General Office of the State Council on accelerating medical education
Guiding Opinions on Innovation and Development
State Council Office [2020] No. 34
The people's governments of all provinces, autonomous regions, and municipalities directly under the Central Government, all ministries and commissions of the State Council, and all agencies directly under the State Council:
Medical education is an important cornerstone of the development of health care. Since the 18th National Congress of the Communist Party of my country, medical education in our country has developed vigorously, providing a large number of high-quality medical talents for the health industry. In the prevention and control of the new coronavirus epidemic, medical workers trained by my country's medical education have played an important role. But at the same time, in the face of new challenges posed by the epidemic, new tasks in implementing the Healthy China strategy, and new requirements for the development of world medicine, my country's medical education still has problems such as the talent training structure that needs to be optimized, the quality of training that needs to be improved, and the ability of medical innovation that needs to be improved. In order to accelerate the innovative development of medical education, with the approval of the State Council, the following opinions are hereby put forward.
1. Overall requirements
(1) Guiding ideology. Guided by Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, we will fully implement the spirit of the 19th National Congress of the Communist Party of China and the Second, Third, and Fourth Plenary Sessions of the 19th Central Committee of the Communist Party of China, and in accordance with the decisions and arrangements of the Party Central Committee and the State Council, implement the fundamental task of cultivating moral character and cultivating people, and place medical education at the forefront of the development of education and health care. Important position, based on basic national conditions, guided by service needs, taking the construction of new medical science as the starting point, focusing on innovating systems and mechanisms, cultivating research-based, compound-based and applied talents in categories, comprehensively improving the quality of talent training, and providing a strong talent guarantee for promoting the construction of a healthy China and ensuring people's health.
(2) Basic principles.
——Plan medical development with new concepts. Expand the concept of medical development from disease diagnosis and treatment to prevention, diagnosis, treatment and health care, accelerate the transformation from disease treatment to health promotion, and serve the entire life cycle and health process.
——Promote the development of medical education with a new positioning. With the new positioning of "great national economy, great people's livelihood, great subjects and great majors", we will promote the reform and innovative development of medical education, and serve the construction of a healthy China and the construction of a powerful educational country.
——Strengthen the training of medical students with new connotations. Strengthen the education of Taoist skills of saving lives and healing the wounded, benevolence skills with love in the heart, solid academic knowledge, strong skills, and scientific methods of art, and cultivate people's health guardians with noble medical ethics and superb medical skills.
——Lead the innovation of medical education with new medical disciplines. Optimize the structure of disciplines and majors, embody the concept of "big health" and the connotation of the new scientific and technological revolution, put forward new requirements for the concept content, methods and technologies, and standard evaluation of existing majors, build a number of new medical-related majors, and vigorously promote the in-depth cross-integration of medicine and multi-disciplines.
(3) Work objectives. By 2025, the professional structure of medical education disciplines will be more optimized, and the management system and mechanism will be more scientific and efficient; the deep cross-integration of medicine and multi-disciplines, a high-level medical talent training system will be basically established, and the quality of training will be further improved; the incentive mechanism for the use of medical talents will be more complete. By 2030, a higher-level medical talent training system with Chinese characteristics will be established, medical research and innovation capabilities will be significantly improved, and the ability to serve health care will be significantly enhanced.
2. Comprehensively optimize the medical talent training structure
(4) Improve the level of medical professional academic education. Strictly control the enrollment scale of clinical medicine majors in higher vocational colleges (junior colleges), vigorously develop higher vocational nursing education, and increase the supply of nursing professionals. Steadily develop undergraduate professional education in clinical medicine and traditional Chinese medicine, and reduce the enrollment plans of medical schools with excessive enrollment in clinical medicine and traditional Chinese medicine. Appropriately expand the scale of postgraduate enrollment, adjust the postgraduate enrollment structure, and focus new enrollment plans on talents in short supply. Adhere to recruitment based on needs and reasonably determine the enrollment structure and scale. Colleges and universities should set up medical schools scientifically and rationally based on talent needs and educational resource conditions.
(5) Efforts should be made to strengthen the construction of medical disciplines. In the construction of first-class universities and first-class disciplines, increase the layout and support for the construction of medicine and related disciplines. In 2020, all units that authorize clinical doctorate professional degrees must set up the disciplines of anesthesia, infection, critical care, and pediatrics, and significantly expand the enrollment of postgraduate students in anesthesia, infection, critical care, and pediatrics. Optimize the discipline structure, complete the preparation and adjustment of the medical secondary discipline catalog in 2021, include anesthesia, infection, and critical care disciplines into the clinical medicine guiding secondary discipline catalog and increase construction efforts. Coordinate the research on the establishment of first-level disciplines related to medicine. Revise the training program for doctoral and master's degree students in clinical medicine, strengthen the construction of postgraduate courses in anesthesia, infection, and critical care, and strengthen the cultivation of practical ability and scientific research thinking ability. A number of key laboratories of the Ministry of Education will be built in the medical field.
(6) Increase efforts in cultivating general medical talents. Enhance the career attractiveness of primary health care industry. Gradually expand the scale of order-oriented free medical student training. The central government will continue to support the training of undergraduate oriented medical students for township health centers in the central and western regions. All localities should train a group of higher vocational oriented medical students for village clinics and township health centers in remote and poor areas based on actual conditions, and accelerate the training of general medical talents who are "good at treating minor diseases, good at understanding major diseases, good at turning serious diseases, and good at managing chronic diseases." Systematically plan the general medicine teaching system, promote the universal establishment of general medicine teaching organizations in medical schools within three years, strengthen general medicine education for all medical students, build about 100 national general medicine practical teaching demonstration bases, and strengthen teacher training. Starting from 2021, the recruitment and training of graduate students with a professional doctoral degree in clinical medicine (general medicine) will be carried out, and the enrollment scale of postgraduate students with a professional master's degree in clinical medicine (general medicine) will be expanded. Accelerate the reform of the general practitioner salary system and expand the career development prospects of general practitioners.
(7) Accelerate the construction of a high-level public health talent training system. Improve the positioning of public health education in the higher education system and build a number of high-level public health schools based on the layout of high-level universities. Strengthen the construction of the training system, strengthen the training of practical abilities of undergraduate students majoring in preventive medicine, strengthen medical teaching and research cooperation between medical schools, centers for disease prevention and control, and infectious disease hospitals, and build about 30 public health training demonstration bases within three years. Make the Master of Public Health professional degree training program the main training plan for public health postgraduate education, create and develop professional doctorate degree education in public health, and launch a pilot reform of training high-level public health talents in a multidisciplinary context. Increase the supply of high-level professional talents, include public health and preventive medicine-related disciplines and majors into the support scope of the "Special Enrollment Plan for the Training of High-level Talents in Urgent National Key Fields", increase the number of special postgraduate enrollment plans, and continue to expand the scale of training during the "14th Five-Year Plan" period.
(8) Accelerate the cultivation of high-level compound medical talents. Improve the talent training system oriented to professional needs, set up interdisciplinary disciplines, and promote the cross-integration of medical engineering, medical science, and medical arts. Promote the training of compound innovative top-notch talents with a multidisciplinary background of "Medicine + In the "Basic Subjects Top-notch Student Training Plan 2.0", the training of high-end basic medical talents and pharmaceutical talents will be strengthened. Strengthen exchanges and cooperation with international high-level universities and scientific research institutions, and cultivate high-level innovative medical talents with an international perspective.
3. Make every effort to improve the quality of medical talent training in colleges and universities
(9) Improve the quality of imported students. Actively take measures to attract high-quality students to apply for medical majors. Rely on high-level universities to build a number of first-class medical schools. Universities affiliated to the central government that provide medical education must tap into their potential, focus on improving their training capabilities, and actively expand the enrollment of undergraduate medical majors. Increase support for the training of medical talents in the pilot reform of basic discipline enrollment and include basic medicine and other medical disciplines in the reform pilot. Research will be carried out to incorporate nursing majors into nationally controlled majors.
(10) Cultivate medical talents with benevolent hearts and skills. Deepen the reform of undergraduate medical education teaching content, curriculum system and teaching methods, promote the "Excellent Doctor Education and Training Plan 2.0", and build about 600 first-class professional construction sites for medical undergraduates by 2021. Strengthen the professional quality education of medical students, strengthen the education of medical ethics and scientific research integrity, give full play to the ideological and political role of the curriculum, and strive to cultivate the spirit of medical students to save lives and heal the wounded. Promote the reform of classroom teaching in medical education, focus on improving teaching standards, strengthen the construction of grassroots teaching organizations such as teaching and research offices, improve management systems, and stimulate organizational vitality; strengthen education on public health and preventive medicine, infectious disease prevention and control knowledge for medical students, organize the compilation of high-quality medical textbooks such as infectious diseases, and include Chinese medicine courses as required courses for clinical medicine majors. Strengthen the in-depth integration of modern information technology and medical education and teaching, explore new forms of intelligent medical education, build about 400 first-class national-level medical virtual simulation experimental teaching courses, launch about 1,500 national-level medical online and offline quality courses, and build a national sharing resource library of clinical medicine, traditional Chinese medicine, public health and other teaching cases. Accelerate the reform of integrated basic and clinical teaching based on organ systems, study and establish a policy mechanism to guarantee the clinical practice of medical students, strengthen the management of the clinical internship process, and accelerate the reform of ability-oriented student examination evaluation. Strengthen the training of nursing professionals, build a curriculum system that effectively connects theory, practical teaching and clinical nursing practice, accelerate the construction of a high-level "double-qualified" nursing teacher team, and improve students' critical thinking and clinical practice capabilities. Promote the construction of high-level medical professional groups in higher vocational colleges. Build a national and regional medical education development base for colleges and universities to promote the overall improvement of medical education levels in colleges and universities. Medical schools will further strengthen the examination of candidates' professional qualities and clinical practice skills in the admissions process for master's degree examinations in clinical medicine. Research and release core curriculum guidelines for postgraduates, and continuously improve the organic connection between postgraduate education for professional master's degrees in clinical medicine, stomatology, and traditional Chinese medicine and standardized training for residents (hereinafter referred to as residential training).
(11) Inherit, innovate and develop traditional Chinese medicine education. Strengthen the dominant position of traditional Chinese medicine majors in traditional Chinese medicine colleges and concentrate superior resources to make the main majors of traditional Chinese medicine bigger and stronger. Support traditional Chinese medicine colleges and universities to strengthen the selection and training of outstanding students with a strong foundation in traditional Chinese medicine culture and a love for traditional Chinese medicine. Strengthen inheritance, focus on cultivating the ability of traditional Chinese medicine classics, increase the proportion of classic courses in traditional Chinese medicine majors, integrate traditional Chinese medicine classics into basic and clinical courses of traditional Chinese medicine, and strengthen the cultivation of students' traditional Chinese medicine thinking. Establish a system of early follow-up with teachers and early clinical learning, and integrate teacher-to-teacher education throughout the entire process of clinical practice teaching. Support the compilation of a batch of core course teaching materials that conform to the laws of traditional Chinese medicine education. Pay attention to innovation, pilot a nine-year integrated traditional Chinese and Western medicine education, cultivate a small but refined, high-level, high-level integrated traditional Chinese and Western medicine talents; explore the training of multi-disciplinary innovative traditional Chinese medicine talents.
(12) Consolidate the main position for training medical talents in university-affiliated hospitals. Departments of education, health, and traditional Chinese medicine should collaborate with medicine and education to strengthen and standardize the management of university-affiliated hospitals; promptly formulate and improve standards for clinical teaching bases such as university-affiliated hospitals, and include the quality of talent training as an important part of the performance appraisal of clinical teaching bases and the evaluation of the promotion of medical and health professional titles for health professionals and technicians. Colleges and universities should incorporate the teaching and scientific research construction of affiliated hospitals into the overall development plan of the school. According to the scale of talent training, scientific research and clinical practice teaching needs of medical students, scientifically plan the number of affiliated hospitals to prevent the blind addition of affiliated hospitals; strengthen the main functions of clinical teaching in affiliated hospitals and increase funding investment in the teaching work of affiliated hospitals. University-affiliated hospitals should improve clinical teaching organizations, stabilize teaching management teams, integrate and optimize clinical department settings around talent cultivation, set up specialized teaching clinics and teaching beds, and strive to promote early clinical, multi-clinical and repeated clinical practice for medical students.
(13) Systematically promote the overall management of medical education in comprehensive universities. Realize the functions of the medical school (department), improve the operating mechanism of medical education management in universities, medical schools (departments), and affiliated hospitals, and ensure the integrity of medical education; equip and strengthen management cadres at all levels of medical education, and within the current limit of leadership positions, accelerate the realization that the person in charge of the university with a medical professional background is in charge of medical education or concurrently serves as the main person in charge of the medical school (department). The Ministry of Education and the National Health Commission are accelerating the joint construction of comprehensive university medical schools (departments) with provincial people's governments, improving management systems and mechanisms, increasing support, and improving the capacity and level of jointly constructed colleges and universities.
(14) Establish and improve the quality assessment and certification system for medical education. Accelerate the promotion of professional accreditation of medical education, build a medical education accreditation system that covers all medical majors, and establish a professional accreditation system for medical education in colleges and universities with Chinese characteristics and substantial international equivalence. The accreditation results will be gradually announced to the public, and medical schools that fail to pass the accreditation will be rectified within a time limit. Those that still fail to meet the standards after rectification will be cancelled. The pass rate of the physician qualification and nurse practitioner qualification examinations will be regarded as an important part of evaluating the quality of medical talent training, and colleges and universities with qualification examination pass rates lower than 50% for three consecutive years will reduce their enrollment. Promote the accreditation of post-graduation medical education bases and the certification of continuing medical education credits, and use the pass rate of residential training completion assessment and annual professional proficiency test results as the core indicators of the quality assessment of residential training bases. Professional bases whose passing rate of residential training completion theoretical assessment has ranked in the bottom 5% of the country for two consecutive years will be reduced in enrollment.
(15) Accelerate the establishment of basic medical research and innovation bases. Give full play to the comprehensive advantages of comprehensive university disciplines and establish a "medicine + X" multi-disciplinary cross-integration platform and mechanism. Focusing on the fields of life and health, clinical diagnosis and treatment, biosafety, drug innovation, and vaccine research, we will build a world-class basic medical research and innovation base with Chinese characteristics that is highly integrated with clinical diagnosis and treatment, life sciences, and drug research and development, cross-integrated with engineering disciplines such as artificial intelligence and materials, and science disciplines such as biology and chemistry, and integrates innovation with industry, academia, and research, and basic research supports clinical diagnosis and treatment innovation.
4. Deepen the reform of resident physician training and continuing medical education
(16) Improve the standardized training system for resident doctors. Consolidate the medical theoretical foundation of resident doctors, strengthen the cultivation of clinical thinking and clinical practice abilities, make courses related to medical ethics and medical practice as required courses, and improve the reading and application abilities of foreign language literature. Increase the training of resident doctors in general medicine and other in-demand specialties. Strengthen the standardized training of public health doctors and accelerate the training of a group of public health talents with comprehensive prevention and treatment skills. To ensure reasonable remuneration for resident doctors, residential training bases shall comprehensively consider factors such as economic development, price changes, and the average salary of local urban employees, and formulate salary and remuneration standards for training subjects based on actual conditions. Public medical and health institutions responsible for training are encouraged to favor the remuneration and remuneration of training subjects in urgent need of general medicine, pediatrics, etc., and play a leading role. Specific measures shall be formulated by the National Health Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security, etc. For training subjects recruited from the public, the residential training base signs a labor contract with them in accordance with the law, clarifying the rights and obligations of both parties during the training period. After the labor contract expires, it will be terminated in accordance with the law, and the training subjects will choose their own jobs. Fresh graduates from general universities recruited from society who are employed in medical and health institutions in the same year after passing the training will be treated the same as fresh graduates in the same year in terms of recruitment, dispatch, and settlement. Clinicians with a bachelor's degree who have passed the training will be treated the same as master's degree students in clinical medicine and traditional Chinese medicine in terms of personnel recruitment, professional title promotion, job employment, salary and benefits, etc. Rely on existing resources to implement the quality improvement project of post-graduation medical education, strengthen informatization construction, and build a number of national residential training demonstration bases, key professional bases, key teacher training bases and standardized residential training practical skills assessment bases on the basis of the best.
(17) Promote the innovative development of continuing medical education. Public health knowledge and skills such as medical ethics, laws and regulations, emergency and critical care, infection and self-protection, as well as infectious disease prevention and control, and health education should be made compulsory courses for medical personnel. Innovate continuing education methods and gradually promote verifiable self-study models. Vigorously develop distance education and improve the distance continuing medical education network. Incorporate medical staff’s receipt of continuing medical education into a necessary component of their annual performance appraisal. Employers must increase investment, withdraw and use employee education funds in accordance with laws and regulations, and ensure that all on-the-job medical staff receive continuing education and vocational retraining. In the evaluation of the professional titles of health professional and technical personnel, highlight moral character, ability, and performance orientation, emphasize clinical practice and other professional work abilities, and get rid of the tendency of paper-based work.
5. Improve safeguard measures
(18) Strengthen organizational leadership. The Ministry of Education, the National Health Commission, the State Administration of Traditional Chinese Medicine and other departments should further strengthen the comprehensive management and coordination of medical education and coordinate to solve issues related to the innovative development of medical education. All localities and relevant departments must strengthen leadership, make careful arrangements, coordinate resources, and implement responsibilities, incorporate the innovative development of medical education into the regional economic and social development plans and key work plans of the departments, and formulate implementation plans and supporting policies and measures. All provinces, autonomous regions, and municipalities directly under the Central Government must issue specific implementation plans before the end of December 2020. Give full play to the role and advantages of industry organizations in assisting government services and management of post-graduation medical education and continuing medical education.
(19) Implement major national strategic projects. Coordinate the financial resources of all parties and strengthen investment in medical education. Promote reform and innovation in talent training and scientific research, support the construction of national and regional medical education development bases, first-class medical schools, high-level public health schools, and basic medical research innovation bases, and support major reforms such as the "Excellent Doctor Education and Training Plan 2.0" and the "Basic Subjects Top-notch Student Training Plan 2.0". Support the construction of national residential training demonstration bases, standardized residential training practical skills assessment bases, post-graduation medical education and continuing medical education informatization. Investment within the central budget will increase support for medical schools.
(20) Ensure funding investment. Actively support the innovative development of medical education, optimize the training structure, and improve the quality of training. Based on financial resources, price changes, training costs, etc., rationally determine and timely adjust per-student fixed allocation standards and residential training subsidy standards for medical majors. Support relevant universities to optimize their expenditure structure and increase investment in the training of medical talents and the construction of medical disciplines. Fully mobilize the enthusiasm of society, medical and health institutions, and individual investors, and improve a diversified and sustainable medical education funding guarantee mechanism and a dynamic adjustment mechanism for government investment. Local people's governments at all levels must implement investment responsibilities in accordance with regulations.
general office of the state council
September 17, 2020
(This article is released to the public)
