- Email: [email protected]
Absence of humanities in China's medical education system
Correspondence
3
4
China News Service. Chen Zhu: most of 8·6 million doctors are good in China. http:// www.chinanews.com/jk/2012/0314/3744342.shtml (accessed July 25, 2012). Yin D. Law-regulated practice and evidence-based self-protection. Chinese J Evidence-Based Med 2005; 5: 1–2.
Absence of humanities in China’s medical education system The crisis of trust between doctors and patients in China has been denounced widely.1 An online news story2 on June 5, 2012, described an astonishing scandal at a hospital in Hangzhou, Zhejiang province, in which a female nurse abused an infant and uploaded several photos of the process to her Weibo page (a Chinese social network). The public reacted angrily towards the scandal, and accused the medical staff of having no medical ethics or humanitarianism.2 There are many possible reasons why Chinese doctors are mistrusted by patients. We believe that the primary reason is the absence of humanities education for medical students—a view shared by former president of the Chinese Medical Association, Zhong Nanshan.3 A study of 80 years of medical curricula at the Peking Union Medical College4 revealed that, since 1990, students’ total hours spent on medical humanities have comprised only about 1% of the total; 4% is spent on historical and political courses, and 95% on basic science and biomedical courses (36% basic medicine, 29% basic science, and 30% clinical medicine). Other medical colleges in China do not seem to be much different. As medical students, we have found that most school curricula consist of professional medical courses, but there are few courses on medical humanities and social science. Fortunately, on May 7, 2012, the Chinese Government issued a new policy5—the distinguished physician 648
education programme—declaring that the proportion of medical humanities and social science courses should be increased in medical universities and colleges to reverse the situation. The effort is worth encouraging, and we look forward to a medical curriculum in China that aims to produce doctors whose empathy and ethics equal their clinical skills. We declare that we have no conflicts of interest.
*Jie Li, Feng Qi, Shanshan Guo, Ping Peng, Ming Zhang [email protected] College of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China (JL, SG, PP); and Department of Orthopedics, Ningbo Medical Center and Li Huili Hospital, Ningbo, Zhejiang, China (FQ, MZ) 1
2
3
4
5
Tang S, Meng Q, Chen L, Bekedam H, Evans T, Whitehead M. Tackling the challenges to health equity in China. Lancet 2008; 372: 1493–501. xkb.com.cn. Hangzhou: practice nurse abuses infant takes photos with single hand holding infant. http://news.xkb.com.cn/ zhongguo/2012/0605/204222.html (accessed June 17, 2012). Yuan JZ. Zhong Nanshan: the education of medical and humanistic spirit in the fall. http://informationtimes.dayoo.com/ html/2011-11/13/content_1528200.htm (accessed June 17, 2012). Lin P. Peking Union Medical College, the comparison of 80 years to clinical medicine courses. Chinese J Med Educ 1999; 6: 25–27. Ministry of Health and Ministry of Education. The implementation of distinguished doctor education and training plan. http://www.moe. edu.cn/publicfiles/business/htmlfiles/moe/ s3864/201205/135805.html (accessed June 17, 2012).
Embargo on publication of scientific papers by Iranian authors Iran and western countries have had an unstable political relationship since the Islamic revolution in 1979. Despite this, fruitful academic relationships have occurred during the same period. Scientists from Iranian institutions have published joint papers with scientists from 107 other countries in the past three decades, most commonly from the USA and UK.1 Iran has also experienced a rapid increase in the publication of scientific papers in indexed journals.1,2
Iranian researchers have traditionally placed great emphasis on the importance of publication, a tradition that dates back to the era of Avicenna and before. The number of papers published in non-Persian journals has increased strikingly in the past decade, and in some disciplines— eg, medicine—most Iranian papers are now published in English. This desire of Iranian scientists to share their findings with the world has fostered many international scientific collaborations in which Iranian scientists were usually the initiators. Recently the political environment has become more difficult, with more restrictive embargoes against Iran—a situation that has occurred on several occasions in the past. But a new event is that a few academic publishers have embargoed scientific publications from Iran, irrespective of the subject matter. The basis of, and rationale for, these restrictions is unclear. This type of discrimination is not in concordance with scientific publication ethics. Decisions like these only fill the academic environment with feelings of injustice and unfairness. We urge international scientists to voice their objections to journals that have adopted this discriminatory practice against scientists from Iranian institutions. We hope to see a world in which we do not have double standards in any area, including publishing, and all people are treated in the same way irrespective of their nationality. The sharing of knowledge is the heritage of mankind. We declare that we have no conflicts of interest.
*Kamran B Lankarani, Ali Haghdoost, Peter Smith [email protected] Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Fars 71348, Iran (KBL); Kerman University of Medical Sciences, Kerman, Iran (AH); and London School of Hygiene and Tropical Medicine, London, UK (PS) 1
Mohammadhassanzadeh H, Samadikuchaksaraei A, Shokraneh F, Valinejad A, Abolghasem-Gorji H, Yue C. A bibliometric overview of 30 years of medical sciences productivity in Iran. Arch Iran Med 2010; 13: 313–17.
www.thelancet.com Vol 380 August 18, 2012
3
4
China News Service. Chen Zhu: most of 8·6 million doctors are good in China. http:// www.chinanews.com/jk/2012/0314/3744342.shtml (accessed July 25, 2012). Yin D. Law-regulated practice and evidence-based self-protection. Chinese J Evidence-Based Med 2005; 5: 1–2.
Absence of humanities in China’s medical education system The crisis of trust between doctors and patients in China has been denounced widely.1 An online news story2 on June 5, 2012, described an astonishing scandal at a hospital in Hangzhou, Zhejiang province, in which a female nurse abused an infant and uploaded several photos of the process to her Weibo page (a Chinese social network). The public reacted angrily towards the scandal, and accused the medical staff of having no medical ethics or humanitarianism.2 There are many possible reasons why Chinese doctors are mistrusted by patients. We believe that the primary reason is the absence of humanities education for medical students—a view shared by former president of the Chinese Medical Association, Zhong Nanshan.3 A study of 80 years of medical curricula at the Peking Union Medical College4 revealed that, since 1990, students’ total hours spent on medical humanities have comprised only about 1% of the total; 4% is spent on historical and political courses, and 95% on basic science and biomedical courses (36% basic medicine, 29% basic science, and 30% clinical medicine). Other medical colleges in China do not seem to be much different. As medical students, we have found that most school curricula consist of professional medical courses, but there are few courses on medical humanities and social science. Fortunately, on May 7, 2012, the Chinese Government issued a new policy5—the distinguished physician 648
education programme—declaring that the proportion of medical humanities and social science courses should be increased in medical universities and colleges to reverse the situation. The effort is worth encouraging, and we look forward to a medical curriculum in China that aims to produce doctors whose empathy and ethics equal their clinical skills. We declare that we have no conflicts of interest.
*Jie Li, Feng Qi, Shanshan Guo, Ping Peng, Ming Zhang [email protected] College of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China (JL, SG, PP); and Department of Orthopedics, Ningbo Medical Center and Li Huili Hospital, Ningbo, Zhejiang, China (FQ, MZ) 1
2
3
4
5
Tang S, Meng Q, Chen L, Bekedam H, Evans T, Whitehead M. Tackling the challenges to health equity in China. Lancet 2008; 372: 1493–501. xkb.com.cn. Hangzhou: practice nurse abuses infant takes photos with single hand holding infant. http://news.xkb.com.cn/ zhongguo/2012/0605/204222.html (accessed June 17, 2012). Yuan JZ. Zhong Nanshan: the education of medical and humanistic spirit in the fall. http://informationtimes.dayoo.com/ html/2011-11/13/content_1528200.htm (accessed June 17, 2012). Lin P. Peking Union Medical College, the comparison of 80 years to clinical medicine courses. Chinese J Med Educ 1999; 6: 25–27. Ministry of Health and Ministry of Education. The implementation of distinguished doctor education and training plan. http://www.moe. edu.cn/publicfiles/business/htmlfiles/moe/ s3864/201205/135805.html (accessed June 17, 2012).
Embargo on publication of scientific papers by Iranian authors Iran and western countries have had an unstable political relationship since the Islamic revolution in 1979. Despite this, fruitful academic relationships have occurred during the same period. Scientists from Iranian institutions have published joint papers with scientists from 107 other countries in the past three decades, most commonly from the USA and UK.1 Iran has also experienced a rapid increase in the publication of scientific papers in indexed journals.1,2
Iranian researchers have traditionally placed great emphasis on the importance of publication, a tradition that dates back to the era of Avicenna and before. The number of papers published in non-Persian journals has increased strikingly in the past decade, and in some disciplines— eg, medicine—most Iranian papers are now published in English. This desire of Iranian scientists to share their findings with the world has fostered many international scientific collaborations in which Iranian scientists were usually the initiators. Recently the political environment has become more difficult, with more restrictive embargoes against Iran—a situation that has occurred on several occasions in the past. But a new event is that a few academic publishers have embargoed scientific publications from Iran, irrespective of the subject matter. The basis of, and rationale for, these restrictions is unclear. This type of discrimination is not in concordance with scientific publication ethics. Decisions like these only fill the academic environment with feelings of injustice and unfairness. We urge international scientists to voice their objections to journals that have adopted this discriminatory practice against scientists from Iranian institutions. We hope to see a world in which we do not have double standards in any area, including publishing, and all people are treated in the same way irrespective of their nationality. The sharing of knowledge is the heritage of mankind. We declare that we have no conflicts of interest.
*Kamran B Lankarani, Ali Haghdoost, Peter Smith [email protected] Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Fars 71348, Iran (KBL); Kerman University of Medical Sciences, Kerman, Iran (AH); and London School of Hygiene and Tropical Medicine, London, UK (PS) 1
Mohammadhassanzadeh H, Samadikuchaksaraei A, Shokraneh F, Valinejad A, Abolghasem-Gorji H, Yue C. A bibliometric overview of 30 years of medical sciences productivity in Iran. Arch Iran Med 2010; 13: 313–17.
www.thelancet.com Vol 380 August 18, 2012