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    China Relaxes Exam Requirement for Village Doctors

    The new rule aims to provide more employment opportunities while improving rural health care, but experts wonder how much it can help without additional incentives.
    Jul 07, 2020#health#labor

    Graduates from China’s medical colleges will now be able to work as village doctors without passing standardized exams, the country’s National Health Commission said Monday.

    Fresh graduates with degrees in clinical medicine, traditional Chinese medicine, and Western medicine, but without a doctor’s license, can now apply directly to be certified as village doctors, the notice said. Previously, village doctor candidates were required to pass a local medical examination and receive additional health care training before being certified.

    The move is aimed to “foster graduates’ employment, optimize the team of village doctors, and improve rural health care,” according to the notice. Provincial and regional governments have been tasked with revising local policies to facilitate the change by the end of this month, and must report their progress by December.

    Previously known as “barefoot doctors,” China’s village doctors represent the front line of the country’s primary health care network, offering improved access to medical services in remote areas. They are mostly unlicensed practitioners who operate in the countryside, where highly trained medical professionals are in short supply.

    Xu Yucai, a medical reform expert working at the health department in northwestern China’s Shaanxi province, said the new policy may help attract more recent graduates and strengthen rural health care in the country.

    “Currently, many village doctors are not degree-holders, they’re relatively older, and it’s rare to see young people (in the profession),” Xu told Sixth Tone.

    According to Xu, the hypothetical addition of graduates who lack clinical experience but have strong academic qualifications could improve rural health teams. Retaining the fresh faces, however, might be a challenge without additional incentives.

    For medical students like Huang Haitao, it’s unclear if the policy will actually change the status quo.

    “It’s vague in many ways,” said the 21-year-old, who is in his second year of medical school in the southwestern city Chongqing. “Can they improve the work environment for village doctors, or the financial benefits? … This is not specified.”

    Working in village clinics has historically been low-paying in China. Although the government has tried to improve welfare for village doctors and allocate more financial resources for rural areas, not all reforms have been implemented as promised.

    In 2019, dozens of village doctors in the central Henan province resigned to protest alleged unpaid wages and funding cuts, prompting the National Health Commission to investigate.

    Village doctors also have limited opportunities for career growth, as they are rarely promoted to work at better-equipped hospitals. This has led to a decline in the number of village doctors in the country: In 2018, there were 845,000 village doctors nationwide, or 56,000 fewer than the year before.

    “The (new) policy is actually a stopgap solution for responding to this year’s employment issues,” Xu said. “I think the impact will be limited when it comes to addressing the talent shortages in rural areas.”

    Editor: Bibek Bhandari.

    (Header image: A village doctor on a motorbike in Yichang, Hubei province, Nov. 24, 2010. People Visual)