, papers and projects. An excellent senior doctor basically needs to walk on three legs: work, research and project.
According to Rao Yi, in China’s current evaluation system, such a highly research-related promotion chain has to some extent given rise to academic fraud and other research chaos.
Therefore, the “clinical professor system” now proposed is more like opening a new promotion copy for doctors in the first medical system, i.e. a new model of “doctor + medical lecture/clinical teaching → professor”. In this copy, the proportion of scientific research will be reduced, and the merits of clinical work will be judged by new criteria.
The new channel of medical teaching promotion, is it really reliable?
Yesterday, after the new concept was proposed, the internet screamed with approval. Some people shouted that “the Culture of research first should have been changed long ago” and said that “everyone would like to go to such a hospital”.
But reform is often accompanied by pain. This time, is it really possible to “return research to research and clinical to clinical” as everyone expects?
A clinical doctoral student from Capital Medical University told Clove that although this new promotion system has been proposed more than once, it is not yet substantial in the actual review: “This year’s professorship/doctoral fellowship application has been made in the following way.
The new system has been proposed more than once, but in practice it has not yet had a substantial effect: “This year’s professor/doctoral director application evaluation, although it is true that the chief physician can be evaluated as a professor/doctoral director after working for a few years, but the national funds in research and representative works still have a great priority in the order, and several candidates are basically professional top journal mutual combat.
This situation is even more complicated in the rating of associate professors / masters, for doctors who want to promote, “even if they have been rated as associate chief physicians, but also need national funds to apply for associate professors / masters, but because they are not masters can not recruit students, and thus difficult to apply for national projects, so it is easy to fall into an awkward cycle.
Reform needs to come from the top down. Now it seems that the wind of reform has not yet blown to the promotion line.
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Photo source: Screenshot from the comment section of Ding Xiang Yuan’s microblog
Another question is, when the wind of reform really blows into the front line, what criteria can we use to judge whether a doctor is really “good”.
In the previous evaluation system, whether it is the title examination, or core journal papers, research project levels, monographs, etc., they are actually very quantitative and objective detailed indicators.
However, in the promotion channel of “clinical professor system”, it seems to be only “paper talk”.
After all, if we look at the number of years of teaching and teaching workload, it is difficult to quantify the details, and the differentiation of the profession will be low; while if we look at peer review, patient evaluation or student satisfaction, it is easy to produce bias, and it will be more difficult to grasp the fairness and justice.
How to see the merits of clinical competence and teaching ability? There is not yet a complete set of evaluation criteria.
At this point, we can take a look at the United States, where the clinical professor system has long been in place.
In the United States, a clinical professor is an academic appointment for members of the profession who are engaged in the practical (clinical) instruction of students (e.g., medical students), which is roughly the same as the “clinical professor” mentioned by Rao Yi.
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Definition of “Professor of Practice/Clinical Professor” in the United States (Source: Wikipedia)
In the medical field, there is also no standardized division for promotion in this pathway, and teaching ranks are assigned to medical professionals who are teaching full-time, depending on the academic institution. It is important to note, however, that this teaching rank is not equivalent to a physician title.
This is related to the current state of physician employment in the United States. A Chinese doctor working in the U.S., Su Yanhao, told Clove, “In the U.S., research and clinical are not two legs, they are two paths. After entering the clinic, only teaching hospitals have hard targets related to research, so-called titles and promotions, but general hospitals do not care about doctors’ research. The actual fact is that you will not be able to do it if you are not interested.
To put it plainly, no matter what promotion is linked to, it is only secondary, because “seeing patients” is the more profitable thing. Unless one has a passion for teaching or a sense of accomplishment, for most American doctors, teaching and research are more like “thankless” things.
Here, although the two concepts of “clinical professor” are similar, they were established for different reasons, and obviously have no meaning. After all, in China’s case, the status quo of linking doctors’ income to their titles will not change overnight.
But that’s precisely why a new system needs to be proposed to provide doctors with a backup of choice.
The road to reform is long, but change is always good
Back to the beginning of the discussion, the medical and teaching promotion system proposed by Rao Yi is more like a new product with “Chinese characteristics”: there is no reference, no benchmark, and even no test for itself.
But even so, the reason why the reform is a reform is not always relying on the existing experience, but more on the basis of identifying the problems and using the mentality of groping for targeted solutions.
After all, this reform is not a blind negation of scientific research itself, nor is it a support for the abolition of scientific research evaluation, but only a possible new idea based on a reflection of the evaluation system.
Just like yesterday, amidst a chorus of applause and skepticism, a reader commented on Clove’s microblog: “The title should be the same as that of a graduate student, divided into professional and academic ones, which can be chosen by themselves and evaluated on different criteria, just fine.
Will clinical and scientific research really be separated? Will it really be better to separate them? It is not known. But in this matter, as long as the original intention and starting point of the reform is beneficial to the future development, the difficulties and questions encountered along the way will eventually become the directional mark and accelerating accelerant of the reform.
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