Swedish society advocates fairness and equality, and the gap between the rich and the poor is small. Even in the coldest and most remote mountain village in northern Sweden, the qualification requirements of doctors are the same as those in the capital cities, and there is no difference between doctors who have been barefoot for three years, five years, seven years, eight years and China.
In recent years, the Bologna process in Europe has assimilated the medical education of European countries and unified the six-year medical education in Europe. After six years of undergraduate enrollment, I graduated with a master's degree in medicine and a medical license. Sweden, on the other hand, is unique in Europe. It is believed that students who come out of school directly in six years lack clinical practice experience and are not qualified for the work of clinicians after obtaining medical licenses. Therefore, Sweden insists on its traditional medical education of 5.5+ 1.5 years, that is, after five and a half years, it will get a master's degree in medicine, and then after 1.5 to two years of department rotation practice (at), and finally get a medical license through the license examination (AT-prov).
During the period of medical education, Swedish students will contact patients very early, and many students will contact patients for the first time before completing biochemical anatomy in the first year. Although I didn't know much about medical knowledge at that time, the exercises were recorded, and then a group of students and teachers would discuss students' empathy from tone, body language to attitude to dialogue. After setting up clinical courses, the school will also organize group case discussions between clinical medical students and clinical professional students such as nursing students, physiotherapy students, psychological medical students, nutritionists, etc., to understand how different professions cooperate and provide patients with the best all-round medical services. In order to ensure that every student can get in touch with patients, Karolinska Hospital with 1600 beds only accepts 150 freshmen each semester.
Rotation (AT) has a strict outline, which must include internal medicine, surgery, psychiatry and general practice. Not only that, many Swedish medical students will work as temporary doctors' assistants for 65,438+0 years after obtaining the master's degree in medicine, to find their own interests and accumulate letters of recommendation for finding internship (at) positions. Because you have to apply for the internship yourself, and the recommendation letter from a good clinical teacher is very important in the application. Therefore, it usually takes at least 8 years for Swedish doctors to get a doctor's license. If a doctor in China has a medical license in China but doesn't get the position of attending physician, and wants to take the Swedish medical license, he generally needs to pass the Swedish language test, the medical theory test and the same rotation (AT) as Swedish medical students to get the Swedish medical license.
After getting a doctor's license, it is the residency training period, which is about five years in Sweden. After the training, you can become an attending physician. In the training of residents, each subject has a strict outline, and there are strict rules on how many courses to complete, how many projects to do and what diseases to deal with. Surgeons, in particular, have rules on what operations to perform, how many times to perform, and what points to master. Some students choose to study for a doctorate during their internship. If you add four years of doctoral time, the hospitalization period can be as long as nine years. Some people choose to study for a four-year doctoral degree before obtaining a medical license and conduct postdoctoral research during their residency. On average, there are at least 1 doctor for every five doctors in Sweden, and the proportion is higher in big cities.
Another feature of Swedish medical education is the emphasis on general practitioners. The World Health Organization (WHO) believes that developing and strengthening primary health care and establishing a general practitioner system are very important to the health of the whole people, especially in the current situation of aging population and the increase in the number of chronic diseases due to the development of medical science. General practitioners in China have been calling for many years, but the recognition of the masses is not high, and the establishment of the system is faltering. General practitioners in Sweden, like other specialties, have to undergo five years of residency training, of which a lot of time is spent in large hospitals for further study. The United States and other European countries only need three years of training (no rotation) to become general practitioners after graduation. Therefore, general practitioners in Sweden are highly respected, and their salaries are often higher than those of doctors in big hospitals. And because general practitioners don't need to work night shifts and have the opportunity to open their own private clinics, this direction is also quite popular. About a quarter of the country's attending physicians are qualified as general practitioners.
Although the density of doctors in Sweden is high and doctors have undergone strict clinical training, there are still problems such as difficulty in seeing a doctor and long queue time. This problem is largely caused by Sweden's strict medical management and standardized diagnosis and treatment. Everything a doctor does needs to be recorded, and the responsibilities of each department are clearly defined. Although this can greatly reduce the occurrence of medical accidents and ensure the fairness of medical treatment, that is, treat patients according to the priority of their illness, in turn, doctors need to spend a lot of time sitting in front of computers and telephones to write medical records or communicate with doctors and nurses in other departments or fill out various forms of social security bureaus, which greatly reduces medical efficiency.