有医学背景的人都听说过《柳叶刀》杂志,如果能在《柳叶刀》上发表一篇论文,可以说是此生无憾了。然而如此权威的的杂志,却一直用专栏的方式关注和报道着中国的医改,以往的专刊中曾经关注过中国医疗暴力、科研腐败、医务人员待遇差等问题。去年的同一时间,《柳叶刀》第一时间的刊登了对于中国住院医师规培和专培的文章。《柳叶刀》,不会随意刊登文章,他们刊登的文章代表了全世界的关注和态度!
下面是文章全文,和翻译:
The National Health and Family Planning Commission of China introduced an important change on specialist standardisation training on Jan 11, 2016, requiring Chinese doctors to do an additional 2–4 years of specialist training after completing 3 years of resident standardisation training.The announcement has caused disappointment, even aversion, among some young Chinese doctors and medical students.
2016年1月11日中国国家卫生和计划生育委员会对专科医生规范化培训提出了一项重要的改革措施:要求中国医生在完成3年住院医师培训后再接受2-4年的专科培训。此通告一出立即招来许多中国年轻医生和医学生的失望甚至是反感的情绪。
Medical resident and specialist training in China is similar to the resident and fellowship training in the USA. The Chinese Government intended to improve the professional skills of health-care providers with these training programmes, turning Chinese medical graduates into qualified and world leading practitioners. However, the training programmes in China face substantial challenges.
中国的住院医师和专业医师培训类似于美国的住院医师和专科医师培训。中国政府试图通过这些培训来提高医生的专业技能,使中国的医学毕业生转变为合格的甚至是世界领先的专业医务人员。但是,中国的这些培训方面面临着巨大的挑战。
Firstly, in comparison with young doctors in the USA, the residents and young specialists in China are extremely unsatisfied with their salaries. The median salary of Chinese doctors working in the secondary and tertiary hospitals of big cities is about 5000 RMB (US$780) per month.The income is even lower for young doctors on the training programme.
首先,与美国的年轻医生相比,中国的住院医师和年轻专业医师对其薪酬极度不满意。在中国,大城市的二级和三级医院医生的平均工资是每月5000元人民币(US$780),而对于正在接受培训的年轻医生其收入更低。(美国住院医师待遇请见今日“2015全美住院医师薪资报告”)
Secondly, the working environments for doctors have severely deteriorated in the past 20 years. Violence against doctors has been reported repeatedly. Additionally, their workloads will continue to increase dramatically with China's ageing demography and the new two-child policy. A Chinese specialist usually sees at least 50 patients per day in the outpatient clinic. Several young doctors have died tragically in relation to being overworked.
其次,在过去的20年里,中国医生的工作环境不断恶化。据报道,暴力伤医事件不断发生。此外,随着中国老龄化的到来以及二胎政策的出现,使得医生的工作负担不断大大增加。在中国,一位专家通常每天在门诊至少要接待50名患者。悲惨的是,一些年轻医生因过度劳累而不幸去世。
As a result of the relatively poor income and working environments, some young Chinese doctors and medical students have lost their enthusiasm for pursing the career and regret choosing to study medicine.Many are considering dropping out of the training programme. A survey was performed on Ding Xiang Yuan, the most popular biomedical website in China, which found that 91% of doctors believed that China's health-system reforms could not be successful without also reforming the social and economic status of doctors. We sincerely hope that this Correspondence will get the attention of our government. We appeal again that measures are taken to improve the salary and working environment of Chinese medical doctors; the outflow of talented young doctors from China should be halted. Otherwise the health-care system in China will be compromised greatly in the near future.
由于较低的收入和较差的工作环境,一些中国年轻医生和医学生已经失去对其专业的热情,后悔选择了医学这条道路。目前很多人正在考虑退出规陪计划。据《丁香园》的一项调查显示,91%的医生认为中国的医疗改革不可能成功,也不可能改善医生的社会地位和经济收入。我们真诚的希望这篇文章能得到政府的重视。我们再次呼吁政府应采取措施改善中国医生的工资待遇和工作环境,停止中国优秀年轻医生的流失。否则,在不久的将来,中国的医疗保健系统将遭受重创!
卫计委对以上全文是如何评价的呢?
“许多经历过规培的人都感受到规培带来前所未有的益处!”卫计委如是说,然后默默的关闭了评论。
现在卫计委最大的托词就是强调专培的自愿,但是看看原来自愿的规培,现在变成了必修。大学里,不算学分的选修课,有人选么?如果不和其他东西挂钩,还会有人去专培么?如果花2-4年跑到专培基地去当廉价劳动力,回来待遇和晋升都是一样,是不是傻?
91%的调查反对!成千上万人的骂娘!很少看到一个政策受到如此强大的抵制。我们都是真正热爱医疗事业的人,我们都是想要为医疗事业奋斗终生的人,才会如此的关注。只要有一个能反应民意的地方,瞬间就会被医学生刷爆。如果医师协会,没有为医生的切身利益而存在的话,要它何用?