Don't Rush, Needn't Rush, Mustn't Rush

As a folk TCM doctor, I have long wanted to become a fully licensed TCM physician. To realize that dream I have already waited ten years and paid a heavy price. But as of now, this dream is still not fully realized. After the pandemic broke out, I felt deeply sorry for the long-standing patients who trusted me—they had placed their hope of life in me, yet under the strict laws I could no longer provide them with the regular follow-up care I once did, because if I were to trigger an outbreak because of my practice, I would land in prison.

Most of them had already seen many doctors before finding me. Some had been treated by several top specialists in the field without much benefit; through a kind of karmic affinity they got a little better with me—not because my skill surpassed those experts, but simply because medicine is inherently uncertain. I believe that many of the patients I failed to help might have done well under those specialists. I am glad to have prolonged their lives, but now I feel deeply guilty for no longer looking after them as I used to.

In 2012, I completed the traditional-apprenticeship (xuancheng) registration required by the National Health Commission. Unfortunately, the TCM Administration of my province, XX, has been derelict in its duty, refusing for years to schedule the examinations for us TCM apprentices, leaving our formal certification indefinitely out of reach. Finally, a TCM-specialty physician exam was held—this exam had already been delayed for three years—giving us non-graduate TCM practitioners a chance at a watered-down specialty license, but the organization of the exam was quite poor.

As a candidate, I can only describe my experience of sitting that exam as stunned. Compared with other provinces, there was far too much in our XX province's exam that needed improvement. the herbs and formulas tested were improvised on the spot by the examiners, making it impossible to tailor the questions to each candidate. I clearly sensed that some of the formulas and herbs I use routinely were unknown to my examiners, while the questions they asked had little to do with my specialty. During the on-site oral examination they were virtually making professional fools of themselves. They were entitled to correct my mistakes, and I was not entitled to correct theirs, because our relative positions determined that. I believe that if our roles were reversed—if I were the examiner and they the candidates—I could fluster them until they sweated and squirmed with embarrassment.

In other provinces, candidates for the herb exam submit a list of the herbs they commonly use, and the examiners pick a few from it to test them. Our XX province has no such procedure—even though the red-headed document of the provincial Health Commission also requires it. Instead, the examiners would suddenly produce five herbs for us to identify, regardless of whether the candidate used those herbs or whether they were relevant to their specialty. All that mattered to them was getting the exam over with and showing the state that they had complied.

The whole exam can only be described as a complete mismatch. After studying the equivalent examination procedures in Beijing, I realized that the exam our XX province organized was almost a farce. The national policy of selecting TCM apprentices and specialty talents is good, and I strongly support it. Precisely because the state has this policy, I trusted the government and chose the apprenticeship path; but the way it is implemented varies wildly from place to place. Beijing holds the apprenticeship graduation exam every year on schedule; our XX province has not held one in five years. Beijing's specialty-physician exam rules are extremely detailed and available on the Beijing TCM Administration's official website, so both candidates and examiners have a clear basis to follow; our province's exam was nowhere near that standardized.

The sloppiness of this exam was not really the examiners' fault; they too tried hard to select talents fairly and impartially. It was just that the province organized such a directionless exam that the examiners were at a loss. After all, examiners are not omnipotent and cannot master the specialized knowledge of every candidate, and which examiner tested which candidate was drawn at random on the day of the exam. One can only say that the level at which our XX Provincial TCM Administration organized the exam was far too low.

We can still only be called "TCM practitioners" or "TCM (specialty) physicians." How long the road to a regular TCM physician license will be, no one knows. For years I held my tongue for fear that the Provincial TCM Administration would retaliate by setting obstacles for me in the exam. Now I realize that the guilty party is not me, but those derelict officials who neglected their duty. I very much hope the relevant national departments will pay attention to the fate of us TCM apprentices whose status is "unclear." In reality, too many TCM apprentices like me have been treated unjustly. We dare not break the law, yet the law enforcers dare to neglect their duty and deprive us of our legitimate right to take the exams.

Back in 2012, when I chose the TCM apprenticeship path, my wife strongly urged me to retake the college entrance exam and enter a TCM university, getting a formal academic training rather than going the apprenticeship route. Practice has proved her right. She works within the system and understands its sluggish ways far better than I do.

In 2021, ten years after I registered my apprenticeship, I picked up my high school textbooks again, preparing to retake the college entrance exam and enter a TCM university, ready to spend another ten years or so obtaining a formal TCM physician license. The previous ten years had been, more or less, wasted.

Those ten years bought me one lesson: more haste, less speed. I had hoped for a shortcut, only to find that in reality this road had been sealed off. For the past decade I had been suppressing myself, hoping only to avoid trouble, swallow my grievances, and get certified as soon as possible.

Now I realize that was wrong. I should speak out. Even if I cannot change reality, I can at least let people who want to take the TCM apprenticeship path realize that it is a bottomless trap. If you insist on taking this path, choose the right province; do not register your apprenticeship in backward provinces. I only learned this year that the apprenticeship imposes no household-registration (hukou) restriction: apprentices from any province may register their apprenticeship in another province and take the exam locally.

I have now decided to abandon the apprenticeship path, so I want to get this off my chest. I am very grateful to the people who helped me over the years on this road—my teachers, my shifu, my relatives, and many older friends I newly met. Most of all I thank my patients, who did not spurn me just because I was only a TCM apprentice. I also thank the state for its lenient policy, which allows us TCM clinical practitioners to take part in clinical work under a teacher's guidance, giving us a way out and institutional safeguards for safely learning medicine and sitting the exams.

Ten years ago I was rather impatient; now I am no longer. Now I realize that in everything one should not rush, need not rush, and must not rush. But when I was thirty I inevitably longed for quick success. Returning to Beijing this year, a friend at the China Journal of Traditional Chinese Medicine, having learned of my rough apprenticeship road, gave me enormous help, familiarized me with Beijing's TCM apprenticeship rules, and smoothed the way in many respects. But after weighing again the pros and cons of the apprenticeship versus the formal academic route, I decided not to take the apprenticeship path—not even in the well-regulated capital. Because ten years on, the apprenticeship policy has also changed, and the effort needed for the apprenticeship is now about the same as retaking the college entrance exam.

I am very grateful to the friends in TCM circles I have known over the years for lending a hand during the difficult times after the pandemic. After the outbreak, some TCM-doctor friends, knowing my apprenticeship road was not yet finished, used their own prescribing authority to help me out, enabling me to continue caring for my patients, extending their lives, and helping me avoid legal risk.

I am especially grateful to many patients who made considerate concessions to reduce my legal exposure. Although I had long noted in my personal profile that I am only a TCM apprentice, I still feel it necessary to explain my current situation further, in the hope of everyone's understanding. Because if my patients do not understand, they may think that my no longer meeting them face to face is an unfeeling thing to do.

I will keep working hard to become a formal TCM physician as soon as possible, escape this awkward gray zone, and help more patients who trust me. At the same time, I hope everyone will understand my difficulties. I have always dealt openly with everyone, because I believe that only things exposed to light avoid mold, and that only individuals and organizations kept in the sunshine can grow healthily.

I still have great hope for the future. I hope you do too.