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01 June 2020, Volume 40 Issue 6 Previous Issue    Next Issue

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Consensus of experts: remodeling medical education in China to escort the Project of Health China 2030 Expert Group for the Development and Reformation of Medical Education in the New Epoch 2020, 40 (6):  401-404.  DOI: 10.3760/cma.j.cn115259-20200407-00498 Abstract ( 138 )   PDF (902KB) ( 144 )   In face of the great opportunity in the field of global revolution in science technology, emerging project of Health China 2030 and novo integration of medical education with healthcare provision, Medical education in China must take this chance for speeding up reformation of education as a historical mission and with a multi-level and social service based strategy, which has been highlighted by the current pandemic COVID-19 event. In this background the National Center for Health Professions Education Development invited some well-known experts to a summit for development and reformation of medical education in the new epoch and reaches consensus. Related Articles | Metrics

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Analysis on the problems and countermeasures in the construction of quality culture in medical education Sun Baozhi 2020, 40 (6):  405-408.  DOI: 10.3760/cma.j.cn115259-20191101-00938 Abstract ( 59 )   PDF (790KB) ( 59 )   It is the key to cultivate quality culture of medical education for realizing the connotative development of higher education. According to the author's long term experience in clinical medicine accreditation organized by The Ministry of Education of China and data collected from other information resources, the paper summarized current profile of education quality culture in medical colleges and universities focusing on the weaknesses in teaching and education and then, discusses how to arouse the motive power in medical colleges to improve education and put forward suggestions in the view point of spirit, system, resources and education performance, so as to strengthen the quality as a component of medical education culture. References | Related Articles | Metrics

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Current situation and influencing factors of general capacity of medical undergraduates Zhang Yingnan, Wei Jingdan, Wu Xian, Di Xingpeng 2020, 40 (6):  409-412.  DOI: 10.3760/cma.j.cn115259-20190720-00580 Abstract ( 53 )   PDF (802KB) ( 46 )   Objective To understand the situation of medical undergraduates' general capacity and to analyze the differences of them. Methods In March 2019 to June, using stratified sampling method to select China medical university different professional educational system in grade 2014 ~ grade 2018 (including four-year, five-year, seven years, eight years) 1 348 medical undergraduates as the research object. Using the medical undergraduates' general capacity assessment questionnaire on the questionnaire survey. Using t test and single factor variance analysis of characteristics of different students general capacity difference; multivariate analysis of variance was used to analyze the influence of different factors on general capacity. Results Total score of general ability for medical undergraduates in China Medical University was (166.74±20.35). Ethnic minorities and non-minority score [(164.41±21.11) vs (167.37±20.10)], party members and non-party people score [(180.28±17.60) vs (165.83±20.21) ], regular exercise, and no motor score [(170.06±19.80) vs (157.77±19.11)], school choice for my intention and not my will score [(167.56± 21.80) vs (157.45±21.80)], professional choice for my intention and not my wil score [(167.25±20.64) vs (162.99±17.70) ], have experienced cadres and no cadres score [(168.46±20.11) vs (165.16±20.46)], good prospects for employment with poor scores [(168.61±19.67) vs (160.37±21.32)], urban students and rural students score [(167.97±20.84) vs (164.15±19.02)] factors such as the differences were statistically significant (all P < 0.05), The influence factors from big to small are movement, party members, employment prospects, school intention, source of students and nationality. Conclusions The general capacity level of medical undergraduates is high and is affected by many factors and needs to be improved. References | Related Articles | Metrics

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An investigation of the healthcare career willingness among high school seniors in China Li Han'ge, Wang Chuting, Wang Shuai, Sun Yan, Dong Yucheng, Li Fangyuan, Yu Jing, Yang Ping, Ma Chao 2020, 40 (6):  413-416.  DOI: 10.3760/cma.j.cn115259-20190717-00563 Abstract ( 68 )   PDF (804KB) ( 40 )   Objective To investigate the healthcare career willingness among Chinese high school seniors and associated influence factors so that Chinese medical colleges could adjust enrollment policy and enrollment propaganda accordingly. Methods In February 2018, the Academic Affairs Office of Peking Union Medical College conducted a nationwide questionnaire survey of senior three students' willingness to learn medicine. Descriptive statistics were used to analyze the survey results. Results Surveys were completed and returned from 1 382 students in 48 Chinese high schools. The main reasons for potentially choosing medical profession were “a noble profession to save lives and of great social value” [62.4%(863/1 382)] and “interested in medical science” [50.3% (695/1 382)]. The main concerns about learning medicine were “longer educational system in medical college” [50.3% (695/1 382)]and “strained clinician-patient relationship” [45.7% (632/1 382)]. The main ways for high school students to learn about medicine were talking with family members [49.3% ( 681/1 382)], literature [41.8% (577/1 382)] and social media [30.2% (417/1 382)]. Only 11.2% (155/1 382) students had school lectures related to healthcare profession, and only 12.7% (176/ 1382) students had experienced medical social practice.Among the students who learned about medicine from literature, social media, school lectures and social practice, the percentages of “long-term curriculum in medical college” concern were 55.1% (318/577), 55.2% (230/417), 43.9% (68/155)and 48.9% (86/176)respectively; and the percentages of “strained clinician-patient relationship” concern were 52.5% (303/577), 53.5% (223/417), 49.7% (77/155)and 46.6% (82/176)respectively. Conclusions The motivation of Chinese high school seniors to choose medicine as their career is relatively pure. However, they worry about long curriculum and clinician-patient relationship, and their understandings of medicine are not objective and deep enough. Actively exploring the reform of medical college system, improving the relationship between doctors and patients, focusing on medical related lectures and medical related social practice in middle schools will help to attract candidates for learning medicine. References | Related Articles | Metrics

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Present situation analysis and improvement strategy of oncology teaching for medical undergraduates Guo Feifei, Bai Ling, Liang Tingting, Li Wei, Cui Jiuwei 2020, 40 (6):  417-420.  DOI: 10.3760/cma.j.cn115259-20191022-00878 Abstract ( 86 )   PDF (795KB) ( 39 )   In recent years, the incidence and mortality of tumors have shown an upward trend in the world, tumor has become the primary disease that endangers human health and leads to human death. The prevention and treatment of tumors has become a great challenge for medical workers. In the face of this severe situation, it is urgent to speed up the training of oncology professionals and provide more excellent specialists for the clinical diagnosis and treatment of tumors. Medical undergraduates are the backbone of clinical work in the future, so we should attach great importance to oncology in the teaching of medical undergraduates, perfect the teaching system of oncology, help students systematically learn the knowledge of oncology, cultivate students' clinical thinking of multi-disciplinary comprehensive diagnosis and treatment of tumors, and guide the future clinical practice and specialized work of medical students. However, there are still many problems to be solved in oncology teaching in China. This paper expounds the present situation of oncology teaching for undergraduates in medical colleges and universities in China, and probes into the possible effective reform methods in order to lay a foundation for the cultivation of oncology related talents and outstanding medical talents in oncology field, and to provide reference for promoting the development of oncology teaching. References | Related Articles | Metrics

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Research on construction of medical MOOC teaching design normative system Li Xue, Huang Guoqiong, Mei Wen, Yuan Di, Guo Yujun, Wang Na, Tang Yanni 2020, 40 (6):  421-425.  DOI: 10.3760/cma.j.cn115259-20191211-01069 Abstract ( 47 )   PDF (891KB) ( 30 )   In the “Internet +” era, accelerating the construction of MOOC is of great significance for deepening the deep integration of MOOC and traditional medical teaching methods and innovating and reforming the teaching model of medical education. At present, there is no normative construction standard for the teaching design system of medical MOOC. This is a key issue that need to be solved in the construction of MOOC are integrated. Therefore, this paper comprehensively uses research methods such as literature analysis, MOOC production practice summary, and expert argumentation to build a medical MOOC teaching design system framework of “study analysis, content design, teaching process design, teaching evaluation design”, and put forward the MOOC teaching design should pay attention to learning in the process of analysis, realize the split reorganization of teaching content, teaching process design of suitability and reflect the design principle of the diversification of teaching evaluation, with a view to providing a reference for the standardized construction of medical MOOC teaching design, and to promote high-quality medical MOOC construction assistance. References | Related Articles | Metrics

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The construction value fulcrum and realization path of medical professionalism Wang Zhen, Yang Maoling, Xu Jiaming, Li Yanchao, Li Wenyu, Sun Tao, Cao Depin, Yang Libin 2020, 40 (6):  426-429.  DOI: 10.3760/cma.j.cn115259-20191121-01006 Abstract ( 144 )   PDF (841KB) ( 34 )   During the period of constant confluence of Chinese and Western Thoughts, how to keep tradition of China and how to penetrate traditional culture into education of professionalism development is a key element in medical education. We need to construct a Chinese medical professionalism framwork based on Chinese discourse system and ideological system. This paper analyzes the realistic meaning of medical professionalism. The purpose is to explain the necessity of constructing medical professionalism with cultural consciousness as the fulcrum of value. This paper analyzes the “Debate on Morality and Benefit” of the Important Components of Chinese Traditional Culture, to explore the feasible way to realize the construction of medical professionalism by “the symbiosis of morality and benefit”; so we could a new space of medical professionalism development focusing on the unity of morality and benefit. References | Related Articles | Metrics

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Research on the construction of the index system of humanistic curriculum structure in nursing Tan Jiahui, Li Hongyu 2020, 40 (6):  430-434.  DOI: 10.3760/cma.j.cn115259-20200110-00044 Abstract ( 54 )   PDF (836KB) ( 39 )   Objective To construct the index system of humanistic curriculum structure in nursing. Methods The questionnaire of expert consultation was preliminarily formed by literature reading and interview, and the Delphi method was used to conduct 2 rounds of expert consultation from 23 experts. Results The recovery of questionnaires of two rounds were 95.7%(22/23) and 100.0%(22/22) respectively, the expert authority coefficient was 0.87 and 0.88, and the expert opinion coordination coefficient was 0.327 and 0.336 respectively. The Kendall's W test was statistically significant (P<0.01).The integrated and optimized humanities curriculum includes 3 first-level indicators, 8 second-level indicators and 28 third-level indicators. Conclusions The integrated and optimized humanistic curriculum of nursing is scientific and reasonable, the combination of knowledge, capacity and professionalism should be strengthened, which is in line with the cultivation goal of nursing, and provides reference for the compilation of nursing humanistic curriculum materials and specific curriculum design in the future. References | Related Articles | Metrics

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Investigation and reflection on the effect of scientific research and training for undergraduate students in clinical medicine Wang Na, Zhu Qingshuang, Wang Yajun 2020, 40 (6):  435-438.  DOI: 10.3760/cma.j.cn115259-20190718-00572 Abstract ( 90 )   PDF (797KB) ( 56 )   Objective To investigate the training effect of scientific research training on scientific research ability of senior undergraduates of clinical medicine specialty, analyze the existing problems and explore effective improvement measures. Methods This study adopts the method of questionnaire. From April 2018 to March 2019, 100 students from 2014 to 2015 of clinical medicine major in Xuanwu Hospital of Capital Medical University who participated in clinical scientific research innovation project were selected as the research objects, and their participation in scientific research and training was understood through questionnaire survey, and the existing problems were analyzed according to the survey results. Results Before scientific research training, only 19.0% (19/100) of the students approved of their scientific research ability, and 63.0% (63/100) of the students were satisfied with their scientific research ability 83.0% (83/100) of the students recognized the instructors' ability in scientific research and their serious attitude towards scientific research, and 82.0% (82/100) of the students considered that the experience of scientific research and training played a great role in their next academic career 50.0% (50/100) of the students completed the opening, mid-term and closing questions in the project group 51. 0% (51/100) of the students wrote academic theses or reviews, and 18.0% (18/100) of the students published papers. The results of the discussion are mainly related to students' cognition of the significance of scientific research training, the importance of teachers and the supervision of teaching management departments. Conclusions Systematic scientific research training is conducive to the improvement of scientific research literacy and scientific research ability of senior undergraduates, and to the development of undergraduates' career; the evaluation system and incentive mechanism of students and instructors participating in scientific research training should be further improved. References | Related Articles | Metrics

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Application of case-based learning method in psychological health education Wang Yang, Cao Yu, Zhao Zhigang, Zhang Yan, Qiu Huimin, Liu Jintong 2020, 40 (6):  439-442.  DOI: 10.3760/cma.j.cn115259-20190730-00612 Abstract ( 73 )   PDF (795KB) ( 43 )   Objective To explore the teaching efficacy of case-based learning method in psychological health education. Methods From March 2015 to June 2018, a total of 413 students, from 17 specialities of Shandong University, were randomly divided into study group with case-based learning method and control group without case-based learning method for psychological health education. They were assessed by a self-designed questionnaire for teaching efficacy. Results There were statistically significant differences between the experimental group and the control group in the necessity of courses 55.3% (115/208) vs 39.5% (81/205), the understanding of mental health 60.1% (125/208) vs 38.5% (79/205), and the degree of application of knowledge 56.7% (118/208) vs 40% (82/205) (all P<0.05). Conclusions The case-based learning improves students' understanding and acceptance of mental health knowledge, and improves students' enthusiasm for learning mental health knowledge. References | Related Articles | Metrics

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Practice-oriented teaching approach to health law under the new health care reform Qian Yafang, Yin Kou, Hu Weiwei 2020, 40 (6):  443-446.  DOI: 10.3760/cma.j.cn115259-20190911-00746 Abstract ( 31 )   PDF (819KB) ( 18 )   Based on the current new health care reform which aims to guarantee our people full life-cycle health, this study generalizes legal qualifications required for medical workers in practice, explores and comes up with practice-oriented teaching approach to health law, which mainly falls into following three aspects: firstly, the medical staff should be cultivated to respect patients’ rights, involving their rights of life and health, rights of informed consent and rights of privacy; secondly, specialized teaching contents and units should be designed for different professional requirements; thirdly, medical workers should be cultivated to deal with their specific risks in practice. References | Related Articles | Metrics

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Application of plastination technique in orbital anatomy teaching Liu Shuyi, Li Yan, Chun Pu, Sui Hongjin, Lu Wei 2020, 40 (6):  447-450.  DOI: 10.3760/cma.j.cn115259-20191015-00857 Abstract ( 30 )   PDF (843KB) ( 24 )   Objective To evaluate the application of plastination technique in orbital anatomy teaching. Methods Totally 216 students in 2015 grade of five-year clinical medicine who received a orbital anatomy in ophthalmology course from September 2018 to October 2018 and 52 trainees who received standardized training from September 2016 to September 2018 were divided into experimental group and control group randomly. The experimental group adopted plastination specimen,and the control group adopted ordinary specimen. Two groups of students and trainees were assessed at the end of the course. A self-cognition questionnaire was used to investigate the evaluation of the course. Results The score of the students in the experimental group were (79.68±8.84),higher than those in the control group (62.28±12.64).The score of the trainees in the experimental group were (81.25±4.27), higher than those in the control group (71.50±7.07), and the differences were statistically significant(all P＜0.01).The course evaluation of the students in the experimental group were (89.19±5.60), higher than those in the control group (71.48±5.60).The course evaluation of the trainees in the experimental group were (94.82±2.95), higher than those in the control group (80.13±5.80), and the differences were statistically significant(all P＜0.01). Conclusions Compared with conventional specimens, plastination sheets can show the anatomy intuitively, which propel the development of orbital anatomy teaching. References | Related Articles | Metrics

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Application of home-made simulated device combined with flipped classroom in teaching of ultrasound-guided injection Chen Zhaocong, Cao Junyan, Huang Dongmei, Yu Yong, Qiu Weihong 2020, 40 (6):  451-454.  DOI: 10.3760/cma.j.cn115259-20190905-00715 Abstract ( 67 )   PDF (799KB) ( 45 )   Objective To evaluate the effectiveness ofhome-made simulated device combined with flipped classroom on the improvement of ultrasound-guided botulinum toxin injection learning. Methods Forty-one doctors as visitors studying in Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-sen University, were randomly divided into experimental group (n=22) and control group (n=19). The home-made simulated device combined with flipped classroom was used in the experimental group, while the traditional classroom teaching method was applied in the control group. The operation of ultrasound-guided and injection was assessed in both groups, and a questionnaire survey for the teaching method was carried out in the experimental group. Results The score of experimeantal group was higher than that of control group[(14.68±4.75) vs (10.32±5.19), t=2.811, P＜0.01]. The scores of the rationality of ultrasonic discrimination process [(2.41±1.18) vs (2.00±1.22)], the number of correctly identified muscles[(2.50±1.01) vs (1.79±1.13)], the time of examination [(2.41±1.14) vs (1.47±1.17)] and the proficiency[(2.41±1.05) vs (1.32±0.75)] of the experimental group were higher than those of the control group (all P<0.05). The questionnaire survey showed that more than 80% of the students believed that the teaching method ofhome-made simulated device combined with flipped classroom was beneficial for knowledge understanding, increasing learning enthusiasm, improving self-learning ability and operational skills, as well as increasing practical opportunities. Conclusions The simulated device combined with flipped classroom is superior in mastering the ultrasound-guided botulinum toxin injection. References | Related Articles | Metrics

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Effectiveness of the comprehensive experiment of biochemistry and molecular biology in clinical medicine Jiang Xiaogang, Yang Xudong, Yan Xiaofei, Han Yan 2020, 40 (6):  455-457.  DOI: 10.3760/cma.j.cn115259-20190919-00772 Abstract ( 46 )   PDF (780KB) ( 29 )   Objective To explore the effectiveness of comprehensive experimental teaching of biochemistry and molecular biology in clinical medicine specialty. Methods All 65 clinical medicine undergraduates in 2016 of Xi'an Jiaotong University Health Science Center were included in the teaching research. Carry out comprehensive experiments in biochemistry and molecular biology, assess students' course performance after class completion,and master students' experimental interest and teaching feedback. Results Students in this group scored (96.23±2.37), (95.01±1.83), (94.88±1.74) and (94.30±2.27) respectively in theoretical knowledge, experimental operation skills,experimental report analysis and comprehensive assessment. Through the questionnaire survey, students' interest in the experiment was 98.5%(64/65), and more than 90% of the students said that comprehensive experiment would help to develop their comprehensive ability. Conclusions Carrying out comprehensive experiments in the undergraduate teaching of biochemistry and molecular biology will help students better learn and master their experimental theory and operation skills, arouse their interest in experiments, and cultivate their comprehensive ability. References | Related Articles | Metrics

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Application of task-oriented flipped class in residency training during “Internet plus” era Yu Jiao, Liu Yayun, Yin Wei, Fan Wenhan, Xue Jianya, Liang Xuesong 2020, 40 (6):  458-462.  DOI: 10.3760/cma.j.cn115259-20190824-00682 Abstract ( 55 )   PDF (817KB) ( 45 )   Objective To explore the effect of task-oriented flipped class(TFC) in residency training during “Internet plus” era. Methods The experimental control method was used.In July 2019, a total of 74 residents who received standardized training in the department of infection of Changhai Hospital of the Naval Medical University were included. They were divided into TFC group and traditional class(TC) group. The scores of basic theory, clinical skills,daily performance and the results of questionnaire survey were used to evaluate the teaching effectiveness and satisfaction. Results The total score of TFC group was significantly higher than that of TC Group[(208.47±4.58) vs (202.05±5.18),(81.35±2.79) vs (79.57±3.47),(84.38±3.34) vs (80.77±3.50), (42.74±1.44) vs (41.71±1.61), all P<0.05].The results showed that the TFC group has the most significant improvement in self-learning ability, communication and expression ability and humanistic quality(0.671 vs 0.431,0.750 vs 0.472,0.566 vs 0.319).Conclusions “Internet plus” era task oriented flip classroom helps to improve the theoretical and practical teaching effect and students' comprehensive ability, and it is highly evaluated by students. References | Related Articles | Metrics

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Exploration and practice of improving the training effect of surgical residents' surgical skills based on teaching bed and teaching outpatient surgery Liu Jing, Zeng Qingqi, Gao Jie, Zhu Fengxue, Wang Siyuan, Guo Peng, Gao Pengji, Zhao Yan, Li Qing, Wang Jianliu 2020, 40 (6):  463-466.  DOI: 10.3760/cma.j.cn115259-20190329-00227 Abstract ( 116 )   PDF (796KB) ( 49 )   Objective To explore the effect of implementing teaching bed and teaching outpatient operation on surgical skill training of resident doctors who received standardized training in surgery. Methods From March to August in 2018, the doctors in 5 pilot departments of the department of surgery in Peking University People's Hospital (about 3 to 8 doctors per department in every month) were selected as the research objects.Teaching beds and teaching outpatient operations were established in 5 pilot departments,and a series of measures were taken to ensure their implementation.Monthly statistics of the number of residents as surgeons were compared with the survey data before the implementation from December 2017 to January 2018. The teaching secretary and resident of the pilot department were interviewed after that. Results Residents in five pilot departments completed 45.3 operations per month on average, which was significantly higher than the 10.7 operations before the implementation of the pilot. The interviews showed that teaching bed and teaching outpatient surgery could increase the opportunities for residents to participate in the operation, but there were many difficulties in the implementation of the project in terms of residents, departments, teachers and management. Conclusions The reform based on teaching bed and teaching outpatient surgery has a positive effect on improving the surgical training for residents in surgery. However, this model of training need more research to overcome barriers in feasibility. References | Related Articles | Metrics

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Application and assessment of objective structured clinical examination in evaluation of standardized training for stomatological residents Zhu Feng, Wu Li, Yang Jie, Xie Sijing, Sun Weibin, Nie Rongrong 2020, 40 (6):  467-470.  DOI: 10.3760/cma.j.cn115259-20190603-00432 Abstract ( 61 )   PDF (839KB) ( 61 )   Objective To evaluate the effectiveness and reliability of objective structured clinical examination program in standardized training of residents in stomatological department of Jiangsu province, and to provide a reference for the further development of standardized and scientific examination program. Methods The data analysis method was used. The objective structured clinical examination results of 94 resident physicians in Jiangsu Province in 2017 were selected as the research objects to conduct statistical analysis and comprehensive evaluation on the reliability, difficulty and differentiation of the objective structured clinical examination program as well as its results. Results The objective structured clinical examination program consists of 3 parts and 8 stations. The median score of this examination subject is 260.95 (256.21, 263.67), and the passing rate is 90.4% (85/94).The Cronbach coefficient was 0.700, the difficulty coefficient was 0.81~0.91, and the discrimination was 0.125~0.540. Conclusions It is effective, reliable and appropriate to carry out objective structural clinical assessment program in the evaluation of residents in stomatological department of Jiangsu province in the planning and training stage. References | Related Articles | Metrics

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Exploration on building up standardized fellowship training system Yang Ying, Zheng Liyun, Wang Ruoning, Li Ye, Wang Xiang, Cui Shuang, Jiang Hui, Duan Liping 2020, 40 (6):  471-475.  DOI: 10.3760/cma.j.cn115259-20200121-00090 Abstract ( 75 )   PDF (807KB) ( 69 )   It is a necessary way for fostering independent specialist through standardized fellowship training. To pursue the goal of building up a nationwide reproducible and replicable standardized fellowship training system align with international standards, a pilot standardized fellowship training project has been launched in Peking University Health Science Center since 2014.The implement details were elaborated in this article, including defining mission and goals of fellowship training, improving specialty organization, optimizing evaluation and assessment, adjusting and linking up policies. The project has been progressing smoothly under the guiding strategy of “first try, seeking progress in stability, step by step” and following needs based, competency based, top level design principle to make promotion and academic degree collaboration policies, in the same management system with residency training programs. Totally 48 specialties have been covered with standardized curriculum, assessment criteria, program schedule, and the capacity formula. Four examinations were integrated into one. Standardized fellowship training system has been built up. References | Related Articles | Metrics

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Physiotherapists registration system as well as the education in five developed countries and their enlightenment to China Gan Yumeng, Yang Lin 2020, 40 (6):  476-480.  DOI: 10.3760/cma.j.cn115259-20191114-00988 Abstract ( 55 )   PDF (860KB) ( 34 )   After retrieving some databases and the websites of registration institutes of physiotherapists in different areasincluding United States of America, Australia, United kingdom, Canada and New Zealand, the different qualifications, requirements of examination, and standards of continuing competency development were investigated and summarized, which may give some implications for the establishment of Chinese physiotherapists registration system and contributes to the educative reformation of physiotherapy in China. References | Related Articles | Metrics