Admitted to Fudan University School of Medicine did not make Wang He (pseudonym) happy.
Wang He, a native of Shanghai, who studied clinical medicine, did not achieve satisfactory results in World War II this year and is waiting for a transfer or career change.
In the café, he held an unopened straw and gestured: clinical medicine is a closed and long road, and every step is done step by step - after five years of undergraduate examination, after completing the postgraduate examination, after completing the doctoral examination, after the doctoral "regular training" (Note: the abbreviation of standardized training for residents), and finally entering the hospital to become a doctor.
"It's a one-log bridge," he says, "and anyone can see the end, but they don't know if they can get there." ”
In the turbulent years when the epidemic has set off thousands of waves, all walks of life have alternated between rise and fall, but the profession of doctor still looks stable and decent, and it is an "iron rice bowl" in people's eyes in addition to the official examination.
In 2023, after the epidemic was lifted, more than 900,000 medical students faced more brutal competition for employment than in previous years. Lian Junliang, co-founder of Medical Direct Employment, told Eight Points Jianwen that this year, many in-service doctors in hospitals with average benefits began to be eager to move, wanting to go to large hospitals in good cities and grab jobs with fresh graduates, resulting in more and more serious involution of academic qualifications and scientific research.
People cross the narrow bridge, education is inflationary, and the threshold of hospitals is rising. When the clinical students of Fudan University School of Medicine first entered the school, they were told by their teachers that out of each class of 200 students, only about 70 would become doctors.
Graduate school and Kaobo are the two nodes that screen out the medical students on these single-wood bridges.
And the 985 medical students like Wang He have started more than half of the people on the canoe bridge. They are even more reluctant to be "backward compatible" and leave the north to work as grassroots doctors in the county seat. The more elite, the stronger the sense of loss after being left behind. In the concept of some 985 medical students, if they are reduced to going to a community health center, they are "sorry for the school".
Medical students trapped in their academic qualifications have long passed the age of twenty-one who "have many extravagant hopes" and have become "bulls with hammers" in "Golden Age". ”
In the increasingly narrow world view and more and more limited choices, some people stumbled on the single-log bridge, struggled several times, and successfully "landed"; And some people are discouraged after hitting the wall again and again, and choose to go abroad, change careers or take the official examination. The eight-year clinical doctor of medicine examination for civil service is not a new thing at present.
Clinical undergraduates enter the "era of graduate school"
Wang He did not expect that he would fall off the canoe bridge.
In 2020, he could not find a job in a hospital in Shanghai and decided to apply for the neurosurgery department of Huashan Hospital, a graduate student of this university.
Even if he graduated from a top medical school, with Wang He's bachelor's degree, he still can't even enter the regular training of community centers in Shanghai - third-class hospitals only accept top doctors, and community centers only accept master's degrees, which is the consensus of Shanghai medical students.
During that time, it was the internship period of medical students, and Wang He worked in the hospital from 8 a.m. to 5 p.m. every day, and only after work did he have time to go home to study late at night. At the latest, the teacher suddenly had to perform an operation to solve the jaw cyst before leaving work, and Wang He was required to stay and help with the operation, and the operation lasted until 10 o'clock. Wang He came home from the hospital in the middle of the night, turned on the lamp again, and began to review for graduate school.
Wang He was very reluctant. Miscellaneous hospital internships are more like "wasting time" than accumulating "clinical experience". Compared with putting on a white coat on the operating table, the entrance examination is the front line of the rush at hand. They seem to prefer to spend this time doing a few more sets of questions and reading a few more pages of textbooks for graduate school.
To add insult to injury, the graduate admission score line has not stopped rising due to the pandemic. Li Xin, a young doctor in a hospital in Hebei, was successfully admitted to Peking Union Medical College in 2017 with a score of more than 340. Now, he was surprised to find that a junior sister who took more than 370 exams turned out to be just "pressing" to get the school's re-examination qualification.
In 2021, when Wang He was admitted to graduate school, the score line of Fudan University School of Medicine was more than 370 points, and uncharacteristically drew a super high "single subject line" of 220 points, nearly 20 points higher than before. "Even if you pass the school line, you can't pass the single subject line, and you still don't have a book to read," Wang He said.
Not surprisingly, Wang He failed the postgraduate examination. He immediately decided on "World War II" - as a Shanghainese, Wang He felt that he had no way back: "Foreign students may still be able to go home and take postgraduate examinations while training." But twenty years of being born and raised in Shanghai, must stay, there is no other way out. ”
"Anyway, the cycle of being a doctor is long enough, what is another year?" With this in mind, Wang He began "World War II". In order to seek stability, he adjusted his goals this time. Interested in psychiatry, he enrolled in psychiatry at another 985 university.
But Wang He's World War II was destined to be an even more difficult struggle.
In 2017, when Li Xin was admitted to graduate school, the number of graduate students had just exceeded 2 million. Five years later, in 2022, when it was Wang He's turn to take the postgraduate examination, the number of postgraduate examinations soared to 4.57 million, more than double that year. Over the past six years, the number of postgraduate candidates in the mainland has increased by more than 300,000 every year, and last year was the most outrageous - compared with 2021, the number of postgraduate candidates in 2022 increased by 800,000.
Wang He did not elaborate on the situation of World War II, only said that he did not do well in the test and looked at the adjustment. "If you can't adjust it, maybe like my dad, I will switch to selling insurance." Wang He smiled bitterly. He will still be a little disappointed, he feels very secure as a doctor, and he knows exactly what he should do at every stage. He doesn't want to jump straight into the sea of job search with a bachelor's degree like others.
Some of Wanghe's foreign students will choose to return to their hometown in the second and third-tier cities, find a hospital for training, and directly find employment after the end, or side training, World War II, or even World War III.
But now, the second chance for students is slowly disappearing, and the door to training is slowly closing - there are reports that Henan and Hubei will not allow non-fresh graduates to participate in the training this year. In other words, if you take the postgraduate examination while training and training, there are only three opportunities to take the master's degree. And those students who are fully full-time preparing for the postgraduate examination in World War II will directly not be able to apply for the master's degree.
An insider from Shanghai Jiao Tong University School of Medicine tactfully told Eight Points that due to the impact of the epidemic, the employment rate in the past two or three years has not been good. "The Shanghai Education Commission is following the ass and asking us to increase the employment rate." He concluded by saying that the Class of 2023 may not have a good outcome either.
According to the "Lilac Talents 2020 Fresh Graduates Employment Flow Report" released on July 8, 2020, when the article was published, more than 60% of graduates were still looking for jobs, and only 23% of fresh graduates had signed up for employment; When it comes to the impact of the epidemic on job search, 34% said that the recruitment information of the employer was delayed or canceled, 27% believed that the offline job fair was delayed or canceled, and another 17% missed the written test or interview opportunity due to the lockdown.
The academic qualifications at the end of the volume, the scientific research that cannot be completed
The lucky ones who are admitted to graduate school are not all right.
There are two "screening" points on the single-wood bridge of the medical student's career path: one in the postgraduate examination and the other in the examination. At each node, a group of people will "fall" on the canoe bridge.
At the beginning of 2023, Wen Ya, a master's student at a top medical school in Shanghai, realized that she would not be able to take the doctoral exam this year.
Half a year forward, she was still struggling with her graduation thesis. In October 2022, she began to submit papers and prepare doctoral application materials.
She adopted a "wide net" strategy. She went to medical schools in Shanghai, Beijing, and Hangzhou, but she did not apply to this school - because after inquiring around, she found that "there was no drama". Most of the doctoral supervisors in this university have their own graduate students, and most of these graduate students are also willing to study for a PhD. In this case, doctoral supervisors will give priority to recruiting their own masters, and it is basically impossible for Wen Ya to squeeze under the "teacher" of others. "Even if you vote, you will most likely become cannon fodder."
When she really started applying for a Ph.D., she personally felt the "volume", "everyone has more than a dozen articles in their hands". Scientific research ability is the majority of the doctoral application evaluation system, accounting for 60%, including the number of articles, the partition where the article is located, the impact factor, whether it is a work, and so on.
Relying on fruitful scientific research results, including more than a dozen top-notch papers in the first district, Song Chao, a doctor of a 985 university who is about to enter a top hospital in China, has become the person who has gone the farthest on the single-wood bridge among all respondents. As an "old fritters" in the field of scientific research, he has also observed the increasing involution of medical students' scientific research in recent years.
"Times have long been different." He said categorically. According to his observations, ten years ago, a paper with an impact factor of ten could stay in Shanghai's top hospitals, but now it will be added to the National Natural Science Foundation of China; In the past, undergraduates did not need to do scientific research, just follow the study, but now even undergraduates need original results, "otherwise it is impossible to enter the top unit." ”
Scientific research is involuted, academic qualifications are devalued - the "roadblock" on the single-wood bridge is becoming stronger and stronger, and it is becoming more and more difficult to go down.
After three years of graduate school, Wen Ya only published one paper. There are factors in the research group, and there are also factors that delay the half-year experiment due to the epidemic. When she graduated, she felt sad when she saw her only achievements, because "everything was done on her own, and it was actually quite hard to go to graduate school."
But everything is a foregone conclusion, and all that can be done is to look forward. After learning that all her Ph.D. applications had failed, she immediately turned the ship's bow and started looking for a job.
Compared to others, Wen Ya is lucky. In the months before and after the lifting of the lockdown in Shanghai, her school held a number of mutual selection meetings to help students find employment, and Wen Ya finally successfully entered the laboratory department of a third-class hospital in Shanghai. As the most basic doctor, she has to go out to the clinic and work the night shift; When I get home from work, I will sit in front of the computer at 7:30 p.m. and start "working a second job" - writing tenders and applying for projects of the National Natural Science Foundation of China.
Because she still wants to do her Ph.D. and do research, "I prefer the lab to the outpatient window." She hopes to accumulate some results in her work and continue to apply for a PhD in a few years. Around her, there are not a few people who save the country with such curves.
But the process is just as tough. As a young doctor, she had no funds, no data, and could only apply for projects and grants based on the little questions left over from her research during her master's degree.
"Those who have fallen behind", look for another way
Compared with Wen Ya, who is obsessed with Kaobo, Liu Ke, a master's student at a top medical school in Shanghai, has slowed down. Looking at the long road ahead, he felt tired.
Unlike Wang He, Liu Ke didn't like the feeling that medical students could see their heads at a glance—although in the previous seven years, he hadn't thought so much, "Smoothly and smoothly he can always be a deputy director." "Relying on the inertia of many years of study, he completed 5 years of undergraduate studies and was admitted to the top medical school in Shanghai with the idea of continuing to study for a Ph.D.
But now he can't roll up. "When I think that there are also the chief executive, the deputy director, the director behind ... I'm a little tired of rolling for so many years. When he said this, Liu Ke had just completed the procedures for resuming school. Around April last year, he suffered from depression and had to take a break from school to go home to recuperate.
The big topic he "took over" for the application was completely disrupted. I can't remember how many times Liu Ke missed the deadline to recover specimens because he was blocked, and even "stopped for half a year", and could only redo it repeatedly. This prevented him from completing the task he was confident would have completed within two years.
Liu Ke couldn't hold on.
When he first entered the hospital to do scientific research, Liu Ke was curious and excited about everything around him, and he was very motivated to do anything, "feeling that his expectations were higher." That year, the independent institute of his department had just been completed, "very large, estimated at two or three hundred squares." Watching more and more equipment and instruments gradually fill the empty laboratory, he felt a "sense of accomplishment", as if he had been rewarded.
He can meet patients from all over the world, work with his mentors on various incurable diseases, and occasionally brag to his former classmates, "These patients I meet, they have never seen." ”
Staying in Shanghai was his idea before he left school.
Now, Liu Ke is tired. Once, he felt that he was sorry for the eight years of hard work without becoming a doctor after graduation, but now, after listening to and seeing more, he slowly found that it seems that it is good to work in an enterprise. "Companies also recruit medical students, people have gone, and it's normal for me to go."
At the same time, Liu Ke found that during the epidemic, the hospital's income was worrying, and some departments did not see patients much, and even could not pay salaries. "The salary of our department has not been affected too much, but some section directors themselves have a bonus of one or two thousand yuan during the epidemic, and they really can't pay money."
Liu Ke is not the only medical student who has changed the trajectory of his life because of the epidemic. While this plague has completely disrupted the rhythm of people's lives, it has also made many medical students realize that there is more than one choice in front of them.
Maybe it's okay to take a fork in the road? Maybe it's acceptable not to roll up academic qualifications and not to roll up scientific research? Are those who "fall" off the canoe bridge really the so-called "falling behind"? In addition to the exam, is there really only a sea of job seekers who can never "go ashore"?
In addition to returning to second-tier cities to "lie flat", more and more 985 medical students are also eyeing the public examination.
Lu Ming (pseudonym), an eight-year clinical medical doctor who is about to graduate from a medical school in Shanghai, found that among the former seniors, there were few people who went to the public examination, "occasionally one or two." But last year, at least two or three of the classmates he knew who wanted to take the public exam. "Judging from the situation last year, I feel that there are more people around me who have completed their eight-year doctoral program and do not become doctors than before," he said.
Liu Ke is also considering going abroad. In most countries abroad, he could not continue to study medicine, but he could study some life sciences, such as biology or public health. Studying for a PhD abroad, Liu Ke can not only fight for a full scholarship, but also earn a salary.
Xiao Miao, a 985 University medical school in Shanghai, also embarked on the road abroad. After five years of undergraduate clinical medicine, he found that he could not adapt to the pace and system of hospital work. Coupled with the hopelessness of graduate school and the failure of the graduate school entrance examination, Xiao Miao decided to let go of this burden that had been weighing on for five years and go abroad to study business.
During his defeat in World War I and forced to take a break, Xiao Miu applied for the intersection of business and health management programs at both colleges and received a 20% tuition waiver from the school.
"I have a narrow definition of success, which is to make money." Xiao Miu said. "But I knew that doctors weren't really financially independent for a long time, so I wanted to change careers."
Zhang Yuxiao, Zhang Xiaoyi | Written by
Shi Chenjin 丨Responsible editor
This article was first published on the WeChat public account "Eight Points Jianwen" and may not be reproduced without authorization
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