In China, before the introduction of the National Standardized Resident Training (SRT), graduate medical training was scattered, unstructured, and unregulated; and unequal in their demand for training organization and staff, teaching contents, ways of teaching and training, appraisal and assessment of the trainees, and eventual certification. These practices unavoidably had produced unequal products, i.e. doctors, with widely varying quality. They had given rise to dissatisfaction, concern and criticism from the public and strong call for reform.[1,2] To meet these calls, seven related ministries led by the Ministry of Health in 2013 published a circular on the establishment of SRT.[3] Its aims are to design, formulate and implement a much more strengthened, structured and standardized graduate medical training program, and thereby eliminating the unqualified medical practicing doctors and their poor medical service.[4] The national SRT is now made mandatory for any medical graduate who wishes to practice as a medical doctor in China.
Further documents from the relating ministries in the ensuing years had been issued on the construction and work of hospital training bases and professional bases. The bases are asked to learn and follow the relevant national policies as well as the training documents and regulations; and to carry out these guides and rules strictly, with penalty if failing.
Some of the criticism of the training content so far include too much theory, too feeble on humanities and ethics; missing the balance among knowledge, skill and good conduct. There are complaints that many of the teaching staff are ill prepared and unqualified. The trainees have been granted only inadequate decision making and allowed little independent thinking.[5] Above all, the standard and implementation of SRT remain varying and unequal, though to lesser degree nowadays. This is because China has a massive population, expansive land, and numerous regions, some poor and some rich. It is proven a challenge to standardize the training, accreditation and certification.[4]
Shenzhen (SZ) is a fast growing metropolis. Due to the Chinese special and preferential policy granted to it, it has developed into a major Chinese metropolis of some 20 million inhabitants from a fishing village only 40 years ago. For the SZ City Government and its Health and Family Planning Commission, to establish and run an international standard hospital with Chinese socialistic characteristics and to raise the City into a leading world metropolis were high on its agenda for some time. To realize these ambitions, the University of Hong Kong – Shenzhen Hospital (HKU-SZH) was designed and opened in 2012 as a joint venture between the University of Hong Kong (HKU) and the SZ City, hopefully “to be first class nationally and world renown” one of these days. In 2014, it was awarded Australian Council on Healthcare Standards (ACHS) accreditation; and in 2017, the status of 3A Hospital and the National Standardized Resident Training Base. The Department of Medicine of HKU-SZH also became one of the professional training bases in 2017. Our first batch of trainee resident doctors arrived at the Hospital in Sep. 2018.
The Department of Medicine with its seven specialty divisions has formed its own education committee and also a supervisory group comprising the training director of the professional base as well as the medicine training program director, two training secretaries and a teaching assistant (administrative). The education committee meets every two months to discuss teaching plan and methods and so on. The supervisory group participates in inspection of various divisional training bases about their teaching plan and contents, and their implementation and quality, and provides constructive feedback.
Our hospital has been in operation for barely 10 years. The trainers drawn from its medical personnel pool are bound to be relatively young with limited teaching experience. It is a steep learning curve for the young teaching hospital and staff to rise to the challenge. We learn that it is vital to inspire both trainers and trainees to make teaching and learning interesting, inspiring and rewarding. Other than following the national guides and rules, we are trying to introduce some innovative measures of our own to produce competent medical doctors with knowledge, skills, humanity and ethics. Here we describe what we have done so far in these connections and the results achieved. The local ethics committee at the HKU-SZH has granted this study an exemption from requiring ethics approval.