Medicine Is a Humane Profession That Demands Broad Learning

The authoritative textbook used in Western medical schools, Harrison's Principles of Internal Medicine, 19th edition, contains the following definition: "Medicine is a humane profession that demands broad learning."

This definition highly encapsulates the character of medicine. Western medical schools hold that physicians must possess not only natural-science knowledge centered on biomedicine, but also profound, multifaceted knowledge of the social sciences and humanities. This is why the American medical education system requires an undergraduate degree before entering medical school, which better fits the requirements for training medical talent.

China does not currently have such conditions. The "5+3" model being carried out in Chinese medical schools is somewhat along these lines. However, in terms of both faculty and facilities, Chinese medical schools are not yet in a position to train such ideal medical talent.

At present, people with higher education in China account for only about 6% of the total population (those with a bachelor's degree account for only 4%), and the proportion of medical talent is even smaller. It is already good enough for citizens to receive a basic undergraduate education; if we were to train medical talent to the standards of Western medical schools, we would need to invest far more human and material resources in the healthcare sector. In reality, China's investment in healthcare is insufficient.

Therefore, the medical talent China trains has not yet reached the ideal level, and does not embody the character of "a humane profession that demands broad learning."

As early as more than a thousand years ago, China's renowned physician Sun Simiao, honored as the King of Medicine, set forth high requirements for physicians' scholarly level in his essay "On the Training of a Great Physician."

Sun Simiao stated: "Anyone who wishes to become a great physician must be thoroughly familiar with the Suwen, the Jia Yi, the Huangdi Zhenjing, the Mingliu and Liuzhu points, the twelve meridians, the three regions and nine indicators of pulse diagnosis, the five zang and six fu organs, the exterior-interiore acupuncture points, the Materia Medica and paired herb combinations, and the classical prescriptions of Zhang Zhongjing, Wang Shuhe, Ruan Henan, Fan Dongyang, Zhang Miao, Jin Shao and others. They must also skillfully understand yin-yang and destiny calculations, the various methods of physiognomy, turtle-shell divination and the Six Ren methods of the Book of Changes, and master them all. Only then can one become a great physician. If not, it is like walking at night without eyes, constantly risking stumbling and falling. One must then read these formulas thoroughly, ponder their subtle principles, and apply oneself diligently before one can speak of the Way of medicine. One must also read widely — why? If one does not read the Five Classics, one will not know the way of benevolence and righteousness. If one does not read the Three Histories, one will not know the events of past and present. If one does not read the philosophers, one will not be able to comprehend matters silently. If one does not read the Neiye, one will not know the virtues of compassion, joy, and generosity. If one does not read the works of Zhuangzi and Laozi, one cannot embrace true nature and comprehend the workings of life, and all manner of taboos and anxieties will arise at every step. As for the waxing and waning of the five phases and the astronomy of the seven luminaries, these too must be explored in depth. If one can study all of these, then there will be no obstacles on the Way of medicine, and one will achieve perfection."

By Sun Simiao's standards, physicians of that era not only had to thoroughly read the classical TCM texts, but also master Confucianism, Buddhism, Daoism, and even divination and shamanic arts. Sun Simiao himself was well versed in Confucianism, Buddhism, and Daoism; his Qianjin Fang records a great deal of Daoist zhuyou (incantation) techniques — of course, these things now show strong limitations of their time and are not scientific.

Medicine is not purely a natural science; it is an integrated discipline that requires dealing with patients. Merely mastering natural-science knowledge related to life is far from sufficient; one also needs a solid foundation in the humanities and social sciences.

In the diagnostic and treatment process, physicians need to communicate with patients. The high incidence of doctor-patient disputes in China today is related not only to strained medical resources — most physicians' workloads far exceed their capacity — but also to the general lack of humanistic and social-science literacy among Chinese physicians, and to their lack of communication skills with patients.

In any era and any society, physicians should be among the most erudite people. In the past, physicians were even regarded as "elders" — people of broad learning and high moral standing, which set a very high bar. The famous Qing-dynasty physician Ye Tianshu was not only skilled in medicine but, because of his erudition and fairness, became a respected local notable; people even went to him to mediate interpersonal disputes.

For physicians, "learning until old age" is no empty phrase. Some physicians say that after three months without study, they dare not see patients. My own feeling is that if I go a single day without reading, I become anxious and uneasy, deeply afraid of making clinical errors. The famous Qing-dynasty physician Xu Lingtai said that if he woke up in the middle of the night and realized his handling of a patient might have been improper, he would immediately get out of bed and light his lamp to study.

Studying medicine is therefore a hard road; only those who truly love medicine will willingly find joy in this hardship, constantly summarizing experience, learning new knowledge, and improving themselves.