The author of this article: Tun Tun
In the cold wind of January, there was only an empty door left at the gate of Jinan Central Hospital. The original plaque of “Jinan Central Hospital Affiliated to Shandong University” disappeared in the wind along with a document.
Jinan Central Hospital Gate
Image source: provided to Wan (pseudonym)
On December 31, 2021, the Shandong Provincial Health and Health Commission and the Shandong Provincial Department of Education issued the “Notice on the Announcement of Undergraduate University Affiliated Hospitals”, The document lists 96 The list of affiliated hospitals of undergraduate colleges and universities, and the relationship between hospitals outside the list and affiliated hospitals established by colleges and universities will be cancelled, and the rectification will be completed within 10 days. This document identifies Jinan Central Hospital as an affiliated hospital of Shandong First Medical University.
This is the first public document on chaos control in a university hospital.
Photo source: Shandong Provincial Health Commission
Public by request
At the end of 2020, the Ministry of Education clearly pointed out in the “Reply to Recommendation No. 3381 of the Third Session of the Thirteenth National People’s Congress” that affiliated hospitals are an important support for clinical medical education and the construction of clinical disciplines. It is an important carrier of medical schools and an indispensable and important part of medical schools, but it is opposed to blindly adding affiliated hospitals.
In January this year, Shandong University issued the “Shandong University Letter on Doing a Good Job in the Follow-up Work of Special Treatment and Rectification of Affiliated Hospitals”, requesting Jinan Central Hospital to cooperate with the removal of “Jinan Central Hospital Affiliated to Shandong University” plaque.
Above: Jinan Central Hospital before delisting;
Below: Jinan Central Hospital after re-listing
Image source: provided by the parties
With the removal of a sign that says “I don’t deserve it”, the “enclosure movement” in which the medical school has lavished hospital revenue seems to have come to an end.
No wind, no waves
This hand that wants to be delisted may have been in the land of Qilu for a long time.
Shandong has a total of 10 colleges and universities with medical schools or medical colleges, and colleges and universities compete fiercely for listed affiliated hospitals.
In 2019, Shandong No. 1 Medical University landed, and in less than a year, it had 13 directly affiliated hospitals and 23 non-directly affiliated hospitals.
In 2018, Shandong University listed 6 affiliated hospitals in 2 days. A large number of affiliated hospital brands under the name of Shandong University may not have been hot, and they have been delisted in this rectification, either disappearing from the list announced this time, or being identified as affiliated with other universities.
However, looking at the whole country, it is not only Shandong that has set off a wave of affiliates.
In 2004, 6 universities including Tsinghua University, Taishan Medical College and Southern Medical University simultaneously added 9 affiliated hospitals. In the following five years, 19 colleges and universities led by Southern Medical University have added more than 40 affiliated hospitals, and Southern Medical University alone has added 8 non-directly affiliated hospitals.
In 2009, after the Ministry of Education and the Ministry of Health jointly issued “Several Opinions on Strengthening Medical Education and Improving the Quality of Medical Education”, the expansion of university-affiliated hospitals showed a blowout trend; only that year There are more than 20 hospitals have been incorporated into the medical schools.
Among them, unless it is an affiliated hospital of a newly established medical school or a newly established hospital, most of the other listed affiliated hospitals are not directly affiliated hospitals.
Ranking of the number of affiliated hospitals in China
As of January 2021
Picture: I made it myself
But there’s a lot of chaos in it.
The first question exposed is, can so many hospitals, colleges and medical schools manage it?
Like Grandet who saw money, some universities blindly pursued to expand the number and scale of their affiliated hospitals, and even many medical schools began to encompass hospitals from other places. However, in a land of 9.6 million square kilometers, it is difficult to guarantee the consistency of teaching level among various hospitals. A number of interns from a medical university in Shandong told Lilac Garden: “There are too many hospitals, and it is difficult to distribute teaching resources evenly among students. The effect of internships in non-directly affiliated hospitals is not as good as that of the two schools in their own schools. A major affiliated hospital.”
Regardless of whether it is directly affiliated or not, one of the most important tasks of the affiliated hospital is to undertake the clinical teaching task of medical students. Professor Liu Tingfang, founder of Tsinghua University Hospital Management Research Institute and senior advisor to the dean, told Dingxiangyuan, “In fact, the quality of clinical teaching practice in a large number of affiliated hospitals is difficult to meet the standards, and they do not meet the requirements of affiliated hospitals.” strong>
Another question is, how will the new medical school come out? A large number of hospitals have been divided up by colleges and universities, and it is even more difficult for newly established medical schools to set up their own directly affiliated hospitals.
In 2015, the University of Chinese Academy of Sciences established Cunji Medical College, but because the major tertiary hospitals in Beijing have been almost replaced by Union Medical College, Peking University, Tsinghua University, Capital Medical University, Beijing Zhongshan University After the division of the Medical University, etc., none of the six directly affiliated hospitals of Cunji Medical College is located in the capital. Apart from the North China Hospital Affiliated to the National University of Science and Technology in the Xiongan New Area, the nearest affiliated hospital is located in Hangzhou, 1,500 kilometers away.
Similarly, after East China Normal University was planning to build a medical school, its only general affiliated hospital was located 300 kilometers away in Wuhu City, Anhui Province.
Some people come and go, some people lose it
Grande’s love for money may be unrequited love, but the affiliated hospitals of colleges and universities often go both ways, and the interests of both parties can be satisfied.
For the hospital, after becoming an affiliated hospital of the university, it can rely on the scientific research platform of the university to establish contact with the laboratories of various disciplines of the university and form a unified scientific research community. At the same time, you can also apply for various types of funding in the name of the university. For example, after the First Affiliated Hospital of the University of Science and Technology of China became an affiliated hospital, the number of national natural projects in 2020 is second only to the Peking University People’s Hospital.
In addition, undertaking the teaching tasks of colleges and universities is also one of the assessments of the hospital grade review. Hanging up the brand of colleges and universities, the hospital has added another confidence on the road of rating.
Excerpted from the Accreditation Criteria for Tertiary Hospitals (2020 Edition)
Source: National Health Commission
For universities, hospitals in their affiliated regions can seize the opportunity of regional medical care and form a better medical network. At the same time, the scientific research output of the affiliated hospitals can be counted under the name of the university, and the joining of high-level hospitals plays an almost decisive role in enhancing the prestige of the university’s medical school.
In addition, Xu Yucai, former deputy director of the Shanyang County Health Commission of Shaanxi Province, told Lilac Garden, “Universities sometimes choose to list affiliated hospitals in large provinces where students come from to attract more candidates. Apply for college.”
Expanding the pool of affiliated hospitals for the sake of reputation and influence is bound to be a mixed bag. As mentioned above, some affiliated hospitals are only listed, and do not actually undertake the teaching tasks of colleges and universities. It is in response to this phenomenon that Shandong issued a document this time to cancel the affiliation between a large number of hospitals and universities.
Professor Liu Tingfang said to Lilac Garden, “This rectification is very necessary and timely, which ensures the high-quality development of public hospitals and ensures that the medical students trained by our medical school are It truly complies with national regulations and the needs of patients.”
Becoming an affiliated hospital of a university should not be the only life-saving straw for the development of the hospital. Xu Yucai told Lilac Garden, “The country also has the task of training general practitioners for teaching practice. If it is a medical institution with clinical teaching capabilities, it can completely win the teaching points of general practitioner training by its own strength, and cultivate more It is also one of the very important tasks of public medical institutions to have more competent medical staff.”
Photo source: National Health Commission
Under the changing circumstances, perhaps the most helpless among age-old intricate partnerships and frequent affiliate changes are medical students. Xiang Wan (pseudonym), a student from a university in Shandong, told Lilac Garden, “I have seen classmates and teachers arguing in the department because the teacher asked that the article must be published in the name of the new partner university.”
Who’s next?
For these “behemoths” dragging dozens of affiliated hospitals, Shandong took the lead in starting the forced slimming, leaving only 96 affiliated hospitals in the province.
And to the south to the Southern Medical University, to the east to Nanjing University of Traditional Chinese Medicine, to the north to Hebei Medical University, to the central Chengdu University of Traditional Chinese Medicine, and many medical schools still have a large number of affiliated hospitals. .
Professor Liu Tingfang said to Lilac Garden, “The affiliated hospitals of medical universities and medical schools should be in short supply rather than excessive, and the quality must be guaranteed, and some hospitals that do not meet the requirements cannot be made affiliated hospitals because of insufficient resources. Medical-trained students are related to human health and life. Humans are not machines, not as simple as repairing a screw.”
“The problems to be solved in Shandong are not limited to Shandong.”
Planning: yuu., carollero
Producer: gyouza, Leu.
The source of the title map: provided to the evening