The COVID-19 Epidemic Calls for a New Model of Educational and Training for Medical Talents
The outbreak of COVID-19 is a great challenge to China and medical personnel training in our country. This requires us to further improve the concept, strategy, system and mode of medical talent cultivation, and accelerate the integration and innovation of disciplines, so as to cultivate high-quality medical talents for China.
The COVID-19 Epidemic put forward a New Topic for Construction of Medical Science in China
Since the 1970s, the global medical community has gradually shifted the focus from infectious diseases to cancer, cardiovascular, metabolic, other chronic and non-infectious diseases, because of a decline in the overall incidence of infectious diseases in the world. This makes the whole world remain optimistic even after the epidemic of SARS, bird flu, Ebola and other infectious diseases. When there is a sudden outbreak, a large number of medical workers from other specialties will be sent to the front line, because the number of medical workers in the fields of infection, severe illness and emergency care is small. However, they generally had not received systematic training in infectious disease prevention and control and critical care, coupled with a short supply of protective materials at the early phase, which increased the risks of being infected when the medical staff took their duties in this battle. A study by the International Medrxiv pre-printing platform shows that, with the same insufficient knowledge of COVID-19 in the initial stage, there was almost no infection among medical staff in the department of infectious disease department, respiratory and intensive care unit of a general hospital in Wuhan. However, the departments not directly related to the infectious disease had become the worst-hit areas of infection among medical staff. The outbreak of COVID-19 reminds us that we have to improve the prevention and control of medical staff in dealing with major outbreaks of infectious diseases and the capacity of medical staff in critical treatment of severe diseases.
In the meantime, medical workers’ psychological coping capacities deserves attention. A survey showed that 92.7% of nurses who were interviewed had experienced adverse emotions during the treatment of COVID-19 in Wuhan. The medical team was sent by the First Affiliated Hospital of Sun Yat-sen University to Wuhan, about 40% of the medical staff in the team developed significant psychological problems, including symptoms such as insomnia, anxiety and depression. The incidence was higher in groups without infection or with a background of intensive care. The main reasons for psychological problems among medical workers include fear of being infected or skill panic due to lack of treatment ability. The appearance of psychological problems is related to the neglect of mental education in the training of doctors and nurses.
The mechanism of multi-disciplinary integration and collaboration needs to be improved. In recent years, China's medical reform has made great achievements, but it is mainly focused on the level of clinical healthcare, however, the shortcomings in public health are still obvious and the attraction of talent is difficult and the high-level brain drain is serious. On the one hand, university's teachers in public health are lack of research and practical experience in responding to emergent major public health events, and a few of them have cooperated with clinicians. On the other hand, there is a lack of systematic education and practice in public health, infectious diseases and general practice in the training of clinical medical talents. In addition, the cooperative research mechanisms between basic medicine, clinical medicine, public health and pharmacy require to be improved and cross-platform integration with non-medical disciplines such as the internet, big data, artificial intelligence and information science is even more inadequate.
Training top innovative talents for 'Medicine + X" in the new era
The COVID-19 epidemic has proved that we must strengthen the capability of medical staff to deal with major impacts on public health. The teaching concept, curriculum system and educational methods need to be improved in medical education. At the same time, the courses of public health should be properly integrated into the whole process of the medical talents’ education and career. Furthermore, we should pay attention to the training of the ability of medical personnel to prevent and control infectious diseases, critical treatment and cope with mental and psychological problems.
Our country requires cross-discipline leading talents in clinical medicine and public health. The training model of Doctor of Medicine + Master of Public Health (MD+MPH) is relatively mature in the medical education system of developed countries. It has been practically proved that the medical talents with the combination of clinical medicine and public health are better qualified to be a clinician, health policy maker and leader. Therefore, it is necessary to explore and study the talent training mode of MD+MPH which is suitable for China's national conditions.
Our country requires medical scientists qualified in both clinical medicine and basic medical sciences (MD+PhD). The current situation and major problems of medical education in China are mainly reflected in two aspects: first, the most of the scientific researchers in medical colleges and universities have no background of clinical medicine, it is difficult to carry out basic medical research to explore the nature and rules of diseases guided by clinical problems. Secondly, the lack of scientific research training makes it difficult for clinicians to provide innovative ideas for the diagnosis and treatment of diseases. Given the above problems, it requires us to select the clinicians who are engaged in basic research, and train medical scientists combining clinical and basic research in the process of exploring the talent training model of MD+PhD.
Our country requires innovation oriented “medicine + X” leading talents. Nowadays, the Internet, big data, artificial intelligence, information science in the process of rapid development, comprehensive universities should explore the possibility of combining medicine with liberal arts, science and engineering, and form a standardized 'medicine +X" innovative training model for top talents. Outstanding non-medical graduates who devote themselves to medicine should be selected to enter the medical education system hence bringing cross-platform knowledge into the field of medicine.
The key to the training of medical talents includes strengthening the top-level design, improving the system and mechanism, and building the excellent team of faculty. We need to put a high value on the coordination between universities and affiliated hospitals. At the same time, the foundation of medical talent training needs to be taken seriously, coordinate and straighten out the relationship between the medical school, affiliated hospital, school of public health, school of pharmacy and other non-medical disciplines of comprehensive universities.
The covid-19 epidemic has given us a new perspective on medical talent training, which will strongly promote the reform and development of medical education in China. We believe that a large number of medical professionals will be cultivated in our country, they can shoulder important responsibilities with the missions of “Heal people's body and soul in addition to treating illness, Save the nation and the world in addition to saving lives” to protect people's health in the future.
(About the author: XIAO Haipeng, Vice President of Sun Yat-sen University, President of the First Affiliated Hospital of Sun Yat-sen University)