诊断: 症结就在于 pathology as an important medical discipline is misclassified in China。

I agree with many points made by  “不能考执业医师的病理研究生们都来看看”.  In fact, “病理研究生无法报考执医而从业” is only one of the major challenges facing pathology and pathologists in China.  There are several other related issues and serious challenges.

I.   症结就在于 pathology is misclassified in China。In most part of the world, including U.S.A, pathology service belongs to one of key clinical disciplines! But pathology diagnostic service in China is classified as “second class, auxiliary” clinical discipline. 

The inappropriate classification of pathology in clinical disciplines determines the social-economic status of pathology and pathologists.  As a result, the misclassification of pathology causes subsequently three key problems, among others:

(1)    The status of pathology service is not well respected by other “major” clinical services. 病理学科在疾病的诊断和治疗中的关键作用有目共睹. Pathology diagnosis is the gold standard! But in China, only when a malpractice happens, people (the CEOs, presidents of the hospitals) realize the importance of pathology. Otherwise, not much attention is paid to pathology. 病理科是不讨好的科室. Pathologists are just humble “grandchildren” in the hospital. 病理科 often time has  small work spaces, unfavorable locations, and very limited resource allocations of the hospital budget.

(2)    病理医生低收入. In USA, pathology is very competitive medical discipline, and pathologists in USA are paid reasonably well compared to other clinical disciplines! One of the main reasons is that the pathology diagnostic service fees in USA consist of “professional component (about 70%), and material/instrument component (about 30%)”. But in China, the services fees consist mainly of material/instrument component. We need to change this: pathologists in China need to get higher salaries!

(3)    Because of the above 1 and 2,  中国病理人才越来越少，病理学科的发展停滞不前. A lot of young students with interest and knowledge of pathology are ending up doing something else!

I have visited more than 80 Chinese hospitals/university medical centers since I practiced pathology in U.S.A in 1999. There are significant shortages of good dedicated pathologists in China. Many places re-hired retired pathologists/professors since talent young medical students want to do other medical disciplines rather than pathology because the above problems. As a matter of fact, the situation was not the same when I was studying pathology in China in early 1980. At that time,  pathology service was still considered as a clinical discipline as other major medical disciplines and many dedicated medical graduates chose pathology as a career.

II.  In summary,  new policy should be considered to address problems of pathology in China.  New policy should be discussed, planned, tested, and implemented based on three major aspects, namely professional input, international standards, and the demands from the society!!

(1). Professional input, as stated in the above, is already very clear.

(2). International standards are also easy to check via web, international pathology organizations, and international pathologists including myself.

(3). The demands from the society, from the patients, are very high. China has transformed significantly during the past 30 years.  For example, China now has the best 5 star hotels, best high-speed trains, and best shopping malls. That is wonderful. But pathology services have not been improved during the same period of time. In fact, they are becoming worse.  China, and Chinese people need the best pathologists!! Chinese patients need to enjoy the best quality of pathology diagnosis services!!

III. We need to work together to solve the problems. Each and everyone of the pathology community have the responsibility and duty to respond to the problems. We need every 病理医生积极主动参与的热情. The following are major suggestions:

            (1). To mobilize all national and local pathology organizations. It is very important to act as a massive group, with a stronger voice! To mobilize the media: newspapers, websites, radio and TV stations. Huaxia Pathology website is a very useful platform. To unite organizations of other medical disciplines, which are relied on pathology services.

            (2) To address the issues one by one directly: namely RECLASSIFY PATHOLOGY DIAGNOSTIC SERVICE AS A MAJOR CLINICAL MEDICAL DISCIPLINE!! SO IT WILL promote the social-economic status of pathology service and pathologists among the professional field of medicine.

            By doing this, the whole landscape of pathology will change: more and more people will do pathology, more and more resources will be allocated to pathology services and pathology research. The final mission of medicine, serving the patients well, will be accomplished. However, these all need the involvement of pathology organizations and every pathologist. Everyone can make a contribution to this effort.

            To address the problem of 病理研究生无法报考从业,  it also needs to 制定一个严格的完善的准入、管理体系, 准许病理研究生直接参加医师考试. But 病理研究生 still needs to be trained for additional years before being allowed to sign out pathology diagnosis report.

为发展中国的病理事业, 为病理学科后继有人，Let’s work together！

I certainly will try my best to contribute to this long-term project.

谈东风   May 27, 2010 from Houston.

强烈要求提高病理医师的社会和经济地位！！！

这个贴太好了！！！！深刻！！！！这就是中国的现状！！！！

 谈教授对国内病理现状分析的很透彻，切中命脉。

一方面经过专业学习的病理医生不能考证；一方面临床紧缺病理医生。

长期以来始终没能招聘到合适的病理医生，真的很为难。

退休的病理医生也忙的不可开交。

不知制定政策或有能力改变政策的机构是否了解，病理人才的问题已迫在眉睫了。

基层病理科太需要有热情有知识的病理学生了，强烈建议变更病理学科设置，强烈建议准许病理研究生直接参加医师考试，并于适当的培训，让有志学子补充到病理队伍中去，这样病理学科才有希望人才济济.蓬勃发展。倘若病理硕士博士毕业证不能作为行业入门的依据，其价值还会高吗？想学的人还会多吗？

 感谢谈老师！！说出了病理人的心声。

年轻医生应该提高自己的业务水平是必须地。国外病理发展比国内好很多，这是现实，期望多学习经验，希望病理学科能快速健康地发展

昨天看报，某领导谈到新医改“医务人员的关键作用”，要求他们“发挥积极性和创造性”，“加强医德医风建设”，而不是调动他们的积极性。

 顶！！感谢谈教授的理解和心急如焚，更是感谢谈教授的策略。

大家不妨试试，努力和领导沟通，会有转机的。我就在努力这样做！！

实际上大家越来越发现，我们比临床医生能力强些，所以病理医师是值钱的。我们在继承传统的时候要有创新！！不要总结省，不舍得投入！！要知道有舍必有得！！

将病理进行到底，大家加油，各位老师们多多支持哦

 粉蓝医疗科技（杭州）有限公司网真的很不错！特别是对基层的病理医生来说真的是个很好的学习平台！

网络课堂很不错！各个系统的论坛也相当不错！！

真心的感谢各位前辈大师们特地抽出时间给我们上课！！！

收益匪浅！

My points are very clear:

事实上，“病理研究生无法报考执医而从业”只是在中国病理学和病理学家的所面临的重大挑战中的一个。还有其他一些相关的问题和严峻的挑战。

关键症结就在于：在中国病理专业被错误地分类。在世界大多数地方，包括美国，病理专业服务都属于临床学科的重点之一！

Do you think it is right to put 的病理诊断服务在中国被列为“第二类，辅助性”的科室??

Your argument may be right. "大家觉得在中国这个十几亿的泱泱大国，会缺乏人才吗？在中国什么都缺，就是不缺人才！人才有得是!"  But my point is  that the number of 中国病理人才 does not match to 十几亿的泱泱大国!

I did not 为病理研究生抱不平. We should encourage and help everyone who would like take pathology as his/her professional career. 为了解决病理研究生无法报考从业的问题，I suggested 需要制定一个严格的完善的准入，管理体系，准许病理研究生直接参加医师考试。但病理研究生仍然需要several years 的训练，然后才获准发出病理诊断报告。