title: Development of a medical academic degree system in China.
abstract: BACKGROUND
  The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform.
  
  
  OBJECTIVE
  We describe the current status of the Chinese medical degree system and its evolution over the last 80 years.
  
  
  BACKGROUND
  Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP). The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants.
  
  
  CONCLUSIONS
  The future education reforms might include: 1) a domestic system of 'credits' that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2) International - a mutual professional and academic recognition between China and other countries by reference to the Bologna Accord, setting up a system of easily comparable and well-understood medical degrees.
authors.affiliation: Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Wu
authors.affiliation: Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
authors.forename: Youxin
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Peng
authors.affiliation: Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
authors.forename: Manshu
authors.initials: M
authors.lastname: Song
authors.affiliation: Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Guo
authors.affiliation: Shekou International SOS Clinic, Shenzhen, China; hugh19480915@gmail.com.
authors.forename: Hugh
authors.initials: H
authors.lastname: Nelson
authors.affiliation: Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia; wei.wang@ecu.edu.au.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
mesh_terms: D002681:China; D002983:Clinical Competence; D004501:Education, Medical / Q000458:organization & administration* / Q000592:standards; D018166:Health Care Reform; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D011057:Politics; D015397:Program Evaluation
keywords: Bologna Accords; China; medical degree; medical education; medical licensing