The “medical community” has approached a number of people familiar with the matter and tried to answer some of the doubts of Pearson.
Writing | Wang Hang
Source | “Medical Community” Public Account
On August 23, the 2022 resident standardized training completion theory assessment results were officially announced.
Recently, a number of hospitals have “released the list” to share their experience in training medical talents. All the residents of the Stomatological Hospital Affiliated to Southwest Medical University passed the graduation examination. After achieving a 100% pass rate in 2020, Hanzhong Central Hospital of Shaanxi Province has achieved excellent results again this year.
“Graduating is not the end, but a new starting point for independent practice of medicine.” A medical student told the “Medical Community” that although he successfully passed the assessment, he was not in the process of becoming a high-level clinical physician. “I still have a long way to go.” At the same time, there were also candidates who failed and expressed the hope of “adding an exam opportunity this year”.
A qualified physician is only a professional physician
The beginning of independent practice
“1095 days, 36 departments, 156 small lectures, 78 teaching rounds…”
On August 24th, at the “Graduation Ceremony of the 2022 Resident Standardized Training Trainees” in Hunan Provincial People’s Hospital, a video recorded the epitome of residents’ life and study in the hospital. In the latest residential training assessment, the candidates of the hospital have achieved good results, and the pass rate of the clinical practice ability assessment has reached 100%.
In this year’s assessment arrangement, most provinces across the country have completed the final assessment on July 19. Affected by the new crown epidemic, the theoretical examinations for some candidates in Gansu, Jiangxi, Hainan, and Beihai, Guangxi and other places have been postponed.
The final assessment of the live training is a test after three years of training, and it is also a “gorgeous transformation” of the doctor’s role. To become a doctor, a medical student needs to take the medical practitioner qualification examination and obtain a medical practitioner qualification certificate, which means becoming a doctor with basic medical qualifications (regardless of specialties).
Standardized training for resident physicians is the only way to cultivate the level of qualified clinicians in various specialties (internal medicine, surgery, general practice, etc.). In other words, passing the final assessment of the residential training program represents the basic ability of a “professional physician”.
This also means that young doctors who pass the assessment cannot “sit back and relax” and be content with the status quo. A qualified residency is just a new starting point on the road of growth.
In recent years, with the continuous investment of the National Health Commission in cultivating health talents, in line with the principle of “quality as the lifeline”, the quality of standardized training for Chinese residents has been continuously improved, and a large number of excellent Medical talents are sent to medical institutions at all levels.
In 2021, the Chinese Medical Doctor Association conducted a questionnaire survey of 50,000 residents. The results showed:
95% of instructing physicians and 97% of managers believe that residency training is basically competent for the job;
93.9% of resident physicians said they could find professional jobs;
85.6% of the resident physicians said that their core competencies have been improved after training, and the scores of each item are generally greater than 8 (the highest score is 10).
Completion assessment system for residential training
Increasingly stable and improved
The assessment of the completion of the residency training focuses on the clinician’s job competence, which mainly evaluates his/her ability in clinical thinking, interpersonal communication, practical operation, etc. to independently and regulate the clinical diagnosis and treatment activities of the specialty. Comprehensive quality. There is no fixed pass rate, nor is it a last-place elimination system.
The “medical community” has learned from relevant parties that the overall pass rate of this year’s residential training theory assessment is about 90%, of which the pass rate of the first test is about 93%, and the first pass rate of postgraduate students is about 90%. The pass rate is over 95%, which is basically the same as in previous years.
The “medical community” found that the failed candidates in Weibo were mainly postgraduates, and most of them said that “the lack of a certificate of residence training will affect their further studies and employment. I hope that it will be the same as last year.” , give me another chance.” “We medical students are struggling in the front line, and our 8-year efforts have been denied by a transcript again. We can’t study for a Ph.D. and can’t find a job. We really have no choice…”
There is disagreement among medical students and physicians on this request. A medical student publicly stated: “We basically only have one or two people every year, but they are the ones who never read books and don’t take them seriously.”
Some instructors also said: “Most provinces have a pass rate of more than 90% for standardized training exams, and some even exceed 95%, which is not low. Any exam must be serious, Strict control is also for the life, health and safety of the common people. Failure in the examination indicates that the basic skills are still lacking, and it is necessary to spend time in clinical practice to make up for it, rather than ‘replacing training with examinations’, which neither conforms to the rules of examinations nor guarantees the quality of physician training. In the end, it is the health rights and interests of the common people that will be harmed.”
Reviewing the completion assessment, since the implementation of the residential training in 2014, due to inconsistent work in various places and different batches of trainees, the state has not made a unified arrangement, and the implementation is carried out by specific local organizations.
During the period from 2017 to 2019, the state provided twice-a-year graduation assessment services for local selection to meet the needs of different training objects. The assessment in May mainly meets the graduation needs of postgraduate students, and in the second half of the year, it mainly meets the needs of residents who are admitted late (mainly residents recruited and recruited for the society).
However, in the actual operation process, some regions allow those who fail the assessment in the first half of the year to participate in the assessment in the second half of the year. This may be the main reason why some candidates mistakenly believe that “the exam can be taken twice a year” .
With the gradual unification of the training time of students in various places, the completion assessment work also has the conditions to resume the design of the “one test a year” system. In addition, due to the impact of the new crown epidemic, the national graduation assessment in 2020 will be implemented for the first time in “one test a year”.
In 2021, the national graduation assessment will continue to implement the “one test a year”, and the Ministry of Education has not simultaneously “decoupled” the degree award from the residency training certificate, which is strongly reflected by graduate students. Taking into account the new crown pneumonia epidemic and other aspects, and some graduates in the second half of 2020 still need to take the first test, the relevant departments have taken temporary special measures and provided an “additional test” in October last year.
From a deeper level, as a humanized design, “additional test” is more like a run-in period of health and education systems, as well as a helpless move under the situation of new crown pneumonia epidemic prevention and control. And standardizing the completion assessment is an inevitable move to standardize the training itself. Since the second half of 2021, the Chinese Medical Doctor Association, the National Health Commission’s Talent Exchange Center, provincial health departments, and training bases have repeatedly preached to the trainees, and the graduation assessment in 2022 will continue to be held once a year.
A number of authoritative experts said that the final assessment of residential training is the “baton” of the quality inspection of living training, the “wind vane” of the living training system, and the “big inspection” of the clinical ability of the training subjects. , “We must strictly control the attitude of being responsible for people’s health, and never ‘release water’.”
At the same time, the nature of the residential training assessment is a level evaluation test rather than a selection test. Passing the test represents that the trainee has the most basic level of ability to safely and effectively engage in the clinical work of this specialty. The standard setting should not be “excessive” “.
Experts also clearly pointed out that for such a serious examination as the graduation assessment, the return to the system design of “one test a year” is an inevitable choice to standardize the training work and ensure the quality of training, which cannot be shaken. .
What if I fail the final exam?
“What should I do if I don’t pass the graduation assessment this year?” Facing the questions of many candidates, Weibo V “bug doctor monk” analyzed that “it is almost impossible to make up the test”.
He stated that this year’s final assessment was different from last year’s. “Last year, the final exam was still linked to the degree certificate, but it was announced early this year that it was delinked. Now it’s the end of August, and everyone’s degree certificate has already been obtained.”
A number of teachers and students in residential training said that in September 2021, the “First Lecture for Admission to Training” organized and implemented by the Chinese Medical Doctor Association has been communicated to teachers and students in residential training bases nationwide in advance The examination policy clarifies the organizational form of “one test a year”. Some candidates said: “The teacher repeatedly emphasized that one test is required, and the informed consent was signed before the test, so there is a psychological expectation for this.”
Affected by the epidemic, the 2022 graduation assessment will be postponed from May to July, which is in the “graduation season” and “employment season”. In order to promote the smooth employment of candidates, the National Health Commission and the Ministry of Education have made corresponding adjustments to the employment policy and degree awarding policy.
It is understood that the National Health and Health Commission issued a notice in May this year, requiring medical institutions at all levels not to make the acquisition of a residency training certificate a prerequisite for the recruitment of clinicians in their units this year. The Ministry of Education also stipulates that this year, the relevant degree-granting units may not regard the obtaining of the certificate of qualification for residence and training as a necessary condition for degree-granting.
Weibo Big V “Insect Doctor Monk” suggested to the failed candidates, in order to minimize the impact, “If you have a degree certificate this year, is it feasible to communicate with the unit well, many graduates this year I have already joined the job, and the file and job number have been processed, and it should be negotiable.”
Some experts also said that although candidates who fail the assessment do not have a training certificate, they already have the qualifications for practicing physicians and can engage in related medical practice activities. It is recommended that candidates do not blindly increase and choose employment units rationally. , First get a job, improve your ability in practice, and try to pass the exam next year.
The “medical community” learned from the Chinese Medical Doctor Association that the association is in contact with some students who have failed the assessment to understand the specific difficulties and assist in solving them. The Chinese Medical Doctor Association will also carry out targeted inspections on training bases with low training quality based on clues.
Another expert appealed to the “medical community”, hoping to “reduce the burden” of the standardized training examination and reduce the additional items associated with the completion assessment and postgraduate study. He said that the purpose of live training is to ensure the homogeneity of clinician training and promote the homogeneity of medical level, so as to provide safer and higher-quality medical and health services for the common people.
“Certificate of Qualification for Residential Training is the certification of the clinical ability level of the training object, and does not represent other abilities. Graduate education has its own educational goals and training rules. Universities confer master’s degrees and recruit doctoral degrees. In such links, it should be comprehensively evaluated from the aspects of academic development, scientific research thinking, professional ethics, etc., so as to give young people more room for growth.”
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