新华网两会访谈：解码“医学毕业生为何不愿穿上白大褂” Xinhua net two interviews:The decoding"Why do medical graduates don't want to put on a white coat"

　　据估算，我国每年培养数十万名医学生，只有约10万人穿上白大褂，不少在职医生也在转行，基层医生流失严重。

It is estimated,The training was conducted among hundreds of thousands of students each year in our country,Only about 100000 people wearing white coats,A lot of on-the-job doctor was turned,Grassroots doctors erosion is serious.

　　“白衣天使”是一个神圣的称谓。可如今为何那么多医学毕业生弃医改行，更不愿到基层？2013年全国两会期间，全国政协委员、宁夏医科大学校长孙涛做客新华网两会访谈，从他所了解的西部基层医疗事业面临的困境，解读相当一部分医科学生对未来职业纠结之情。

"White angel"Is a sacred title.But now why so many medical graduates abandon health reform,More reluctant to the grassroots?In 2013 the country during the two sessions,The CPPCC national committee/Ningxia medical university principal Sun Tao at xinhua both interviews,From what he understand the plight of the grassroots medical enterprise faces,Read quite a number of medical students professional struggle for the future of love.

　　

“普通感冒本可以在基层解决，但实际又不能在基层解决，这是医患双方的问题” "The common cold, this can be solved at the grassroots level,But it can't solve at the grassroots level,This is a question of both doctors"

　　现年56岁的孙涛曾是一名赤脚医生，在宁夏农村行医多年，恢复高考后接受了系统医科教育，经过不懈努力最终成为一名神经外科专家。即使在如今担任行政领导职务，他仍坚持每周一次大查房，每周做一台手术。作为一名地方医疗事业的领军人物，孙涛对西部医疗现状有深刻认识。

The 56-year-old Sun Taoceng is a barefoot doctor,In ningxia rural medical practice for many years,Restore the university entrance exam after accepted the medical education system,After unremitting efforts to finally become a neurosurgical specialist.Even in today's administrative leadership positions,He still insists on grand rounds once a week,A week to do a surgery.As a leader of a local medical enterprise,Sun Tao have deep understanding on western medical status.

　　“温总理的《政府工作报告》确实让人非常振奋。我作为一个医学教育工作者，特别关注总理提到要完善基层的卫生医疗机构运行新的机制，我觉得这说到了问题的根本。相当多的病人愿意到大医院看病，这是由于基层医疗卫生的人员缺乏和质量不到位，功能不完善。现在国家投入主要花在大城市大医院和中小城市的大医院，应该让基层的医疗机构得到更多保障。”

"Premier wen's[The government work report]Do let a person very exciting.I, as a medical education workers,Pay special attention to the health of prime minister mentioned to perfect the grass-roots medical institutions run the new mechanism,I think this says to the root of the problem.Quite a lot of patients are willing to large hospital see a doctor,This is due to the lack of basic medical and health personnel and the quality does not reach the designated position,The function is not perfect.Now countries invest mainly spend big hospitals in big cities and small and medium-sized cities of hospitals,Should let grassroots medical institutions get more security."

　　孙涛说，“老百姓一个普通的感冒，本来完全可以在基层解决，但实际又不能够在基层解决，这是医患双方的问题。”

Sun Tao said,"People a common cold,Originally can solve at the grassroots level,But the actual can't resolve at the grassroots level again,This is a question of both doctors."

　　基层医疗人才缺口到底有多大？ 北京大学公共卫生学院教授陈育德在此前接受媒体采访时曾谈到，按照国家计划，到2015年要为城乡基层培养15万名全科医生，目前只有7.8万，且大部分是转岗培养的。

How much grassroots medical talent gap? School of public health, Peking University professor Chen Yude before media interview talked about,According to the national plan,In 2015 for the urban and rural grassroots culture 150000 gp,At present only 78000,And mostly job-transfer training.

　　孙涛告诉记者，他曾带领课题组做过一项调查，每千人拥有的乡镇卫生院编制人数或者村卫生院人数在西部地区指数大概是0.91和0.95，全国是1.18，中部地区达到了1.12。“以千人为单位，不论农村人口拥有的乡卫生院的数量、还是每千人农村人口拥有的村医的数量，宁夏都低于全国平均水平，也低于中部地区。这说明西部地区卫生人员的短缺情况非常严重。”

Sun Tao told reporters,He had led the team to do a survey,Per 1, one thousand people have in towns and townships of number or number in the western region village health hospital index is about 0.91 and 0.95,The country is 1.18,The central region is 1.12."With thousands of units,Regardless of the rural population has the number of township hospitals/Or every one thousand people the number of rural population have the village doctor,Ningxia is below the national average,Also below the central region.This shows in the western region the shortage of health personnel situation is very serious."

　　让孙涛担忧的不只是基层人员匮乏，还有基层医务人员队伍结构问题。“宁夏的村医只有40%达到中专学历，其余都是非医学专业出身，基层卫生机构不仅仅是人才短缺，功能不完善，医疗人员学历低、医疗质量差等，加剧了老百姓看病难。”

Let Sun Tao concerns not only the lack of personnel at the grass-roots level,And grass-roots medical personnel structure problem."Ningxia village doctor only 40% reached technical school education,The rest are medical professional background,Grassroots health institutions is not only a talent shortage,The function is not perfect,Medical personnel degree is low/Medical quality is poor,The people see a doctor difficult."

　　2009年新医改启动以来，国家在政策方面不断给予中西部地区农村人口加大医疗服务保障力度，2010年针对中西部特别是农村出台了《关于开展农村订单定向医学生免费培养工作的实施意见》，定向招生，定向培养，送回农村，以此解决基层的卫生人员短缺的问题。孙涛说，这是一个非常好的政策。

Since the reform began in 2009,Countries in the aspect of policy continue giving the Midwest rural population increasing medical service safeguard,In the Midwest especially rural issued in 2010[About rural order oriented medical students' training work of the implementation opinions for free],Directional recruit students,Orientation training,Back to the countryside,In order to solve the shortage of grassroots health workers.Sun Tao said,This is a very good policy.

　　

定向生为何不愿下基层 Directional why refuse to supply

　　定向培养能否留住医科毕业生？尤其是在社会经济发展水平相对落后的西部农村，有多少医学院学生愿意到基层工作？虽然宁夏医科大学的第一批定向培养学生刚上三年级，要到2015年才毕业，但一种强烈的担忧已盘亘在孙涛心头。

Orientation training can keep medical graduates?Especially in the social and economic development level is relatively backward in western rural areas,How many medical students are willing to work at the local level?Although ningxia medical university the first batch of orientation training students just in grade three,To graduate until 2015,But a strong concern has stretch in Sun Tao mind.

　　“学校做过一次关于就业意向的调查，70%的学生表示签了定向协议后就后悔了，23%的学生表示很迷茫，只有7%的人愿意到基层。”孙涛说。

"The school made a survey about employment intention,70% of students said they signed the oriented protocol and then regret it,23% of students said confused,Only 7% of people would like to base."Sun Tao said.

　　北京大学医学人文研究院一项针对380名医学本科生所做的就业意愿调查也显示，8成医学生希望留在大城市，只有2成愿意去基层。

Medical humanities research institute of Beijing university did a study of 380 medical undergraduates employment intention survey showed,8 into medical students hope to stay in big cities,Only 2 into willing to grassroots.

　　孙涛说，这三年来，宁夏医科大学分别接收了180位定向培养学生，政策规定学生毕业后要到基层服务6年。联想到此前学校曾推行过的一个类似项目，60名定向培养的学生最终没有一人履行承诺，前往基层，也就是县级和县级以下医疗机构工作，孙涛更加忧心忡忡。

Sun Tao said,The past three years,Ningxia medical university received 180 directional cultivating students respectively,Policy sets students after graduation to grassroots service for six years.Lenovo has introduced a similar to the previous school project,60 directional cultivating students final commitments by no one,To base,That is at the county level and the following work of medical institutions at the county level,Sun Tao more worried.

　　学医学习时间长、学业压力大、培养学生国家投入大，医生的成长成才之路尤其艰辛。真正成为一名医生之后，工作超负荷，劳动超强度，没时间陪家人、没时间谈恋爱，这是我国医生们的普遍现状。与医生工作强度形成反差的是其正常收入并不算高，基层医务人员工资收入更少。

Study medicine long learning time/Academic pressure/Trains the student to countries with large,The doctor's growth is especially hard on the road success.Really to be a doctor,Work overload,Labor intensive,Don't have time with family/Have no time to fall in love,This is the general status of doctors in our country.And doctors work intensity contrast is their normal income is not high,Grass-roots medical personnel pay less.

　　宁夏情况同样如此。孙涛说，相当多的村医靠正常收入无法养家糊口，同时还要下地种田或去打工。

The same story.Sun Tao said,Quite a number of village doctor on normal income cannot feed their families,Even at the same time engaged in farming or go to work.

　　定向生们最关心的就是将来到了基层能够拿多少钱、有没有编制、将来的晋升能否解决。这是事关每个人切身利益的现实问题。但正是因为对编制、待遇、晋升等问题的不确定，导致他们到基层就业的方向十分不放心。比如，现行政策规定，在一个乡镇卫生院要解决晋升问题，就需要求按照县卫生院的标准来要求，比如要求发表两篇论文。在孙涛看来，这样要求乡镇卫生院的医生甚至村医，实际上是很难做到的。

Directional are most concerned about is how much money the local can take in the future/If there is any preparation/Promotion can solve in the future.It is about everyone vital interests of the real problem.But it is because of the establishment/treatment/Not sure. The problems of the promotion,Lead them to the grassroots employment direction is not assured.Such as the,Current policy,In towns and townships to solve the problem of promotion,Will need to request requirements in accordance with the standards of county hospitals,Such as requiring published two papers.It seems to Sun Tao,Ask the doctor even village doctor in towns and townships,In fact is hard to do.

　　“当务之急是需要解除学生的后顾之忧，让他们下得去，留得住，也就是《政府工作报告》所提到的，要完善基层的卫生医疗机构运行新的机制。”孙涛说。

"It is imperative to remove trouble back at home of students,Let them have to go,To retain,That is[The government work report]mentioned,To improve the grassroots health institutions to run the new mechanism."Sun Tao said.

　　

“大医院像自由市场，医学生不愿下基层，我忧心忡忡” "Large hospital as the free market,Medical students are reluctant to supply,I'm worried about"

　　医生这项职业，救死扶伤，对很多人来说是充满荣誉感的行业，可是根据中国医师协会对医生子女学医的态度进行调查发现，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 medical profession,Heal the wounded and rescue the dying,For many industry is full of sense of honor,But according to the Chinese medical doctor association survey found on doctor the attitude of the children to study medicine,An increasing proportion of doctors don't want their children to study medicine,53% in 2002,63% in 2004,78% in 2011.

　　从医多年，孙涛深刻体会到，当前医患矛盾突出带来的不信任感是很多医科毕业生“弃医”的重要原因。“所以必须强调医学人文教育，因为医术是个人术，因为他的服务对象是人，而不是物。所以医学不仅仅是你有一个技术的问题。虽然你有了技术，但你没有一个好的医德，没有责任心，没有对病人最起码的尊重和爱，那将会带来严重的问题。”

Working for many years,Sun Tao profound experience,The mistrust of the doctor-patient contradiction is a lot of medical graduates"A medical"The important reason."So must be emphasized that medical humanities education,Because medical skill is a person,Because of his service object is a person,Rather than the content.So medicine is not only do you have a technical problem.Although you have the technology,But you don't have a good medical ethics,Without the sense of responsibility,Have no respect for the patient at the very least, love,That will lead to serious problems."

　　宁夏医科大学在教学方案中特别设计了人文教育课程，专门开设了医学人文系。在后期的临床教学阶段由从事医疗卫生管理和医学管理的人员对学生进行医学卫生政策、医患的沟通、医学伦理等方面的教育。

Ningxia medical university in the teaching plan in the special design of the humanities education curriculum,Opened the department of medical humanities.In the late stage of clinical teaching by the personnel engaged in medical and health management and medical management for medical students health policy/The doctor-patient communication/Education of medical ethics, etc.

　　“这几年整体社会的反响不错。在当前的大环境下，如何让学医的学生更富有仁爱之心，有良好的医德，去服务于基层老百姓，是非常重要的。如果我们医学生没有仁爱之心，不能为老百姓服务，那将是很可怜的事儿。”孙涛说。

"In recent years the response of the community as a whole is good.In the current circumstances,How to make the medical students is more rich in the heart of love,Good medical ethics,To serve the people at the grass-roots level,It is very important.If we don't have any kindness blent medical students,Can't service for people,It will be very poor."Sun Tao said.

　　当记者问及孙涛的“中国梦”，他说，“我是一个医生，每当我出诊的时候看到大医院的大厅里挤得就像自由市场一样，老百姓都拥挤到此，我们培养的学生不愿到基层去，基层医院不能完成基本的医疗服务，让我忧心忡忡。我最大的梦想是希望更多的学生愿意从事基层医疗卫生工作，让老百姓回归基层医院，就近接受就诊、保健等一系列完整的医疗服务。”(新华网记者 曹滢 李莹)

When a reporter asked about Sun Tao"The Chinese dream",He said,"I am a doctor,Every time I visit to see big hospital in the lobby of packed just like the free market,People crowded into it,We cultivate students don't want to go to grassroots,Basic-level hospitals could not be completed basic health services,Let me worried.My biggest dream is to hope that more students are willing to work in the basic medical and health care,Let people return to the grassroots hospitals,Accept to see a doctor nearby/Health care and a series of complete medical service."(Xinhua Cao Ying unpaid)