Doctors in China: improving quality through modernisation of residency education

• Published in: The Lancet (British edition) Vol. 388; no. 10054; pp. 1922 - 1929
• Main Authors: Zhu, Jiming, Li, Wenkai, MD, Chen, Lincoln, MD
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 15.10.2016; Elsevier Limited
• Subjects: Accreditation; Certification; China; Clinical Competence - standards; Education, Medical - history; Education, Medical - trends; Health care policy; Health Care Reform; Health education; History, 20th Century; History, 21st Century; Humans; Internal Medicine; Internship and Residency - methods; Internship and Residency - organization & administration; Internship and Residency - standards; Internship and Residency - trends; Licensure; Medical residencies; Medical schools; Medicine, Chinese Traditional - standards; Medicine, Chinese Traditional - trends; Models, Educational; Patient satisfaction; Physicians; Physicians - history; Physicians - standards; Physicians - statistics & numerical data; Physicians - trends; Public Opinion; Quality Improvement; Quality of care; Quality of Health Care - standards; Quality of Health Care - trends; Trust; United Kingdom; United States; China
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(16)00582-1

Summary There is growing recognition that the ultimate success of China's ambitious health reform (enacted in 2009) and higher education reform (1998) depends on well educated health professionals who have the clinical, ethical, and human competencies necessary for the provision of quality services. In this Review, we describe and analyse graduate education of doctors in China by discussing the country's health workforce and their clinical residency education. China has launched a new system called the 5 + 3 (5 year undergraduate and 3 year residency [standardised residency training]), which aims to set national quality standards. To improve understanding for the Chinese model, we present a comparative perspective with systems from the UK and USA. To succeed, the 5 + 3 model will need to overcome major challenges of accreditation and certification, alternative education pathways, and China's unique degree and credentialing system. We conclude by reviewing the challenges of clinical competencies in China, especially the complementarity of specialist training and general practitioner training, which are essential for the quality and equity of China's health-care system.