逃离白大褂：医学生弃医改行的背后 Escape from white:Medical students abandon cure done behind

　　

编者按： Editor's note:“不为良相，则为良医。”这是中国的一句古话。在世界很多地方，医生都是一个令人羡慕的职业，既有丰厚的经济收入，又有较高的社会地位。医生，作为人们生命与健康的“保护神”，光荣而高尚。

"Not for good phase,; for the."This is a Chinese traditional saying.In many parts of the world,The doctor is a the profession of envy making a person,Both rich economic income,And a higher social status.The doctor,As people life and health"Guardian angel",Glorious and noble.

　　然而，在社会转型期的中国当下，医生的职业吸引力和社会美誉度出现较大程度弱化。有业内专家估算，国家每年培养数十万名医学生，只有约10万人穿上“白大褂”。除了刚毕业的医学生逃离以外，不少在职医生也在转行，尤其是基层医生流失现象较为严重。

however,In the social transition period of today's China,The doctor's professional attraction and social reputation appear larger weakening degree.The expert inside course of study estimation,Countries each year hundreds of thousands of famous doctor students training,Only about 100000 people put on"white".In addition to just graduated from the medical students outside,A lot of on-the-job doctors are in line,Especially the grass-roots doctor erosion phenomenon is relatively serious.

　　中国医师协会曾就医生对子女学医的态度进行调查，结果发现，医生不希望子女学医的比例不断上升：2002年为53%，2004年为63%，2011年为78%。

The Chinese medical doctor association had children, doctors to investigate the attitude,The results showed that,The doctor don't hope that their children, rising proportion:53% in 2002,63% in 2004,78% in 2011.

　　医学生弃医改行的背后到底折射出哪些深层次社会原因？如何采取有力的对策措施，留住这些“白衣天使”，激励其乐于担当救死扶伤之使命？半月谈记者最近分赴北京、吉林、江苏、河南等地进行了深度调研。(《半月谈内部版》2012年第10期)

Medical students abandon cure done exactly what behind reflects the deep social reasons?How to take strong measures,Keep these"angels",The incentive to bear the mission of the healing the wounded and rescuing the dying?半月谈 reporter recently had fanned out Beijing/jilin/jiangsu/Henan and other places and carry on the depth of the research.([半月谈 internal edition]In 2012, the 10th issue)

　　“我妈妈说了，如果我当医生，就打折我的腿！”近期，一名医生的子女在网上发布这样一则帖子，引起人们热议与反思。一些医生为何不愿让子女学医？医学毕业生缘何不愿从医？半月谈记者调查了解到，主要原因是“三大三低”：投入大、压力大、风险大，收入低、待遇低、安全感低。

"My mother said that the,If I when the doctor,My leg is at a discount!"recent,A doctor children in online publishing such a post,Cause people hot discussion and reflection.Some doctors why not let their children to learn cure?Medical graduates working why don't want to?半月谈记者调查了解到,主要原因是"三大三低":投入大/压力大/风险大,收入低/待遇低/安全感低.

　　

学业压力大，工作超负荷 学业压力大,工作超负荷

　　“我总感觉自己可能猝死，太累了！”河南某医学院研究生张晨说。这位外科学生当前最大的梦想是“睡觉睡到自然醒”。“我们研究生都被当成住院医生使用，工作强度太大了。我们是24小时值班制，早上8点上班，次日8点下班。一旦遇到有手术，或者是病人出现紧急情况，什么时候下班就很难说了。交班后走出病房大楼，有种虚脱的感觉，脚下都是飘的，头重脚轻。心里只有一个念头，赶紧回到宿舍睡觉。”

"我总感觉自己可能猝死,太累了!"河南某医学院研究生张晨说.这位外科学生当前最大的梦想是"睡觉睡到自然醒"."我们研究生都被当成住院The doctor使用,工作强度太大了.我们是24小时值班制,早上8点上班,次日8点下班.一旦遇到有手术,或者是病人出现紧急情况,什么时候下班就很难说了.交班后走出病房大楼,有种虚脱的感觉,脚下都是飘的,头重脚轻.心里只有一个念头,赶紧回到宿舍睡觉."

　　从事医学的艰辛是其他许多行业所无法比拟的。医学技术日新月异，医生必须不断充电才能跟上潮流，免遭淘汰。半月谈记者从北京多家三甲医院了解到，要进入这些医院，医生大都需要博士学历，甚至要有留洋背景。工作后，还要继续学习、考试、做课题、写论文……永远也忙不完。

从事医学的艰辛是其他许多行业所无法比拟的.医学技术日新月异,The doctor必须不断充电才能跟上潮流,免遭淘汰.半月谈记者从北京多家三甲医院了解到,要进入这些医院,The doctor大都需要博士学历,甚至要有留洋背景.工作后,还要继续学习/考试/做课题/写论文……永远也忙不完.

　　工作超负荷、劳动超强度，是很多医务工作者的现状。北京同仁医院眼科主任魏文斌是业内一知名专家，同样承受着巨大的压力。该院眼科护士王晶雪告诉记者：“医院本来就很忙，赶上魏主任出门诊，更是忙上加忙。魏主任门诊最高纪录是一天看110个病人。从早上8点开始一直看到晚上9点。匆匆扒几口凉饭菜后，他接着又去病房了。魏主任在上班时很少喝水，他说水喝多了去卫生间的次数就多了。腾出这功夫，能多看几个病人。”

工作超负荷/劳动超强度,是很多医务工作者的现状.北京同仁医院眼科主任魏文斌是业内一知名专家,同样承受着巨大的压力.该院眼科护士王晶雪告诉记者:"医院本来就很忙,赶上魏主任出门诊,更是忙上加忙.魏主任门诊最高纪录是一天看110个病人.从早上8点开始一直看到晚上9点.Hurry steak a few mouth cool after meal,He then went to the ward.Wei director at work in seldom drink,He said water drink many go to toilet is the number of times more.Make this kung fu,Can see more patient."

　　而类似魏文斌这样工作繁忙的医生，在我国有很多。南京妇幼保健医院一儿科主任曾经一边打着点滴，一边给病人看病。她说：“平时工作非常忙，有时一天都离不开诊室，要看近百个病人，连上十几个小时的班。看着排长队等待看病的家长和孩子，作为医生，我们只有争分夺秒。”

And similar WeiWenBin this job is busy doctor,In our country there are many.Nanjing maternity and child health care hospital department of pediatrics director once part dozen drop,See a doctor to the patient side.She said:"Work at ordinary times very busy,Sometimes a day cannot leave the clinic,Want to see nearly patients,Even ten hours of class.Look at long queues waiting for the doctor's parents and children,As a doctor,We have only a little at a time."

　　假期少，没时间陪家人，没时间谈恋爱，是很多医生面临的现实困惑。高红是一位外科医生的妻子，她对丈夫的意见越来越大。“连续加班、值夜班是常事，有时在医院一待就是两三天，春节都要在医院过。”

Holiday less,No time with family,Don't have time to fall in love,Many doctors is faced with the reality of the confusion., is a surgeon's wife,Her for her husband's opinion is more and more big."Continuous work overtime/Watches is common,Sometimes in a hospital for a stay is two or three days,The Spring Festival will have in the hospital."

　　郑州大学第一附属医院医生魏冬琳告诉半月谈记者：“医院里的大龄青年越来越多，主要原因就是没有时间谈恋爱。和对方定好的约会时间却不能按时赴约，加上交往的圈子很小，谈恋爱的成功率很低。有的谈了一段时间，对方发现我们医生忙得离谱，就渐渐冷淡了。”

Zhengzhou university first affiliated hospital doctor WeiDongLin 半月谈 told reporters:"The hospital older youth more and more,The main reason is that have no time to fall in love.And the other set good appointment time but not arriving on time for appointments,Add contacts circle is very small,Fall in love of success rate is very low.Some talk about a period of time,The other party found we doctors are busy,Will grow cold."

　　国务院医改专家咨询委员会委员、北京大学经济学教授李玲表示，很多医务人员非常辛苦，承担着巨大的工作压力，基层一些医院还要求医生们分担创收任务。在这种种压力之下，很多医学生不愿意从事医生职业，在职医生辞职转行的也不在少数。

Cure of the state council changes a expert consultation committee/Beijing university professor of economics LiLing said,Many medical staff very hard,Responsible for the huge pressure of work,Grassroots some hospitals also requires doctors share revenue generating tasks.In this kind of pressure,Many medical students do not want to be in the doctor career,On-the-job a doctor to resign line breaks is not in a few.

　　

收入不高待遇差，不能体现劳动价值 Income is not high treatment difference,Can't reflect labor value

　　与医生所承担的工作强度形成强烈反差的是，在社会各阶层当中，医生群体的正常收入并不算高。虽然也有医生靠“灰色收入”致富，但只是个别。如果只算“阳光收入”，对于绝大多数医生来说，并不能体现其劳动价值。

And the doctor of work undertaken strength form sharp contrast is,In the society of all levels,The doctor groups of normal income isn't high.Though there are also by the doctor"Gray income"rich,But only individual.If only calculate"Sunshine income",For the vast majority of physicians,And can not reflect the labor value.

　　北京大学社会学系进行的一项调查显示，医生平均工作时间每周为50小时，法定工作时间应该是40小时，也就是说工作时间高出20%，但是工资水平却没有相应体现。

Beijing university department of society a survey,The doctor average working time for 50 hours a week,Legal working hours should be 40 hours,That is 20% higher than that of working time,But wages but no corresponding reflect.

　　一位基层卫生局长透露，大部分基层医院医务人员工资少得可怜，收入不及大医院的1/3，还要承担相当大的责任，因此很难留住人。

A grassroots health chief said,Most of the basic-level hospital medical personnel salary little,Income less than a third of the large hospital,And you have quite a big responsibility,So it is difficult to keep people.

　　在苏北某乡镇医院工作的陈春连告诉记者，大专毕业后，她回到了所在乡镇的医院工作，但逐渐发现自己的收入与在县市里工作的同学相差越来越大。“我并不怕吃苦，但大家的水平、所做的事情都差不多，为何待遇相差这么大，这我有点接受不了。”

In a northern township hospital ChenChunLian told reporters,After graduating from college,She returned to the villages and towns in the hospital,But gradually found their own income and in the county town of the students work are more and more big."I'm not afraid of hardship,But everyone's level/Do the same,Why pay differ so big,I cannot accept it."

　　近年来，基层医院医生流失的趋势并未得到根本遏制。吉林东丰县小四平镇卫生院院长吕金权谈起此问题，显得有些无奈：“原来卫生院下边有15个村医，现在五六个都不干了。他们有的出去开药店，有的出去打工，还有的人宁可在家具厂做油漆工也不愿当医生。”

In recent years,Grassroots hospital doctors erosion trend did not get the fundamental containment.Jilin siping DongFengXian small township health centers dean LvJinQuan talk about this problem,Appear some helpless:"The original health center has 15 village doctor,Now five or six have quit.They have out open pharmacy,Some work out,Still some people would rather in furniture factory do painter than when the doctor."

　　长春市人民制药厂总经理蓝志民原来是名医生，学了8年才成为正式医生，后来转行经营医药。他说：“学医要求特别严格，天天战战兢兢，担心出差错。”另外，收入太低也是促使他转行的一个原因。他有个同学是吉林省一家医院的儿科权威，从不收红包，但快40岁了房子还买不起，同学们聚会时凑钱帮他买房子。

长春市人民制药厂总经理蓝志民原来是名The doctor,学了8年才成为正式The doctor,后来转行经营医药.他说:"学医要求特别严格,天天战战兢兢,担心出差错."另外,收入太低也是促使他转行的一个原因.他有个同学是jilin省一家医院的儿科权威,从不收红包,但快40岁了房子还买不起,同学们聚会时凑钱帮他买房子.

　　“的确存在这样的状况，与发达国家相比，我国医务人员收入还是偏低，工作量要大很多，而且是高风险、高强度的。”国务院医改专家咨询委员会委员、中华医学会党委书记饶克勤在接受半月谈记者采访时表示。

"的确存在这样的状况,与发达国家相比,我国医务人员收入还是偏低,工作量要大很多,而且是高风险/高强度的."国务院医改专家咨询委员会委员/中华医学会党委书记饶克勤在接受半月谈记者采访时表示.

　　北京大学公共卫生学院教授陈育德亦有同感：“医生曾经在很多人眼中是很有前途的职业，国外有经验的医生，收入会高于教授，在社会上也极受尊重。但如今在我国一些地方，情况却不是这样。”

北京大学公共卫生学院教授陈育德亦有同感:"The doctor曾经在很多人眼中是很有前途的职业,国外有经验的The doctor,收入会高于教授,在社会上也极受尊重.但如今在我国一些地方,情况却不是这样."

　　

医患纠纷频发，执业环境安全感低 医患纠纷频发,执业环境安全感低

　　“如临深渊、如履薄冰”是很多医生的切身感受，工作中他们的神经始终处于高度紧张状态。即便如此，还要随时应对可能发生的医疗纠纷甚至医闹困扰。

"如临深渊/如履薄冰"是很多The doctor的切身感受,工作中他们的神经始终处于高度紧张状态.即便如此,还要随时应对可能发生的医疗纠纷甚至医闹困扰.

　　医患关系本应是人世间最亲密的关系之一，人们从摇篮到坟墓，最初见到的和最后见到的人，都有可能是医生。但在当前不少地方，医患关系失去了往日的纯净与温情，变得紧张和冷漠。患者对医生不满，医生对患者戒备，医患冲突升级，医生的生存环境不容乐观。

医患关系本应是人世间最亲密的关系之一,人们从摇篮到坟墓,最初见到的和最后见到的人,都有可能是The doctor.但在当前不少地方,医患关系失去了往日的纯净与温情,变得紧张和冷漠.患者对The doctor不满,The doctor to the patient,Doctor-patient conflicts upgrade,The doctor's living environment is not optimistic.

　　江苏省人民医院内科张医生坦言：“作为一名医生，救死扶伤是我们的天职，工作再辛苦也能承受。但不能接受的是，辛苦为病人诊治，最后却屡屡被误解。”根据经验，张医生总结出误解的三大焦点：一是一些候诊病人因等候时间过长，直接跑进来斥责看病太慢；二是给病人开药时经常会被人怀疑是大处方；三是一些病人病情较重，甚至快要死亡时送至医院，没有救治成功，病人家属轻则埋怨医生不尽责，重则直接打骂。

Jiangsu province people's hospital medical doctor zhang said:"As a doctor,Healing the wounded and rescuing the dying is our bounden duty,Work hard again also can bear.But can't accept is,Hard for diagnosis and treatment the patient,The last is often misunderstood."According to the experience,Zhang sums up the misunderstanding of the three major focus:One is waiting for some patients waiting time is too long,Direct run in rebuked the doctor too slow;The second is to prescribe patients are often when people doubt is DaChuFang;Three are some patient heavier,Even death is sent to the hospital,No treatment success,The patient's family light is not blame the doctor responsible,Weight is directly beat and scold.

　　长春市中心医院妇产科医生杨佳说，患者常为一点小事发火，比如遥控器找不着也要骂人。她有两个成绩特别好的同学，就是因为实习期间与患者闹不愉快，最终选择转行做医药代表、考公务员。“学了这么多年，真的挺可惜的。”

Changchun city center in the department of obstetrics and gynecology hospital doctor YangJia said,Patients often for a little thing firing,Such as remote control can't find also want to call names.She has two performance very good students,It is because during the internship and patients make unpleasant,Final choice turned do medicine representative/Take an examination of civil servants."Learn for so many years,It's really a pity that."

　　吉林省人民医院副院长韩梅出国学习5年，回国后发现医生让患者签的知情协议也越来越多。做骨穿要签，腰穿要签，用的塞米松也要签……“签的知情协议越多，医生可信度也越低。但是没有办法，为了防止医疗纠纷引起的官司，必须要签协议。”

The people's hospital of jilin province, vice President of the han mei study abroad for 5 years,After returning home found the doctor asked patients informed agreement signed more and more.Do bone wear to sign,Lumbar puncture to sign,Use plug include also have to sign..."The more familiar with the sign of the agreement,The doctor credibility also is lower.But there is no way,In order to prevent medical dispute lawsuit caused,Must want to sign the agreement."

　　河南省一家三级甲等医院的脑外科大夫杨丽华认为，医学是一门经验和实证密切结合的科学，要付出相当长的时间来学习和实践。但在实践过程中，现实社会不允许医生出错。“医疗纠纷是当前许多临床医生都不得不面对的问题，我们开玩笑说是‘隔墙扔砖头，不一定砸着谁’。工作做得再好，都难以避免医疗纠纷。”

Henan a three level of first-class hospital brain surgery doctor YangLiHua think,Medicine is a foreign experience and empirical combined with science,Have to pay quite a long time to learn and practice.But in the process of practice,Reality does not allow the doctor error."Medical disputes is the current many clinical doctors have to face the problem,We joke say‘Partition to throw a brick,Not necessarily hit who’.Work to do better,Are hard to avoid medical disputes."

　　2011年9月，中国医师协会公布的第四次医师执业状况调研显示，48.51%的医疗工作人员对目前的执业环境不满意，位于首位的工作压力是医疗纠纷和病人及家属对他们工作的不理解。

In September of 2011,The Chinese medical doctor association published the fourth physician practice status survey shows,48.51% of the medical staff to the present practice environment not satisfied,Is located in the first working pressure is the medical dispute and patients and their family members to their jobs don't understand.

　　紧张的医患关系让一些医生怀念和羡慕过去的时代。北京某三甲医院负责人说，他的母亲也是一名医生。“那个年代国家很穷，医生挣钱也不多，但只要看好病就可以。老百姓对医生非常好，患者给医生织袜子，送玉米、大蒜，很朴实。那不是贿赂医生，而是表达感谢。现在还那么纯粹吗？我是不愿意让孩子再学医了。”

Tense doctor-patient relationship let some doctors miss and envy the past age.Beijing some 3 armour hospital officials said,His mother is a doctor."That s state is very poor,The doctor not to earn money,But as long as valued disease can.Common people on the doctor is very good,Patients to the doctor knitting socks,Send corn/garlic,Very simple.It's not a bribe the doctor,But express gratitude.Now is so pure?I am not willing to let the children go to learn cure."

　　中国医师协会2011年对北京、河北、广东、海南、云南、甘肃等11个省市的6000余位各层级的医师进行的执业状况调查问卷显示，近8成医师不希望子女从医，近5成医疗工作人员对目前的执业环境不满意，甚至不少医生对自己的执业环境感到恐惧和不安。(半月谈记者 李亚红 蔡玉高 郎秋红 秦亚洲)

The association of Beijing in 2011/hebei/guangdong/hainan/yunnan/Gansu province is one of 11 provinces and cities more than 6000 bit at all levels of doctors in practice condition investigation questionnaire display,Nearly 8 into a doctor don't hope that their children becoming doctors,Nearly five into medical staff to the present practice environment not satisfied,Even many doctors to his own practice environment feel fear and upset.(半月谈 reporter LiYaGong CaiYuGao LangQiuGong qin Asia)