Doctors with specialized training: Concerns about the quality of incoming students.

(Baonghean) - While many also wear the doctor's coat, not all of them have to compete for every point in the university entrance exam with its consistently high entry scores; instead, they take "detours" to become doctors such as continuing education programs, selective admissions, or even training programs tailored to specific local needs. Although these paths often require more time to study, the quality of graduates is a cause for concern.

"General practitioner - The most demanding field of study in Vietnam"

"To be a doctor, you'll have to be a 'student' for life."

Taking advantage of the weekend to visit his wife and children, before he could even see his family, Mr. Nguyen L. (30 years old, from Nghe An province) had to rush to catch a bus to Hue City to be on time for his classes. He is a final-year student in the general medicine program at Hue University of Medicine and Pharmacy.

“For over three years now, I’ve had to travel back and forth like this. Now, if I can just work for another year, I’ll become a doctor,” said Nguyen L. This older student also asked to remain anonymous “for fear of affecting my job prospects” after graduation.

Hue University of Medicine and Pharmacy trains the majority of specialist doctors in Central Vietnam and the Central Highlands. Photo: Tien Hung

Becoming a doctor was Nguyen L.'s dream since childhood. Therefore, after graduating from high school, his only option was to apply to medical school. Despite his "abundant passion," his average academic performance led to him failing the university entrance exam repeatedly. Each time, his scores were below 20, while the general medicine program typically requires scores above 27.

After realizing he couldn't compete for admission to general medicine programs, which have very high entrance scores, Nguyen L. accepted a vocational course at a medical college in Hanoi. Upon graduation, to find work, he had to leave his family and travel hundreds of kilometers to work at a health station in a mountainous commune of Nghe An province. After working there as a medical assistant for three years, he was selected to pursue a full-time bridging program at Hue University of Medicine and Pharmacy, requiring only a small entrance exam.

"For a full-time medical student, even someone as academically gifted as me has to struggle so much with my studies, so for someone in a specialized training program like mine, it's even more difficult," Nguyen L. said.

To study here, he received a small grant, not enough to cover the expenses. But as long as he could get his medical license, he could endure any hardship or expense.

“After graduation, I won’t work at that health station anymore; I’ll apply to a district-level hospital. That way, I’ll be closer to home. I know some people there,” Nguyen L. excitedly boasted. Although he had been sent to study there simply because it was a remote village lacking doctors, he wasn’t sure if, in nearly a year’s time, he would have the confidence and expertise to treat difficult cases.

Nguyen L. is one of hundreds of students pursuing a medical degree through the bridging program at Hue University of Medicine and Pharmacy. Among them are many medical assistants from Nghe An province who were sent to study there to serve in disadvantaged areas lacking doctors.

Professor Vo Tam, Vice Rector of Hue University of Medicine and Pharmacy, said that students in the bridging program (also known as specialized training) and the government-sponsored training program are two types of medical training programs with a "quite different" level of expertise compared to regular students currently studying at the university.

“A few years ago, there was a training system here that was tailored to local needs. Doctors practicing through this method certainly wouldn't be of high quality because the entry requirements were lower. Before pursuing further studies, they usually had to take the regular university entrance exam and fail,” said Dr. Tam. Before the establishment of Vinh Medical University and the Faculty of Medicine and Pharmacy of Da Nang University a few years ago, Hue University of Medicine and Pharmacy was the only place in Central Vietnam that trained doctors.

Being a doctor is a specialized profession, requiring rigorous training. Photo: Tien Hung

Considering that medicine is a specialized profession, requiring high entry standards to sustain the rigorous training environment, Professor Vo Tam also suggests that the medical field should gradually reduce these types of training programs.

“For the scholarship program, many students find it very difficult to keep up. Some study for 10 years straight, only graduating at the last minute. Knowing that the quality of incoming students is not high, we have had to arrange for a few scholarship students to be placed in each regular class to provide tutoring. This allows them to study with talented classmates so they can improve, although the end-of-year results are still very different,” Professor Vo Tam said, adding that currently, like many other prestigious medical schools, Hue University of Medicine and Pharmacy is gradually reducing its enrollment quotas for transfer and scholarship programs.

Meanwhile, the director of a large hospital in Vinh City (Nghe An province) said that many doctors trained through the scholarship and transfer programs are clumsy and inexperienced when it comes to direct medical examination and treatment.

"Doctors, especially general practitioners, need to have sufficient qualities, receive thorough training, and produce high-quality graduates. With the entry requirements from distance learning and scholarship programs, most graduates don't meet these requirements," this person said, adding that the shortage of human resources in remote and rural areas is a problem for all professions. However, the medical field directly affects people's lives and health, so quality must be paramount. Currently, doctors who graduate from specialized training and scholarship programs mainly work in district-level hospitals, specialized hospitals, and health centers.

From 2013 to the present, the Nghe An Department of Health has sent 205 medical assistants to pursue further education to become doctors, mainly from commune health stations and hospitals in mountainous districts and specialized units. “On average, the entire health sector needs to recruit 120-150 doctors each year to fill the shortage. However, in recent years, we have only been able to recruit about 100 doctors annually. To meet the annual demand for doctors, we must send medical assistants to pursue further education at medical universities nationwide, especially at the commune level and in mountainous health units,” said Mr. Duong Dinh Chinh, Acting Director of the Nghe An Department of Health, adding that the province currently has over 2,100 doctors, while the need is for 2,800.

These individuals were sent for training to meet local needs; however, in reality, there are quite a few cases where, after obtaining their degrees, they request transfers to more convenient locations.

In Nghe An province, from 2015 to the present, there have been 13 cases of doctors who, after being sent for specialized training or recruited under a special program, have requested transfers to other units. Of these, 5 cases occurred in 2015, 4 in 2016, and 4 in 2017.

According to Mr. Duong Dinh Chinh, this is one of the issues causing difficulties for the unit, because although they had created conditions and developed plans to send staff for specialized training to serve the unit later, these doctors did not return to serve the unit, which caused some impact.

(To be continued)

Tien Hung