医生是一份对生命负责的专业职业

2025年3月，我们团队赴绍兴，对当地三家最大的三甲医院进行了为期一周的实地调研。在与医院科主任交流时，我们问：“你们希望推动学科建设吗？”几乎所有科主任都说：“那是医院领导的事，和我们没关系。”再问普通医生：“你们希望提升自己的门诊和手术能力吗？”回答仍是：“没有特别打算。”听完这些回答，我们震惊，更感到沉重。从上到下，整个城市医疗界弥漫着混日子的气息，没有成长意愿、没有责任意识，仿佛只求维持最低生存标准。人活在这个世界上，最重要的是对这个世界的贡献。医疗就是一个国家国运级的行业。绍兴是一座文化底蕴深厚、人才辈出的城市。但我们却看到，在这里，医生普遍处于一种无意识、无追求、无责任的状态，这不仅是医院的悲哀，更是这座城市的悲哀。反观德国，成为一名合格医生的路径，是建立在系统的专业训练和高门槛基础上的。首先是6年医学院课程，相当于中国的本科加硕士阶段；多数医学生还会再花两年时间攻读医学博士学位。虽然博士并非强制要求，但在学术医院工作、日后升职几乎是隐性门槛。之后，每位医生都必须进入为期5至6年的专科培训，在教学医院中进行严格的临床轮转、系统的理论学习和阶段性评估。德国国家科学院院士、慕尼黑大学附属医院泌尿外科主任Stief院长以他所在的科室为例分享：前3年是在常规泌尿外科岗位上打基础，第4年才开始亚专科的培训，甚至有些医生会赴国外进修一年。整个培训结束后，还需通过德国医学协会的正式考试，才有资格获得专科医生认证，正式独立执业。说句可能刺耳的话：如果以德国的医生培养体系为标准，中国现在90%的医生连最基本的要求都达不到。他们中很多人从未真正经历过系统的亚专科培训，也从未真正走出过自己的医院去看看外面的世界。更糟糕的是，他们却还以为自己很牛，还敢自我标榜技术一流，还敢到处去讲课、当“专家”。只有真正没见过世面的人，才敢狂成这个样子。德国为什么是现代医学的发源地？因为它的医学体系是建立在规范与敬畏之上的。而中国的很多医生，连起码的规范都没有，却已经开始享受“专家”的身份感。这才是最危险的地方。医生不是一个头衔，而是一份对生命负责的专业职业。我们不怕医生水平不够，但我们怕的是他们不愿学习、不肯承认差距、还觉得自己已经很优秀了。一个医生不学习，一个医院就会停止进步；一个城市的医生都不学习，那这座城市的医疗就注定原地踏步，甚至倒退。中国到底有多少“不合格”的医生？

In March 2025, our team made a week-long field research at the three largest Grade III Class A hospitals in Shaoxing, Zhejiang province. When we asked clinical department heads, “Do you hope to promote specialty development in your department?” Almost every directors responded, “ That’s the responsibility of the hospital executives, not ours.” We then asked several junior doctors, “Do you want to improve your outpatient and surgical skills?” The answers remain “We don’t have any plan.” Upon hearing these answers, we were shocked but more disappointed. From top to bottom, the city’s medical system seemed to be pervaded by a mentality of apathy and stagnation. No desire to grow, no sense of professional responsibility, as if the only goal was to meet the bare minimum of survival. As human beings, our most fundamental value lies in our contribution to the world. Medicine is such a national industry influencing national fate. Though Shaoxing is a city with rich cultural heritage and a long tradtion of producing talents, what we witnessed was a medical community operating in a state of unconsciousness without drive nor sense of responsibility. This is not just a tragedy for the hospitals, but for the city as a whole. On the contrary, the path to becoming a qualified doctor in Germany is built on systematic professional training and high standards. Medical education begins with a six-year program in medical school, comparable to the combined bachelor’s and master’s level of studies in China. Most students then spend an additional two years earning a doctoral degree in medicine. Though an MD degree is not mandatory, it’s widely seen as an unspoken prerequisite for working in academic hospitals or advancing in one’s career. Then, every doctor must undergo a specialist training for 5 to 6 years in a teaching hospital, which includes intensive clinical rotation, systematic theoretical education and staged evaluations. As Prof. Stief, a member of German National Academy of Sciences Leopoldina, Chairman of the Dept. of Urology  and Deputy Medical Director at the University Hospital of Ludwig Maximilians University of Munich, shared with us: in his department, doctors spend the first three years laying a foundation in general urology, and only begin sub-specialty training in the fourth year. Some even go abroad for one year for further training. Only after completing the full program and passing a formal board exam administered by the German Medical Association can a doctor be certified and begin independent practice. It may sound unpleasant, but if followed the Germany’s training standards, 90% of Chinese doctors would fail to meet the basic requirements. Many have never received structured sub-specialty training, nor stepped outside their own hospital to see how the wider world of medicine operates. What’s worse, they still believe they are top-tier, eagerly claiming to be “experts,” giving lectures, and flaunting their skills. It is often those with the least exposure who boast the loudest. Why is Germany considered one of the birthplaces of modern medicine? Because its medical system is rooted in rigor and reverence. Despite failing to meet the minimum norms, many Chinese doctors are already busy enjoying the prestige of being an “expert.” That’s where the real danger lies. Being a doctor is not about a title, but about bearing responsibility for life itself. We are not concerned about doctors who have room to improve, what we worry about is those who have no desire to learn, no awareness of their shortcomings, and yet still think they’re outstanding. When doctors stop learning, the hospital stops improving. And when an entire city’s doctors stop learning, its healthcare system is bound to lapse into stagnation or even regression. How many “unqualified” doctors are there in China today?