Analysis of Integrating Training in Scientific Research and Clinical Practice among Current Medical Postgraduates of Three Academic Systems

  Objective  To explore the situation of training in scientific research and clinical practice among medical postgraduates of different academic systems, analyze the advantages and shortcomings of each academic system in the mode of training medical postgraduates, and provide reference for future planning, adjustment and reform to medical education.

  Methods  Using the methods of questionnaires and individual interviews, information from senior graduate students in clinical medicine at the School of Clinical Medicine, Peking Union Medical College (Peking Union Medical College Hospital) in 2021 were collected. These participants included doctoral students in the traditional master-doctor system(TMD) from the 2018 doctoral class and 2016 direct and transfer class, graduates of class 2021 from eight-year program of clinical medicine (8YCM), and medical students from the new academic "4+4" pilot class (NAPC) entering in 2018 and 2019. Their information about research training and clinical practice was summarized and analyzed.

  Results  A total of 55 valid questionnaires were collected, including 33 (60.0%) from TMD, 15(27.3%) from 8YCM, and 7 (12.7%) from NAPC. Eleven people were willing to be interviewed, including 6 from TMD, 3 from 8YCM, and 2 from NAPC. 97.0%, 93.3%, and 71.4% of participants from TMD, 8YCM and NAPC respectively planned to commit to clinical work upon graduation. Regarding motivation for scientific research, 84.8% of TMD students believed that the drive was the needs of career development. 53.3% of 8YCM and 57.1% of NAPC students held the same view. During the training in scientific research, the main problem faced by TMD students was their weakness in scientific research design (60.6%) while 8YCM and NAPC students claimed that their main problem was the insufficiency of time for scientific research (73.3%, 71.4%). The proportion of those who were satisfied with or enjoyed the current status of scientific research was the highest among NAPC students (57.1%), followed by TMD students (39.4%) and 8YCM students(26.7%). The proportion of those who were satisfied with scientific research output was the highest among TMD students (54.5%), followed by NAPC (42.9%) and 8YCM students (33.3%). As for time committed to research, TMD, 8YCM and NAPC students who spent more than 20 hours per week accounted for 63.7%, 26.7% and 14.3%, respectively, and accounted for 24.2%, 20.0%, and 42.9%, respectively for clinical practice of over-20-hour's commitment. 84.8% of TMD, 100% of 8YCM, and 85.7% of NAPC students established their directions of scientific research under the guidance of their mentors. When the progress of scientific research encountered difficulties, 48.5%(TMD), 53.3%(8YCM), and 42.9%(NAPC) of the students of the three academic systems turned to their supervisors for help. The proportions of students who had more than 8 hours of contact with their supervisors each week were 12.1%(TMD), 20.0%(8YCM) and 14.3%(NAPC). Among the three educational systems, the proportion of postgraduates who were satisfied with or enjoyed current clinical practice was highest in NAPC (71.4%), followed by TMD(42.4%) and 8YCM (40.0%).

  Conclusions   The cultivation of scientific research thinking and clinical ability is a gradual process, requiring time investment and the guidance of tutors. The three systems of graduate education have their own advantages and disadvantages. The resources of clinical practice and scientific research of hospitals and medical schools should be integrated, and the time allocation for clinical practice and scientific research should be rationally planned to stimulate the initiative of graduate students, so as to cultivate more high-level and top-notch innovative medical talents with international perspectives that meet the needs of society.