medicine in China

[abhoriel]

Hi all,

 

I've recently qualified as a doctor and am wondering if there are any real opportunities for working in China as a doctor at some point in the future. Of course, I'd need to complete my training here in the UK first. Do many clinics/hospitals employ foreigners? What fields of medicine do they employ?

 

Doctors don't seem very popular in China from what I've read though..

 

I was just wondering if anyone has any experience!

 

 

[gato]

There are a number of expat hospitals in Shanghai and Beijing that employ foreign doctors. Search for Parkway Health and United Family Hospital.

[hedwards]

I think it depends where you go. The couple times I went to see a doctor I received excellent service and my condition cleared up more quickly than if I had seen a doctor in the US. But, the bigger issue is whatever is in the pills. The QA has improved, but you're still taking a risk when you take pills, or at least that was the information I got from my friends.

 

I think it was like $6 or something like that for the entire visit.

[Lu]

Do you speak Chinese? If so, you can look into how feasible it is to work in a Chinese hospital. If not, your options are basically limited to expat hospitals, but that should absolutely be an option. Several expat hospitals in Beijing and Shanghai, and I imagine with economic development as it is, over the coming years there will only be more of them and in more cities.

[gato]

Doctors in local hospitals make less than USD 1500 a month, which is why many local doctors make money on the side by taking bribes from patients and drug companies. I doubt you'd be willing to make that little. Doctors at expat hospitals make international wages or more.

[Touchstone57]

It seems like a fairly lucrative career these days, if you are fully qualified and have the right training under your belt. From people I know you can get quite a good contract working in one of the expat hospitals/clinics, which includes a housing allowance, good annual holidays etc.

 

There are a lot of roles of GPs, but of course you need to be fully qualified in your home country before you can come out, as well as a few specialisations. I wouldn't even want to think about working in a Chinese hospital...

[Lin You Le]

I study Chinese Medicine and all my teachers said it's very very difficult to a foreign work as a doctor in China, because China already have many doctors and seems to have a law about it also. I don't know about international hospitals

[abhoriel]

thanks everyone for all the replies!

 

International hospitals definitely seem the way to go, and thanks for the hospital names - their websites let me see what they're looking for.

 

As for a bit more background.. I am very recently married to a Chinese woman and I have been studying since not long after we met a few years ago. My Chinese isn't great at all, but I can get the gist of things and have conversations if they are not too complicated. It looks like knowing Chinese is often not requirement for positions in these expat hospitals!

[anonymoose]

Doesn't one have to 考执照 to work in China?

[gato]

See here: http://www.yixuejia.com.cn/manage/experience/666.html

[roddy]

Came across this old but relevant topic. 

[cinxj4]

There are several levels to being a foreign-trained physician working in China. At the most un-Chinese level, you will find that there are some foreign-focused institutions that are involved in the relatively lucrative market of caring for foreigners. United Family Clinics (Beijing and Shanghai) is the best-known example. UFC was just bought by a Chinese parent company, so they are no longer a foreign-owned China health enterprise. They have retired foreign doctors and well-trained Chinese doctors (who speak at least one foreign language) at UFC. The quality of care there can be as good as or somewhat less than you'd get in the U.S., Canada or the U.K.

 

There are other outfits (such as Parkway in Shanghai and Global Doctor--scattered in different places) that mainly provide outpatient services. Like UFC, locals may use such services, so being able to speak Chinese is a plus but may not be required. Another level includes foreign doctors who try to contribute to the Chinese healthcare system in some way (as opposed to those who "just work in China"). There are some UFC doctors in this group.

 

There are Family Medicine (in the U.S. sense of the term) training programs in Shenyang and Macau and Haikou. There are foreign doctors working in local hospitals in places such as Qinghai. There are also several places where foreign doctors do development work which may include training of local healthcare workers in places such as Chengdu and Shanxi.

 

In addition, there are other foreign doctors who are not practicing clinical medicine but are teaching, translating, doing NGO work and other types of jobs. There is a large market for editing/translating Chinese medical articles into English for publication. (Unfortunately, plagiarism and scientific fraud are significant problems).

 

There are also dozens of Chinese medical school departments that train foreign students from all over the world. Depending on the languages spoken by their students, these departments may welcome a foreigner physician to join their staffs. Occasionally, there are foreign doctors who come to China to get expertise in Chinese medicine (I know of one very smart African doctor who did that and is competent in both western and Chinese medicine).

 

However, there are significant differences to practicing medicine in China compared to western countries. These differences can make clinical or non-clinical work unpleasant for some. In order to understand these differences, it would help to spend time in China or have discussions with someone who has worked in the healthcare field. Also, it would help to understand the recent history (especially since the 1950's) of China's healthcare system.

 

Some important points: physician licensure is dependent upon one's employer in China. Therefore, one gets employed first and then you can use a license--whereas, it is the other way around in western countries. This means that, if you join a large enough outfit, your employer can arrange for you to get a medical license without you having to pass a Chinese medical exam.

 

Also, the doctor culture in China is very dependent on "face" as well as a cultural value of paternalism and outward authority. For this reason, local doctors almost never contradict the care of other doctors. For those of us who come from "the-needs-of-the-patient-come-first" orientations, this kind of attitude is jarring.

 

Related to this, when I visit a friend in the hospital, I almost never reveal that I am a doctor from the U.S. because local doctors are easily offended, thinking that I may be there to make them look bad. This means that, if one wants to have good relationships with local doctors, a good amount of effort and time on the part of the foreigner is required. These are some of my thoughts for anyone from a foreign country who is considering working as a doctor in China. There are lots of stories that can be told about this...

[abhoriel]

thanks for these fantastic responses.

 

cinxj4, I'll read about all these options, thanks for the extremely comprehensive reply! 

[icebear]

At the most un-Chinese level, you will find that there are some foreign-focused institutions that are involved in the relatively lucrative market of caring for foreigners. United Family Clinics (Beijing and Shanghai) is the best-known example.

 

 

Just to add my view on this - I go to UFC for any medical needs in Beijing, and I'd guess that roughly 75% of the patients are local (wealthy) Chinese. My understanding is that the main source of income for the hospital is its maternity ward, which markets to rich Chinese considering paying high fees to give birth in the US/Canada/EU for quality concerns. 

 

Also, I agree that the quality of care there is similar to levels in the west - always felt it competent hands, whereas at some foreign-oriented outpatient clinics one sometimes feels more like they're in a Chinese hospital with nicer decoration and more smiles.

[abcdefg]

Just to present an alternative scenario, here's my story.

 

I'm an American physician, now retired and living in China, who considered working as a doctor here several years ago but ultimately decided against it.

 

Realize that the original poster @abhoriel is at a totally different point in his career, so much of what I have to say will not be relevant to his or her needs. Really appreciate the insights from @cinxj4 and am glad to see his useful post. Welcome to the forum!

 

I was more interested in working in a Chinese setting in a second or third tier city than in an ex-pat clinic in a first-tier city. Here in Kunming I tend to associate more with Chinese friends and quickly get impatient with most expats. Don't really enjoy talking baseball and drinking beer with foreigners on Saturday night. It's just a personality quirk.

 

The feature of practicing medicine in China with Chinese patients that worried me the most was the difficulty involved in understanding unspoken wishes, needs, and expectations in a cross-cultural setting. Not sure how to make that point clear to laymen, but much of any clinical interaction between a patient and doctor inescapably has its roots in the fabric of the culture and goes beyond just scientific problem solving and making appropriate therapeutic interventions.

 

The subtle nuances of what things mean and how things are done in a clinical interaction have vast importance and are not easy to master in an alien cultural setting. Behaviors, including body language, that convey an appropriate degree of confidence mixed with caring and concern in one culture may send a different message in another culture. Patient perception becomes the reality in these matters and needs to be considered as such.

 

I tried to divorce myself from clinical medicine and do some teaching at the local medical school (in Kunming.) They were trying to build market share in providing medical education to English speakers from non-western countries, mainly India and parts of Southeast Asia. My job was to help certain members of the faculty get up to speed with their Medical English. Did it part time on a contract basis for a couple years.

 

Met more and more physicians who wanted help with submitting scientific publications to English-language medical journals. So I assisted them with translation, spending most of my effort in "smoothing out" and improving their first attempts and making the results more readable, making them sound more native and natural.

 

There is a big niche for this, as @cubxj4 pointed out. It's something the usual foreign English teacher cannot do well because he or she doesn't already have the necessary technical vocabulary. If the Chinese doctor whose paper I'm helping translate is talking about the role of specific enzymatic biomarkers such as troponin in the early diagnosis of sub-endocardial myocardial infarction, I don't have to go to the library to understand his intentions.

 

One of the more interesting tasks that I met over and over was helping well-respected doctors change the wording of plagiarized source articles enough that they would be less easily recognized. The ethics of the profession here in China leave much to be desired, and this soon became obvious in other ways as well.

 

An additional consideration entered into deciding whether or not to practice medicine in China, namely that my specialty is not recognized here. I'm an emergency physician, and in the US that specialty is not only recognized, it is in high demand, and thus well paid. But in Chinese hospitals the usual approach to emergency care is to just require junior physicians to rotate through the emergency room or emergency department providing temporary staffing.

 

Furthermore, I get the impression, though I don't know for sure, that it's considered an undesirable assignment and many of the doctors just grit their teeth and try to get it over with and move on to better things. Nobody wants to hang around and try become proficient. Doubtless it has to do, at least in part, with reimbursement issues.

 

So I wound up just practicing six months back home each year, living lean and stashing away most of my earnings. Then I'd spend the remaining months here studying and traveling, living from savings. That worked out well until I finally retired. Now I have no real need for income beyond pension and investments and can spend most of my time doing what I'd like. 

 

Have thought some about volunteering with a NGO to help out in a needy part of Yunnan, of which there are many. But have not yet found a good way to do that and it may or may not come about. Much of what exists in that sphere tends to be "all consuming" and require a 110% commitment of one's resources with an almost religious zeal.

 

It requires an altruistic self sacrificing mindset that I just don't have anymore. Would still like some life outside medicine to pursue my other interests. Realize that's selfish, but that's just the way it is.

[Mouseneb]

I'm not a doctor but rather an occasional patient in the excellent International Clinic in the Haikou City People's Hospital, which runs one of the family medicine training programs mentioned above. Which means access to American and western trained doctors at local Chinese hospital prices. I just wanted to say how amazing that is and how much I appreciate them. They are doing excellent work training local doctors and providing quality care for the haikou community, and I love them.

Hope you find a position in China, abhoriel, there is a lot of need for people like you!