2025年3月，我們團(tuán)隊(duì)赴紹興，對(duì)當(dāng)?shù)厝易畲蟮娜揍t(yī)院進(jìn)行了為期一周的實(shí)地調(diào)研。在與醫(yī)院科主任交流時(shí)，我們問：“你們希望推動(dòng)學(xué)科建設(shè)嗎？”幾乎所有科主任都說：“那是醫(yī)院領(lǐng)導(dǎo)的事，和我們沒關(guān)系。”再問普通醫(yī)生：“你們希望提升自己的門診和手術(shù)能力嗎？”回答仍是：“沒有特別打算。”聽完這些回答，我們震驚，更感到沉重。從上到下，整個(gè)城市醫(yī)療界彌漫著混日子的氣息，沒有成長(zhǎng)意愿、沒有責(zé)任意識(shí)，仿佛只求維持最低生存標(biāo)準(zhǔn)。人活在這個(gè)世界上，最重要的是對(duì)這個(gè)世界的貢獻(xiàn)。醫(yī)療就是一個(gè)國家國運(yùn)級(jí)的行業(yè)。紹興是一座文化底蘊(yùn)深厚、人才輩出的城市。但我們卻看到，在這里，醫(yī)生普遍處于一種無意識(shí)、無追求、無責(zé)任的狀態(tài)，這不僅是醫(yī)院的悲哀，更是這座城市的悲哀。反觀德國，成為一名合格醫(yī)生的路徑，是建立在系統(tǒng)的專業(yè)訓(xùn)練和高門檻基礎(chǔ)上的。首先是6年醫(yī)學(xué)院課程，相當(dāng)于中國的本科加碩士階段；多數(shù)醫(yī)學(xué)生還會(huì)再花兩年時(shí)間攻讀醫(yī)學(xué)博士學(xué)位。雖然博士并非強(qiáng)制要求，但在學(xué)術(shù)醫(yī)院工作、日后升職幾乎是隱性門檻。之后，每位醫(yī)生都必須進(jìn)入為期5至6年的?？婆嘤?xùn)，在教學(xué)醫(yī)院中進(jìn)行嚴(yán)格的臨床輪轉(zhuǎn)、系統(tǒng)的理論學(xué)習(xí)和階段性評(píng)估。德國國家科學(xué)院院士、慕尼黑大學(xué)附屬醫(yī)院泌尿外科主任Stief院長(zhǎng)以他所在的科室為例分享：前3年是在常規(guī)泌尿外科崗位上打基礎(chǔ)，第4年才開始亞?？频呐嘤?xùn)，甚至有些醫(yī)生會(huì)赴國外進(jìn)修一年。整個(gè)培訓(xùn)結(jié)束后，還需通過德國醫(yī)學(xué)協(xié)會(huì)的正式考試，才有資格獲得?？漆t(yī)生認(rèn)證，正式獨(dú)立執(zhí)業(yè)。說句可能刺耳的話：如果以德國的醫(yī)生培養(yǎng)體系為標(biāo)準(zhǔn)，中國現(xiàn)在90%的醫(yī)生連最基本的要求都達(dá)不到。他們中很多人從未真正經(jīng)歷過系統(tǒng)的亞?？婆嘤?xùn)，也從未真正走出過自己的醫(yī)院去看看外面的世界。更糟糕的是，他們卻還以為自己很牛，還敢自我標(biāo)榜技術(shù)一流，還敢到處去講課、當(dāng)“專家”。只有真正沒見過世面的人，才敢狂成這個(gè)樣子。德國為什么是現(xiàn)代醫(yī)學(xué)的發(fā)源地？因?yàn)樗尼t(yī)學(xué)體系是建立在規(guī)范與敬畏之上的。而中國的很多醫(yī)生，連起碼的規(guī)范都沒有，卻已經(jīng)開始享受“專家”的身份感。這才是最危險(xiǎn)的地方。醫(yī)生不是一個(gè)頭銜，而是一份對(duì)生命負(fù)責(zé)的專業(yè)職業(yè)。我們不怕醫(yī)生水平不夠，但我們怕的是他們不愿學(xué)習(xí)、不肯承認(rèn)差距、還覺得自己已經(jīng)很優(yōu)秀了。一個(gè)醫(yī)生不學(xué)習(xí)，一個(gè)醫(yī)院就會(huì)停止進(jìn)步；一個(gè)城市的醫(yī)生都不學(xué)習(xí)，那這座城市的醫(yī)療就注定原地踏步，甚至倒退。中國到底有多少“不合格”的醫(yī)生？

In March 2025, our team made a week-long field research at the three largest Grade III Class A hospitals in Shaoxing, Zhejiang province. When we asked clinical department heads, “Do you hope to promote specialty development in your department?” Almost every directors responded, “ That’s the responsibility of the hospital executives, not ours.” We then asked several junior doctors, “Do you want to improve your outpatient and surgical skills?” The answers remain “We don’t have any plan.” Upon hearing these answers, we were shocked but more disappointed. From top to bottom, the city’s medical system seemed to be pervaded by a mentality of apathy and stagnation. No desire to grow, no sense of professional responsibility, as if the only goal was to meet the bare minimum of survival. As human beings, our most fundamental value lies in our contribution to the world. Medicine is such a national industry influencing national fate. Though Shaoxing is a city with rich cultural heritage and a long tradtion of producing talents, what we witnessed was a medical community operating in a state of unconsciousness without drive nor sense of responsibility. This is not just a tragedy for the hospitals, but for the city as a whole. On the contrary, the path to becoming a qualified doctor in Germany is built on systematic professional training and high standards. Medical education begins with a six-year program in medical school, comparable to the combined bachelor’s and master’s level of studies in China. Most students then spend an additional two years earning a doctoral degree in medicine. Though an MD degree is not mandatory, it’s widely seen as an unspoken prerequisite for working in academic hospitals or advancing in one’s career. Then, every doctor must undergo a specialist training for 5 to 6 years in a teaching hospital, which includes intensive clinical rotation, systematic theoretical education and staged evaluations. As Prof. Stief, a member of German National Academy of Sciences Leopoldina, Chairman of the Dept. of Urology  and Deputy Medical Director at the University Hospital of Ludwig Maximilians University of Munich, shared with us: in his department, doctors spend the first three years laying a foundation in general urology, and only begin sub-specialty training in the fourth year. Some even go abroad for one year for further training. Only after completing the full program and passing a formal board exam administered by the German Medical Association can a doctor be certified and begin independent practice. It may sound unpleasant, but if followed the Germany’s training standards, 90% of Chinese doctors would fail to meet the basic requirements. Many have never received structured sub-specialty training, nor stepped outside their own hospital to see how the wider world of medicine operates. What’s worse, they still believe they are top-tier, eagerly claiming to be “experts,” giving lectures, and flaunting their skills. It is often those with the least exposure who boast the loudest. Why is Germany considered one of the birthplaces of modern medicine? Because its medical system is rooted in rigor and reverence. Despite failing to meet the minimum norms, many Chinese doctors are already busy enjoying the prestige of being an “expert.” That’s where the real danger lies. Being a doctor is not about a title, but about bearing responsibility for life itself. We are not concerned about doctors who have room to improve, what we worry about is those who have no desire to learn, no awareness of their shortcomings, and yet still think they’re outstanding. When doctors stop learning, the hospital stops improving. And when an entire city’s doctors stop learning, its healthcare system is bound to lapse into stagnation or even regression. How many “unqualified” doctors are there in China today?