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動態
2025年3月，我們團隊赴紹興，對當地三家最大的三甲醫院進行了為期一周的實地調研。在與醫院科主任交流時，我們問：“你們希望推動學科建設嗎？”幾乎所有科主任都說：“那是醫院領導的事，和我們沒關係。”再問普通醫生：“你們希望提升自己的門診和手術能力嗎？”回答仍是：“沒有特別打算。”聽完這些回答，我們震驚，更感到沉重。從上到下，整個城市醫療界彌漫著混日子的氣息，沒有成長意願、沒mei有you責ze任ren意yi識shi，仿fang佛fo隻zhi求qiu維wei持chi最zui低di生sheng存cun標biao準zhun。人ren活huo在zai這zhe個ge世shi界jie上shang，最zui重zhong要yao的de是shi對dui這zhe個ge世shi界jie的de貢gong獻xian。醫yi療liao就jiu是shi一yi個ge國guo家jia國guo運yun級ji的de行xing業ye。紹shao興xing是shi一yi座zuo文wen化hua底di蘊yun深shen厚hou、人才輩出的城市。但我們卻看到，在這裏，醫生普遍處於一種無意識、無追求、無(wu)責(ze)任(ren)的(de)狀(zhuang)態(tai)，這(zhe)不(bu)僅(jin)是(shi)醫(yi)院(yuan)的(de)悲(bei)哀(ai)，更(geng)是(shi)這(zhe)座(zuo)城(cheng)市(shi)的(de)悲(bei)哀(ai)。反(fan)觀(guan)德(de)國(guo)，成(cheng)為(wei)一(yi)名(ming)合(he)格(ge)醫(yi)生(sheng)的(de)路(lu)徑(jing)，是(shi)建(jian)立(li)在(zai)係(xi)統(tong)的(de)專(zhuan)業(ye)訓(xun)練(lian)和(he)高(gao)門(men)檻(kan)基(ji)礎(chu)上(shang)的(de)。首(shou)先(xian)是(shi)6年醫學院課程，相當於中國的本科加碩士階段；多數醫學生還會再花兩年時間攻讀醫學博士學位。雖然博士並非強製要求，但在學術醫院工作、日後升職幾乎是隱性門檻。之後，每位醫生都必須進入為期5至6年的專科培訓，在教學醫院中進行嚴格的臨床輪轉、係統的理論學習和階段性評估。德國國家科學院院士、慕尼黑大學附屬醫院泌尿外科主任Stief院長以他所在的科室為例分享：前3年是在常規泌尿外科崗位上打基礎，第4年(nian)才(cai)開(kai)始(shi)亞(ya)專(zhuan)科(ke)的(de)培(pei)訓(xun)，甚(shen)至(zhi)有(you)些(xie)醫(yi)生(sheng)會(hui)赴(fu)國(guo)外(wai)進(jin)修(xiu)一(yi)年(nian)。整(zheng)個(ge)培(pei)訓(xun)結(jie)束(shu)後(hou)，還(hai)需(xu)通(tong)過(guo)德(de)國(guo)醫(yi)學(xue)協(xie)會(hui)的(de)正(zheng)式(shi)考(kao)試(shi)，才(cai)有(you)資(zi)格(ge)獲(huo)得(de)專(zhuan)科(ke)醫(yi)生(sheng)認(ren)證(zheng)，正(zheng)式(shi)獨(du)立(li)執(zhi)業(ye)。說(shuo)句(ju)可(ke)能(neng)刺(ci)耳(er)的(de)話(hua)：如果以德國的醫生培養體係為標準，中國現在90%的(de)醫(yi)生(sheng)連(lian)最(zui)基(ji)本(ben)的(de)要(yao)求(qiu)都(dou)達(da)不(bu)到(dao)。他(ta)們(men)中(zhong)很(hen)多(duo)人(ren)從(cong)未(wei)真(zhen)正(zheng)經(jing)曆(li)過(guo)係(xi)統(tong)的(de)亞(ya)專(zhuan)科(ke)培(pei)訓(xun)，也(ye)從(cong)未(wei)真(zhen)正(zheng)走(zou)出(chu)過(guo)自(zi)己(ji)的(de)醫(yi)院(yuan)去(qu)看(kan)看(kan)外(wai)麵(mian)的(de)世(shi)界(jie)。更(geng)糟(zao)糕(gao)的(de)是(shi)，他(ta)們(men)卻(que)還(hai)以(yi)為(wei)自(zi)己(ji)很(hen)牛(niu)，還(hai)敢(gan)自(zi)我(wo)標(biao)榜(bang)技(ji)術(shu)一(yi)流(liu)，還(hai)敢(gan)到(dao)處(chu)去(qu)講(jiang)課(ke)、當“專家”。隻zhi有you真zhen正zheng沒mei見jian過guo世shi麵mian的de人ren，才cai敢gan狂kuang成cheng這zhe個ge樣yang子zi。德de國guo為wei什shen麼me是shi現xian代dai醫yi學xue的de發fa源yuan地di？因yin為wei它ta的de醫yi學xue體ti係xi是shi建jian立li在zai規gui範fan與yu敬jing畏wei之zhi上shang的de。而er中zhong國guo的de很hen多duo醫yi生sheng，連lian起qi碼ma的de規gui範fan都dou沒mei有you，卻que已yi經jing開kai始shi享xiang受shou“專家”的de身shen份fen感gan。這zhe才cai是shi最zui危wei險xian的de地di方fang。醫yi生sheng不bu是shi一yi個ge頭tou銜xian，而er是shi一yi份fen對dui生sheng命ming負fu責ze的de專zhuan業ye職zhi業ye。我wo們men不bu怕pa醫yi生sheng水shui平ping不bu夠gou，但dan我wo們men怕pa的de是shi他ta們men不bu願yuan學xue習xi、不肯承認差距、還覺得自己已經很優秀了。一個醫生不學習，一個醫院就會停止進步；一個城市的醫生都不學習，那這座城市的醫療就注定原地踏步，甚至倒退。中國到底有多少“不合格”的醫生？
In March 2025, our team made a week-long field research at the three largest Grade III Class A hospitals in Shaoxing, Zhejiang province. When we asked clinical department heads, “Do you hope to promote specialty development in your department?” Almost every directors responded, “ That’s the responsibility of the hospital executives, not ours.” We then asked several junior doctors, “Do you want to improve your outpatient and surgical skills?” The answers remain “We don’t have any plan.” Upon hearing these answers, we were shocked but more disappointed. From top to bottom, the city’s medical system seemed to be pervaded by a mentality of apathy and stagnation. No desire to grow, no sense of professional responsibility, as if the only goal was to meet the bare minimum of survival. As human beings, our most fundamental value lies in our contribution to the world. Medicine is such a national industry influencing national fate. Though Shaoxing is a city with rich cultural heritage and a long tradtion of producing talents, what we witnessed was a medical community operating in a state of unconsciousness without drive nor sense of responsibility. This is not just a tragedy for the hospitals, but for the city as a whole. On the contrary, the path to becoming a qualified doctor in Germany is built on systematic professional training and high standards. Medical education begins with a six-year program in medical school, comparable to the combined bachelor’s and master’s level of studies in China. Most students then spend an additional two years earning a doctoral degree in medicine. Though an MD degree is not mandatory, it’s widely seen as an unspoken prerequisite for working in academic hospitals or advancing in one’s career. Then, every doctor must undergo a specialist training for 5 to 6 years in a teaching hospital, which includes intensive clinical rotation, systematic theoretical education and staged evaluations. As Prof. Stief, a member of German National Academy of Sciences Leopoldina, Chairman of the Dept. of Urology and Deputy Medical Director at the University Hospital of Ludwig Maximilians University of Munich, shared with us: in his department, doctors spend the first three years laying a foundation in general urology, and only begin sub-specialty training in the fourth year. Some even go abroad for one year for further training. Only after completing the full program and passing a formal board exam administered by the German Medical Association can a doctor be certified and begin independent practice. It may sound unpleasant, but if followed the Germany’s training standards, 90% of Chinese doctors would fail to meet the basic requirements. Many have never received structured sub-specialty training, nor stepped outside their own hospital to see how the wider world of medicine operates. What’s worse, they still believe they are top-tier, eagerly claiming to be “experts,” giving lectures, and flaunting their skills. It is often those with the least exposure who boast the loudest. Why is Germany considered one of the birthplaces of modern medicine? Because its medical system is rooted in rigor and reverence. Despite failing to meet the minimum norms, many Chinese doctors are already busy enjoying the prestige of being an “expert.” That’s where the real danger lies. Being a doctor is not about a title, but about bearing responsibility for life itself. We are not concerned about doctors who have room to improve, what we worry about is those who have no desire to learn, no awareness of their shortcomings, and yet still think they’re outstanding. When doctors stop learning, the hospital stops improving. And when an entire city’s doctors stop learning, its healthcare system is bound to lapse into stagnation or even regression. How many “unqualified” doctors are there in China today?
