Currently, there are main models for cultivating top innovative talents in clinical medicine in China. The "5+3+X" program aligns with the standardized physician training system, ensuring a seamless transition from academic education to professional development. The eight-year model breaks the barriers of traditional segmented training and enhances the efficiency of medical talent cultivation. The "doctor of medicine+doctor of philosophy" dual-degree model integrates clinical and research competencies, cultivating well-rounded professionals who excel in both clinical proficiency and scientific research. And balancing three key relationships: the interplay between clinical skills and scientific research capabilities, the trade-off between time investment and training outcomes, and the choice between consistent training and interdisciplinary training.

Since the early 20th century, clinical medical education in the United States has undergone three major reforms, each of which has profoundly influenced the global landscape and development trajectory of medical education. Viewed through the lens of medical-education collaboration, these reforms exhibit a clear evolutionary logic in terms of reform goals, institutional cooperation, and curriculum design. The reform goals have shifted from cultivating doctors' scientific thinking to competency orientation, institutional cooperation has evolved from institutionalized foundation to ecological collaboration, and curriculum design has progressed from segmented practice to deep integration. These developments have gradually established a medical education collaboration system with "dynamic goal-setting, ecosystem-based cooperation, and clinically-oriented curricula", promoting a deep coupling of the medical education system and the healthcare system. China can learn from its reform experience, establish a dynamic response mechanism for educational goals, build a cross-sectoral collaborative governance structure, and strengthen the clinical orientation and integration of medical curricula.

Background Medical school admission practices vary globally, with China and the US representing two mainstream models: post-secondary and post-baccalaureate. The former relies on a single standardized test score, while the latter evaluates candidates holistically. In this study, we aim to delineate the distinct advantages of each model by examining the experiences of matriculating medical students from both countries and analyzing their perspectives on these divergent admission models. Methods The authors conducted individual semi-structured interviews with first-year medical students from two highly ranked higher-education institutions in China and the US: Peking University Health Sciences Center (PKUHSC), Beijing, and David Geffen School of Medicine (DGSOM) at UCLA, Los Angeles, California. The authors interviewed twenty students from each institution, performed inductive thematic analysis on interview transcripts, and conducted descriptive quantitative analyses of medical student survey data. Results PKUHSC participants were younger and less exposed to clinical medicine before application; many cited external factors that influenced their decision to pursue medicine, and some stated that medicine was not their top choice field of interest. DGSOM participants had more clinical experiences; many took gap years before committing to medical school. Altogether, participants desired medical school admission practices that allow for 1) adequate opportunity for career exploration, 2) consideration of non-cognitive skills and non-academic achievements, and 3) flexibility in the journey before medical school and diversity in the student body. Participants also cautioned about the impact on finances and personal lives, bias in standardized test scores, and limitations to a holistic evaluation in medical school admission. Discussion Striking a balance between selectivity and equity in medical school admission is challenging. The post-baccalaureate model excels in identifying candidates demonstrating preparedness for career in medicine, while the post-secondary model offers accessibility to applicants from disadvantaged backgrounds. Further research is essential to inform best practices in medical school admission.

Background: An important component of global engagement in health professions education is facilitating students having international experiences. Although cross-border visits have existed at some of China’s academic medical centers (AMCs) for more than 30 years, there are few quantitative studies on its overall development and variations between different types of AMCs. Aims: We aim to provide an overall description and measure trends of global engagement of Chinese health professions education programs by comparing inbound and outbound visits of health professions students over a five year interval. Methods: In 2019, Chinese AMCs whose undergraduate medical education programs were eligible for accreditation by the Ministry of Education were invited to complete a web-based questionnaire. Data were analyzed using descriptive analyses, t tests, and Fisher exact tests. Results: A total of 93 AMCs (57.8%) responded to the survey. The number of outbound visits increased by more than three times and the number of inbound visits increased by almost two times between the 2013-14 and 2018-19 academic years. Both the mean and median of outbound visits in 2018-19 academic year were higher than those in 2013-14 academic year (mean 23 vs. 72, p=0.0016; median 4 vs. 22, p=0.000). The mean of inbound visits in 2018-19 academic year was also higher than that in 2013-14 academic year (37 vs. 20, p=0.032). The mean and median of outbound and inbound visits for central government affiliated AMCs were significantly higher than those for other AMCs in these two academic years. Conclusion: Comparison between 2013 and 2018 demonstrated an increased frequency of inbound and outbound visits, indicating a significant expansion of global engagement at China’s AMCs. Measures may be needed to incentivize global engagement at AMCs that are not affiliated with the central government. Trends in the exchanges of students may be related to historical, geographical, and political issues. The findings related to China may be useful to other low- and middle-income countries as they manage global health student exchanges.

目的 使用北京某高校临床医学八年制毕业生就业数据,对其就业情况及变化趋势进行分析,以期探讨对人才培养的启示.方法 采用描述性分析方法,所分析的指标包括就业人数、就业率、就业地域及专业分布.结果 在2009至2021年间,该校共有2 281名临床医学八年制毕业生.其中,毕业当年就业者2 188人,占比96.0%.在医疗机构就业者所占比例平均为90.8%(2 034/2 241),但呈下降趋势.就业地域主要集中在东部经济发达省份,在北京就业者最多,占比78.7%(1 723/2 188).在专业选择方面,以学习外科专业者最多,占比33.0%(753/2 281);其次为内科学,占比24.4%(557/2 281);选择儿科、精神病与精神卫生学等社会急需紧缺专业者极少.结论 临床医学八年制毕业生整体就业形式好,但也需要关注就业呈现的新趋势,进一步优化人才培养方案.在二级学科的选择中,需要进一步加强引导,为学科发展建立合理的人才梯队.需要加强课程思政教育,引导和激励毕业生为急需紧缺专业和边远地区卫生服务作出贡献.

The number of dental schools increased from 55 in 2000 to 66 in 2019 in the United States. The number of public, private, and private-state-related dental schools were 40, 22 and 4, respectively. A majority of them were located in most developed areas, such as western, eastern, and southern regions of the country. In the same period, the number of freshman enrollees rose from 4 234 to 6 231 while the average of enrollees kept under 100. On the basis of learning relevant experiences of the United States, it might be necessary for China to expand the overall scale of stomatology education in order to address the shortage of dentists, take measures to increase the number of stomatology schools and improve their distribution, and control the number of enrollees per school to enhance the quality of education.

Purpose This study compares doctor staffing level and the scale of medical education in China with those of other countries and proposes policy recommendations for future adjustments to the scale of China's medical education. Design/Approach/Methods This study employs a literature review and descriptive analysis. Findings China had 1.98 medical doctors per 1,000 people in 2018, ranking 85th out of the 193 member-states of the World Health Organization (WHO). In 2017, China had 1.99 practicing doctors per 1,000 people, only ranking above Turkey (1.88) in Organisation for Economic Co-operation and Development (OECD) countries. China had only 10.28 medical graduates per 100,000 people—placing in the bottom third of OECD countries. China's provision of 1.4 medical schools per 10 million people was also significantly lower than the global average (3.9). However, the average number of students enrolled in medical schools (509) in China was significantly higher than the global average (160). Originality/Value Although the scale of admission in undergraduate medical education must be expanded in China, this needs to be achieved while controlling the average number of medical students per school and reducing enrollment in low-quality medical schools. Furthermore, it is necessary to establish new medical schools while improving the operating level of existing ones.

BACKGROUND:China has a shortage of physicians and nurses in primary care and rural health. This study explores factors that influence the choices of medical and nursing students in China to select a career in primary care, or in rural health.METHODS:A total of 3826 medical students and 1771 nursing students were surveyed in China. Data were analysed using descriptive statistics, Chi-squared tests, and logistic regression models.RESULTS:The majority of medical and nursing students were willing to practice primary care (55% and 59%, respectively). Yet, only 16% and 5% of medical and nursing students, respectively, desired to work in a village or small city. The most common reasons cited to not practice primary care is the lack of opportunities for clinical skills improvement, academic and personal development, and networking. Medical students who were living in a rural residence between ages 1 and 15years were more likely to report a willingness to work in a rural location (OR: 2.18, 95% CI: 1.33-3.58) or in primary care (OR: 1.72, 95% CI: 1.31-2.25).CONCLUSION:More efforts are needed to understand how preferences among medical and nursing students influence their career choices and change in choices over time. Understanding the concerns of students can help to tailor interventions in healthcare education and training to increase student satisfaction with their career choice and enrolment counts in medical and nursing fields.

印度公立医学院的资金来源主要包括政府投入、学费收入和附属医院的收入盈余.学费收入则是私立医学院的主要资金来源,大多数私立医学院以营利为根本目的.由于监管不严,印度医学院存在腐败问题,损害了医学教育质量.借鉴印度的经验与教训,我国在鼓励私立医学院发展的同时,应注重完善筹资机制以平衡其趋利化倾向;还应进一步完善医学院监督管理制度,以确保人才培养质量.

英国医学院校嵌入式学位项目是医学生攻读第二个学位课程的制度安排,医学生在院校医学教育的第三学年或第四学年等某个时间点中断医学学位课程的学习,额外花费一年或更长时间攻读另外一个学士或研究生学位.分析英国多所医学院校嵌入式学位项目的制度安排与详细课程,发现嵌入式学位制度延长了学习年限,但有利于保证学习效果,拥有较为广泛的专业方向且比较强调科研,在学位授予方面更加灵活,医学生参与程度也较高.嵌入式学位制度是我国建设新医科的一个参考方向.我国高校应引入嵌入式学位制度,以促进"医学+X"新医科拔尖创新人才的培养.

目的:了解当前我国本科医学院校的布局,并对其区域差异性进行深入分析.方法:对院校数量、院校水平利用频数、构成比进行描述性统计;研究院校地区、省份的分布,对区域GDP总量、区域人口与院校规模做相关性分析;用洛伦兹曲线、基尼系数、泰尔指数深入分析院校分布差异性.结果:我国开设医学类专业的本科院校有420所,且分布不均匀;院校水平不一,硕、博点分布不均衡.各省级行政区域的院校硕、博研究生规模主要与该区域GDP总量高度相关,在校生总规模及本科生规模与该区域人口总数相关性更高.院校分布的差异主要源于地区内部,地区间的差异也不容忽视.结论:我国本科医学院校数量相对不足;院校水平不一,硕、博点分布不均;院校分布存在区域差异,需促进区域均衡发展.

Transformative learning in medical education has been adapted in developed countries like UK and USA,and has achieved confirmed effects, such as medical students'attitude of learning and professional values acknowledgement during clinical management of diseases and patients, perception of medicine service in undeveloped areas and continues quality improvement of healthcare services. It is suggested that China may adapt the concept of transformative learning in medical education, pay special attention to the cultivation of medical students' competencies in critical thinking,systems-based practice, and appropriately introduce disorienting environment to challeng and stimulate studens'learning in order to optimize teaching effects.

全球卫生教育是一个以跨国因素引起的健康问题为重点的教育领域,其重要性和必要性随着全球化进程的加速和传染性疾病在全球的肆虐日益突出.开展全球卫生教育成为国际医学教育的重要发展趋势.我国发展全球卫生教育具有十分重要的意义,迫切需要加强高等院校全球卫生科研与教学机构建设,为医学生提供更多全球卫生教育机会,并重视高层次全球卫生专业人才培养.

The rapid development of China's medical education makes great contribution to the building of physician workforce in the country. Chinese physicians play a vital role in effectively treating COVID-19 , pandemic prevention and control. Nevertheless, medical education in China are also faced with a number of challenges, including inadequate number of students, weakness in public health and preventive medicine education, neglect of medical microbiology and infectious diseases, insufficient online study resources. To address these issues, the scale of education still needs to be expanded in order to train more healthcare providers. Meanwhile, public health and preventive medicine education should be strengthened and medical students should be equipped with more knowledge on zoonotic infectious diseases. More investments should be poured into experimental teaching in medical microbiology and the development of virtual simulation experiment teaching. Furthermore, more efforts should be made to construction of strengthen online curriculum resources with the integration and combination of online and offline teaching. The evaluation system for the cultivation of medical professionals should also be reformed in order to promote the capacity building of of clinical and teaching skills.

Introduction Despite China's large and growing global presence, data about global health (GH) education (GHE) in China's medical schools are limited. We aimed to describe GHE in these schools and determine whether some may teach GH concepts without labeling them as such.Methods In 2019, 161 Chinese medical schools eligible for accreditation by the Ministry of Education were invited to complete a questionnaire as part of a national survey. Data were analyzed using descriptive analyses, Chi-square tests, Fisher exact tests, and logit models.Results Approximately 57% of schools completed the survey (n = 93). 33 (35.5%) indicated that GHE was included in the curriculum. Although the majority of responding schools reported the absence of GH in the curriculum, GH topics were identified at many institutions. Schools affiliated with the central government or an aspiring world-class university were more likely to report the inclusion of GHE and offered more opportunities at international away sites.Conclusions Chinese medical schools are frequently teaching GH topics, but may not label the instruction as such. Policy-makers and educators should be equipped with a global perspective to facilitate GHE at China's medical schools and take measures to address differences between schools.

Objectives:To review and summarize the development of China's medical schools, existing issues and put forward policy suggestions based on the perspective of domestic and international comparison.Methods:Descriptive analysis and literature review were implemented.Results:After 150 years' development, the number of China's medical schools reached 192 in 2020. However, there is still a serious shortage of medical schools if taking into account of the large population in the country. The number of medical schools per 10 million persons in China was only about one third of the world average level. The teaching quality of some medical colleges is not satisfactory, and the quantity of highly qualified medical colleges is insufficient. Some other weakness also exist, including large scale of enrollment per school, mal-distribution of medical schools in different regions and lack of a professional administration entity at the national level.Conclusions:China should improve the top-level design and making a national development plan for construction and development of medical schools. Multiple approaches should be taken to steadily increase the number of medical schools. A national organization for professional administration should be established to improve the macro management of medical schools. Finally, Chinese government should play a crucial role in facilitating the construction of medical schools in developing areas.

OBJECTIVE:Mergers of health science faculties in China have resulted in two different admission pathways for medical students. A uniform-code model prioritizes admission to a specific institution with secondary assignment to major. A separate-code model prioritizes admission directly to a school within an institution. This study investigates the impact of these two admission pathways on medical student selection and on the satisfaction of students with their major.METHODS:Medical students at 16 medical schools across China completed a questionnaire survey. Descriptive calculation, chi-square tests, and probit models were used for analysing the data.RESULTS:A total of 3132 completed surveys were included in the analysis. Compared with the students admitted under the uniform-code pathway, a significantly larger proportion of the students admitted under the separate-code pathway had medicine as the first preferred major (89.6% vs 79.6%, p=0.000); compared with those students enrolled into medicine not as their first preferred major, a significantly larger proportion of students enrolled into medicine as their first preferred major were willing to study medicine if choosing again (80.1% vs 62.4%, p=0.000) or to recommend the major to other students (73.3% vs 65.2%, p=0.000). Probit models showed that medical students admitted under the separate-code admission pathway were more likely to choose medicine as their first preferred major at application (β=0.96, p=0.000); medical students admitted into medical school as their first preferred major were more likely to be willing to study medicine if choosing again (β=0.53, p=0.000) or to recommend the medical major to other students (β=0.18, p=0.010).CONCLUSION:Separate-code admission is more likely to result in matriculants who choose medicine as their first preferred major and are more likely to be intrinsically interested in medicine than those applicants assigned to medicine from the uniform admission process.

Objective:To introduce transformative learning theory in nursing education in the United States and Canada and identify its implications to China.Methods:Literature review was conducted to summarize the utilization of transformative learning theory in nursing education in the United States and Canada.Results:In the United States and Canada, transformative learning theory has been increasingly utilized for shaping nursing education and provided theoretical guidance to nursing education reform and innovations. Comparing with traditional teaching approaches, transformative learning has its unique advantages in transforming nursing students' cognition and strengthening the development of competence building, which may futher promote the cultivation of nursing students' competence, including critical thinking and professionalism.Conclusions:Transformative learning theory has exerted important influences on nursing education and innovations in the United States and Canada. It may be necessary to introduce and promote the theory in China in order to improve the quality of nursing workforce training and gradually fill the gap with the international advanced standard of nursing education.

Objective:To understand the influence of COVID-19 on high school students' willingness to apply for medical education.Methods:A self-administered online questionnaire was used to investigate the students from senior one to senior three at 25 key high schools in 10 provinces.Results:Totally 51 147 valid questionnaires were collected. The results showed that 33.9%(17 327/51 147) of the high school students had the intention to apply for entrance into medical schools and to be medical specialties. Among them 34.3%(5 942/17 327)of the students' willingness to learn medicine were not affected by the pandemic and even 39.1%(6 778/17 327) of them were more determined to learn medicine. There are 24.5%(4 238/17 327) of respondents who were not willing to learning medicine before the pandemic shifted their willing to medical education after the pandemic. Only 2.1% (369/17 327)of the students had the intention of learning medicine originally but plan to give up after the pandemic.Conclusions:The overall willingness to apply for medical education and to be medical specialties in high school students is high. Public health and preventive medicine has been better understood by public because of COVID-19 pandemic. However, there is still a long way to go to help high school students to truly recognize and choose it.