中西方医生地位差距迥异

Roy Wang did not want to be a doctor but his grades were too low for engineering so his southern China university transferred him to a course for weaker students: medicine.

王大夫(Roy Wang)当年本不想当医生，但他的高考分数没有达到工程专业的录取分数线，因此被他报考的那所华南大学调剂到医学专业。医学专业的录取分数线较低。

In most western countries, medicine is a profession that guarantees prestige, high salaries – and the approval of parents who love to brag about “my child the doctor”.

在大多数西方国家，医生这个职业意味着体面、高薪以及父母的认可——父母都喜欢炫耀说，“我的孩子是医生”。

But in China, the reverse is true: doctors are ill-paid, overworked and maligned or even attacked by patients while many parents would prefer that they became bankers instead.

但在中国，情况正好相反：医生工资不高、工作辛苦，还可能被病人辱骂甚至殴打。许多中国父母更希望自己的子女成为银行家。

Even Chinese doctors prefer their children not to follow them into the profession: according to a 2011 survey by the Chinese Medical Doctors’ Association, 78 per cent of respondents said they hoped their child would not don a white coat. 

在中国，甚至连医生也不愿自己的子女继承这个职业。2011年中国医师协会(China Association of Medical Doctors)的一项调查表明，78%的受访医生不希望自己的孩子穿上白大褂。

Many of China’s less prestigious medical schools find it hard to recruit students to train as doctors and others find that students with lower scores on the national university entrance exam, or gaokao, use the lower requirements of some medical schools to gain entry to university, only to then transfer to faculties with higher earning potential.

中国许多不太知名的医学院出现了招生难现象。还有些高校发现，一些高考分数较低的学生利用一些医学院录取分数线较低的机会考进大学，目的只是为了在入学后转到其他更有“钱途”的专业。

 “Compared to western countries, the social status and income of doctors in China is not the highest, so [some medical schools] definitely are not able to attract the best students and the result is that the profession of doctors is not the most elite in Chinese society,” says Huang Gang, vice-dean of Jiaotong University medical school in Shanghai.

上海交大医学院(Shanghai Jiaotong University School of Medicine)副院长黄钢表示：“与西方国家相比，中国医生的社会地位和收入都不是最高，因此（有些医学院）肯定招不到最好的学生，结果造成医生在中国社会中也不属于最精英的阶层。”

Top faculties such as Jiaotong usually have little problem filling their quota for students with good marks, he says, adding that he would prefer to lower his grade expectations if the student were truly committed to studying medicine. 

他表示，交大等一流医学院要招到高分学生通常没什么问题，不过他补充称，如果学生真的有志学医，他愿意降低分数要求。

He says only about 5 per cent of Jiaotong medical students transfer to another faculty each year. But less elite medical schools, such as the one at Xiamen University where Dr Wang studied, struggle to fill available spaces. Xiamen medical school recently waived all fees for those training to be doctors, to attract better candidates.

黄刚表示，上海交大医学院每年只有约5%的学生转系。但厦门大学医学院（Xiamen University Medical School，开头提到的王大夫就毕业于这里）等名气较低的医学院，则很难招满学生。为吸引更好的生源，厦大医学院最近免除了医学专业学生的所有费用。

Dr Wang, 25, says he estimates about 80 per cent of his intake class at Xiamen medical school in 2006 did not end up there because they wanted to be doctors: he estimates that less than half ended up wearing white coats. Some chose instead to work in the pharmaceutical industry, now embroiled in bribery allegations which could further damage the public image of the medical profession.

今年25岁的王大夫表示，据他估计，与他一同在2006年入读厦门大学医学院的同学中，大约由80%的学生都是调剂过来的。他估计，他的同学中只有不到一半最终当了医生。还有一些同学选择进入制药行业，而制药业如今爆出的贿赂丑闻，进一步破坏了医疗工作者在公众眼中的形象。

Speaking after a gruelling day working in the emergency department of a Shanghai hospital, Dr Wang says low salaries are one reason that medicine does not attract China’s best students .

在上海一家医院的急诊室，刚刚结束一天辛苦工作的王大夫说，在中国，工资低是医学专业无法吸引最优秀学生的原因之一。

A survey last year conducted by MyCos education consultants in Beijing found that the average monthly salary for clinical medicine graduates was Rmb2,339 ($382) within six months of graduation. Average income for all graduates was Rmb3,051 nationwide, with doctors and nurses the lowest.

北京麦可思(MyCos)的教育顾问们去年的一项调查显示，临床医学专业毕业生在毕业半年内的平均月薪为2339元人民币（合382美元）。中国毕业生的平均月薪为3051元人民币，医生和护士两种职业垫底。

Many doctors complain that disgruntled patients increasingly turn to violence when doctors are unable to cure their ills, even when there is no mal-practice.

许多医生还抱怨称，在疾病无法痊愈时，患者用暴力发泄不满的趋势上升，哪怕医生在治疗方面并无过错。

A plastic surgery patient used a knife to attack three nurses, one pregnant, in the central Chinese city of Changsha in September. Doctors say they often have to pay out of their own pocket when patients sue them.

今年9月，在华中城市长沙市，一名接受了整容手术的病人持刀砍伤三名护士，其中一名护士怀有身孕。医生们表示，遇到患者起诉时，他们经常不得不自掏腰包向病人赔偿。

State media reports that attacks on doctors are becoming more frequent. The average number of assaults rose to 27.3 per hospital in 2012, compared with 20.6 in 2008, according to a Xinhua news agency report, citing a survey from the Chinese Hospital Association. Dr Wang seems resigned to being attacked. “It will happen sooner or later,” he says.

中国官方媒体报道称，患者袭击医生事件日益频繁地发生。新华社援引中国医院协会(Chinese Hospital Association)的调查称，2012年平均每家医院发生27.3起袭医事件，而2008年的这个数字为20.6件。王医生看上去对遇袭已经听天由命了。他说：“这是早晚的事儿。”

Xinhua reported that the violence is starting to chase doctors out of the profession: nearly 40 per cent of medical personnel surveyed at 316 hospitals nationally from December 2012 to July 2013 said they planned to give up their profession because of greater violence in hospitals.

新华社报道称，暴力事件开始让医生们考虑改行。2012年12月至2013年7月的调查显示，在中国各地316家医院中，近40%的医务人员曾因袭医事件日益增多而萌生转行的念头。

But hospital administrators and medical students point out that the situation is not uniformly bad. In poorer areas where other professions may not be available, the best students are willing to risk long hours and possible violence to study medicine.

但医院管理者和医学院学生指出，局面并非全然那么糟糕。在没有其他职业选择的较为贫困的地区，那些最优秀的学生可能仍愿意冒长时间工作和遇袭的风险去学医。

Dr Wang says he has embraced the profession he accidentally ended up in. He just wishes that patients – Chinese hospital physicians sometimes treat 100-200 a day – would give him a break.

王大夫表示，他已接受了这个自己偶然步入的行业。他只希望，病患们能对他宽容一点。在中国，公立医院的医生有时一天要接诊一两百名病人。

“When I see so many patients each day how can I smile at them?” he asks, noting ruefully, “they still want me to smile at them”. 

他问道：“我每天看这么多病人，这种情况下我怎么可能还笑得出来?”他遗憾地指出，“他们还要求我面带微笑”。

Additional reporting by Zhang Yan

张嫣补充报道