Notice of Zhejiang Hospital on Issuing the Relevant System of Standardized Training for Specialists

Notice of Zhejiang Hospital on Issuing the Relevant System of Standardized Training for Specialists

Notice of Zhejiang Hospital on Establishing the Leading Group of Standardized Specialist Training Base

To all departments:

To further strengthen the establishment of standardized training base for national specialists in our Hospital, improve the training quality and ensure the training effectiveness, the Notice of Zhejiang Hospital on Establishing the Leading Group of Standardized Training Base for National Specialists is formulated in combination with the actual situation of our Hospital. The list of leading group members, office members and members of specialty bases is hereby announced as follows:

I. Leading Group of National Standardized Specialist Training Base

Leader: Yan Jing

Deputy leader: Jin Xiaoqing

Members: Cai Guolong, Chen Xinyu, Shen Jiong and Yu Ping

Office Director: Cai Guolong

Deputy Director: Chen Ruian

Member: Jiang Chenyao

II. Specialty Bases for Standardized Specialist Training

Internal Medicine Critical Care Medicine

Base Director: Yan Jing

Teaching Director: Gong Shijin

Base Secretary: Hu Weihang

Internal Medicine Geriatric Medicine

Base Director: Yan Jing

Teaching Director: Chen Xujiao

Base Secretary: Xu Liyu

Surgical Critical Care Medicine

Base Director: Yan Jing

Teaching Director: Gong Shijin

Base Secretary: Hu Weihang

Administrative Rules for Standardized Training for Specialists of Zhejiang Hospital

To all departments:

To standardize the standardized training for specialists, the Administrative Rules for Standardized Training for Specialists of Zhejiang Hospital are formulated according to the relevant provisions of the Guiding Opinions on the Pilot Project of Standardized Training System for Specialists (GWKJF [2015] No. 97).

I. The specialty bases shall be responsible for the establishment, management, assessment and evaluation of specialty bases, and for the clinical training and assessment of specialists. The Science and Education Department shall provide the necessary safeguard measures and training resources for specialty bases, and assist the specialty bases to carry out the relevant training for recruited trainees and the establishment, management, assessment and evaluation of specialty bases. The Human Resources Department shall be responsible for signing the training contract and guaranteeing the treatment for socialized specialists.

II. Qualifications for access of specialists. The trainees may voluntarily apply to participate in specialist training. The trainees are mainly the in-service personnel from the unit or the appointed unit who have received standardized training for specialists and obtained the qualification certificates, and doctors who have not experienced standardized training for specialists but have intermediate or above medical specialty technical qualifications and voluntarily participate in standardized training for specialists.

III. The specialist training base shall implement the base director responsibility system, and shall be responsible for the recruitment of specialists and undertake training tasks. The person in charge of the specialty base shall make overall plans for standardized training. The base sets up a teaching director and a teaching secretary, establishes a teaching group and concretely implements the standardized specialist training related teaching work such as training plans, entrance education, training assessment and regular evaluation to ensure the training quality.

IV. The specialists must abide by the rules and regulations of the hospitals, take good care of public property and equipment, and strictly abide by the leave system. Attention shall be paid to fire safety, medical safety, laboratory, hazardous chemical safety, network safety, etc.

V. The specialists need to participate in various training activities organized by the Hospital during their stay in the Hospital, including pre-job training, quality continuing training, entrance training and CPR training.

VI. According to the training requirements for specialties, the training period is generally two to four years of specialist training. The training is mainly to improve the clinical practice ability of specialists. The Science and Education Department shall implement supervision and inspection of the training rotation plan for specialists every year.

VII. The training assessment of specialists includes process assessment and completion assessment. The specialist training base shall organize the implementation of process assessment. The completion assessment is uniformly required and deployed by the Chinese Medical Doctor Association and organized and implemented by the provincial health administrative department. For those who have completed the training as required and passed the completion assessment, the Chinese Medical Doctor Association will issue the unified Qualification Certificate for Standardized Specialist Training.

VIII. If the training task is not completed as required within the specified period, the training period can be extended for up to two years. Those who fail to pass the assessment may apply for a make-up examination, and the number of taking the make-up examination is limited to two. The specialist training focuses on clinical practice ability training, and also includes rotation training from relevant departments and relevant clinical scientific research and teaching training. The specialists may participate in outpatient emergency treatment independently. Except for statutory festivals and holidays and public holidays, the training period will be extended for those who have maternity leave, breastfeeding leave and sick leave during the training period. During the training period, the specialists shall ask for leave in accordance with the relevant management regulations of the Human Resources Department.

IX. When rotating out of the department, the teachers need to supervise the full-circle appraisal for specialists.

X. The specialists need to change their practice places to their training base in accordance with the relevant regulations. After the training, the scope and place of practice shall be changed accordingly based on the work unit.

XI. Adverse events and emergencies that occur or are found for specialists in the Hospital shall be handled in accordance with the relevant management regulations of the Hospital.

Implementation Rules for Standardized Training for Specialists of Zhejiang Hospital

The standardized training for specialists is to train high-quality clinical specialists with good professional ethics, solid medical theoretical knowledge and clinical skills, meticulous clinical thinking and the ability to independently and standardly undertake the diagnosis and treatment of common and frequent diseases and difficult and severe diseases in the specialty for medical and health institutions based on the standardized training for specialists.

It is mainly reflected in the following four aspects:

(I) Professional quality

Loving the motherland, loving the medical cause, and consciously abiding by various health laws, regulations and rules. Having a good humanistic quality, promoting the professional spirit of respecting life, healing the wounded and rescuing the dying, being ready to sacrifice and having boundless love, and adhering to the patient-centered concept. Being sincere and trustworthy, honest and fair, diligent and prudent, and providing patients with high-quality medical and health services.

(II) Specialty diagnosis and treatment ability

Mastering the theoretical knowledge of clinical medicine and the key points of clinical diagnosis and treatment of the specialty and related specialties, having the concept of disease prevention and the scientific clinical thinking ability, being able to make reasonable medical decisions and standardize the clinical technical operations of the specialty, and being able to solve the diagnosis and treatment problems of common and frequent diseases and difficult and severe diseases in the specialty.

(III) Communication and cooperation ability

Having good interpersonal communication skills, being able to communicate effectively with patients and their families, and making appropriate diagnosis and treatment schemes. Being able to unite and cooperate with other medical personnel, coordinating and utilizing various health resources, and providing reasonable medical care services for patients.

(IV) Teaching and scientific research ability

Pursuing excellence, having the ability of self-directed learning and continuous improvement, being competent to guide the clinical teaching work of subordinate doctors, mastering the basic theory and methods of clinical research, and being able to undertake clinical research.

II. Training content

The standardized training for specialists takes cultivating job competence as the core, and is implemented in accordance with these rules and the corresponding specialist training rules. The training content includes medical ethics, policies and regulations, interpersonal communication skills, professional theoretical knowledge and clinical practice ability. The training focuses on improving the ability of clinical standardized diagnosis and treatment and gives attention to the cultivation of clinical teaching and scientific research ability.

(I) Theoretical study

1. Public theory. It includes medical ethics, policies and regulations and relevant knowledge of humanities and social sciences, and focuses on learning relevant health laws, regulations, rules and standards, medical ethics, medical psychology, doctor-patient communication, prevention and control of key and regional infectious diseases, prevention and control of public health emergencies and emergency medical rescue for emergencies, preventive medicine, evidence-based medicine, and clinical teaching and clinical scientific research knowledge.

2. Professional theory. It includes the theoretical knowledge of clinical medicine of the specialty and related specialties, so that the specialists can thoroughly master it and correctly apply it to clinical diagnosis and treatment practice.

(II) Clinical practice

Under the guidance of superior doctors, the specialists shall learn the etiology, pathogenesis, clinical manifestations, diagnosis and differential diagnosis, treatment methods and clinical pathways of common and frequent diseases and difficult and severe diseases of the specialty and related specialties in clinical practice; guide subordinate doctors to formulate specialty diagnosis and treatment schemes, undertake consultation and chief specialist work, and meet the requirements of the corresponding specialist training rules in the Contents and Standards of Standardized Training for Specialists (Trial).

III. Training methods

(I) Training period

The training period of each specialty is set based on the talent growth law and training objectives of the specialty. The training period is generally two to four years. According to the actual situation, the training period of some specialists can be one year. For those who fail to complete the training tasks as required within the specified period or fail to pass the assessment, the training period can be extended appropriately after an individual application is submitted and the consent of the standardized specialist training base is obtained (for the trainees appointed by the unit, the consent of the appointing unit is required), and the extended period shall not exceed two years in principle. During the extended period, no financial subsidies will be enjoyed, and training-related expenses will be borne by individuals.

(II) Training methods

The theoretical study is mainly the planned self-study, supplemented by the face-to-face teaching, distance teaching and academic lectures. The training of clinical practice ability is mainly carried out in the way of rotation of clinical posts in the department and related departments. The trainees complete the training tasks by participating in clinical diagnosis and treatment practice, as well as clinical teaching practice activities organized by the base such as simulation training, special skills operation training and teaching rounds. The training of scientific research ability is mainly to learn the relevant scientific research theoretical knowledge and skills, participate in research projects, and cultivate the clinical research thinking and thesis writing ability under the overall arrangement of the specialty base.

IV. Others

(I) The corresponding standardized specialist training rules shall be formulated for each specialty according to these Rules and the implementation shall be organized carefully. The experience shall be continuously summarized in practice, and the specific training and management arrangements shall be optimized.

(II) According to the disease spectrum in the region, each specialty base can adjust the specialist training content appropriately, and in principle, it shall not be lower than the basic requirements of the corresponding standardized specialist training rules.

Measures for the Administration of Standardized Training Teachers for Specialists of Zhejiang Hospital

I. General provisions

(I) To implement the spirit of relevant documents such as Guiding Opinions on the Pilot Project of Standardized Training System for Specialists (GWKJF [2015] No. 97) and Implementation Plan for Pilot Project of Standardized Training System for Specialists (Trial) (revised in November 2017), these Measures are formulated to further strengthen the establishment of standardized specialist training (hereinafter referred to as “specialist training”) bases, build a qualified and high-quality teacher team, establish a management and training mechanism for specialist training teachers, and realize the unified employment with certificates of specialist training teachers.

(II) The specialist training teachers as mentioned in these Measures refer to clinicians who are responsible for teaching medical ethics, policies and regulations, clinical practice ability, professional theoretical knowledge and interpersonal communication skills for specialists who are rotated to the department.

(III) These Measures are applicable to all teachers who participate in specialist training.

II. Basic conditions

(I) The specialist training teachers shall have the following basic conditions.

1. Having good professional ethics, observing disciplines and obeying laws, being rigorous in scholarship research, leading by example, being a model for others, and being enthusiastic about the training and teaching of medical professionals.

2. Having a master’s degree or above, obtaining a deputy senior technical title and above specialty technical positions, and having been engaged in medical work of the specialty for more than 10 years.

3. Mastering the theoretical knowledge of the specialty and the diagnosis and treatment rules of common and frequent diseases and difficult diseases, and being able to solve complex medical problems.

4. Mastering the relevant systems and policies of standardized training for specialists and the training contents and rules of the specialty, having strong teaching awareness and teaching ability, and being familiar with the use of teaching methods.

5. Having other conditions stipulated by the specialist training base.

6. Having received the teacher training and obtained the Certificate of Standardized Training Teachers for Specialists.

(II) The specialist training teachers shall perform the following duties.

1. Supervise and educate specialists to abide by medical laws and regulations, and strictly implement the rules and regulations of specialty bases. 

2. Train the specialists to have six core abilities (clinical thinking, disease diagnosis and treatment, skills operation, humanistic communication, teamwork and learning and growth).

3. Carry out clinical teaching work according to the requirements of the Contents and Rules of Standardized Training for Specialists (Trial), and guide specialists to complete the training tasks.

4. Make an objective evaluation of specialists, complete the departmental rotation examination of specialists according to the arrangements of the department, review the training and assessment records of specialists in a timely manner, and correct the problems found in a timely manner; report major problems to the department and the competent department of the training base (the Hospital).

5. Regularly participate in teacher training activities, and continuously improve the teaching ability.

6. Have certain teaching and research ability.

7. In addition to the above conditions, the teaching director shall also have the corresponding teaching management ability. The teaching director shall be responsible for organizing and coordinating relevant departments to implement the training plans, coordinating the implementation of department-entrance education, departmental rotation examination and regular evaluation, and managing the whole training process.

8. The teaching secretary shall assist the teaching director to organize and implement the daily teaching management and supervise the completion of teaching tasks.

III. Registration

(I) It is necessary to establish a mechanism that is coordinated by the state, led by the industry, managed by specialty committees at different levels, and uses the appointment of specialist training teachers after training.

(II) The Chinese Medical Doctor Association shall be responsible for the overall planning of the building of specialist training teacher team, and for formulating relevant management measures.

(III) According to the requirements of the Administrative Measures for the Building of Specialist Training Teacher Team (Trial), the specialty committee shall formulate the training plan for specialist training teachers, conduct regular training, select the teacher training demonstration base, and report it to the Chinese Medical Doctor Association for the record.

(IV) The training base (the Hospital) shall be responsible for conducting the informatization management and evaluation of the unit’s specialist training teachers, establishing the incentive and withdrawal mechanism of teachers, and fully mobilizing the enthusiasm of teachers.

(V) The specialist training teachers shall register and complete their personal information through the “Management Platform for Standardized Training for Specialists”, and participate in the training and assessment. 

(VI) The Certificate of Standardized Training Teachers for Specialists shall be used as the basis for the appointment of specialist training teachers.

IV. Training requirements

(I) The training of specialist training teachers shall focus on strengthening teaching awareness, mastering teaching skills and improving guidance and teaching management ability. The training contents mainly include the following aspects:

1. Establishment and management of specialty base

(1) Interpretation of specialist training systems and policies.

(2) Interpretation of rules for the accreditation of specialty bases, training contents and rules.

(3) Management of training process of specialty base, including rules and regulations, department-entrance education, training plans, rotation plans, arrangements of teaching activities (teaching rounds, small-scale lectures, discussion of difficult and complicated cases, skills operations, etc.), and organization and implementation of departmental rotation examination and assessment.

2. Clinical guidance and teaching methods

(1) Medical humanistic quality education, including medical ethics and doctor-patient communication.

(2) Medical document writing standards, including medical record writing, initial treatment record, consultation record, discharge summary and diagnosis report. 

(3) Training of clinical thinking, teaching rounds, small-scale lectures, skills operation and teaching standards.

(4) Application of clinical teaching and teaching effect evaluation.

(5) Departmental rotation examination and assessment, including theoretical examination, comprehensive ability and skills operation assessment.

(II) The training of specialist training teachers is divided into two forms: centralized and short-term further education and training.

V. Incentive and withdrawal

(I) All kinds of specialist training teacher evaluation activities shall be encouraged.

(II) The training bases shall improve the teacher teaching incentive mechanism. The teaching work shall be regarded as an important part of the performance assessment of personnel in the unit, and priority shall be given to the evaluation and reward, promotion of professional titles and post appointment. The teaching time of teachers shall be guaranteed, and teaching subsidies shall be given to teachers who undertake teaching tasks.

(III) The training base shall implement a regular evaluation mechanism for teachers to comprehensively evaluate the medical ethics, teaching attitude, teaching content, teaching methods, teaching effect, teaching workload and honesty of specialist training teachers. The information about teachers who fail to pass the evaluation or quit for other reasons shall be reported to the specialty committee in a timely manner, and shall be put on record through the “Management Platform for Standardized Training for Specialists” of the Chinese Medical Doctor Association.

(IV) The Chinese Medical Doctor Association shall circulate a notice of criticism, suspend recruitment and order to make rectification within a prescribed time limit for training bases that fail to comply with these Measures. For training bases who fail to rectify or fail to meet the requirements after rectification, the qualification of specialty bases shall be cancelled.

(V) The withdrawal mechanism shall be implemented for teacher management. In case of any of the following circumstances, the employment relationship between the training base and the teachers shall be terminated, and it shall be put on record through the “Management Platform for Standardized Training for Specialists” of the Chinese Medical Doctor Association.

1. The teachers are no longer engaged in the corresponding specialty teaching work due to job changes.

2. The teachers are investigated for criminal responsibility according to the law.

3. The teachers are punished for major medical accidents in their work.

4. The teachers themselves ask for dismissal.

VI. Supplementary Provisions

(I) These Measures shall come into force from the date of promulgation.

(II) These Measures shall be interpreted by the Specialty Office of Department of Postgraduate Medical Education of Chinese Medical Doctor Association.

Measures for the Administration of Assessment of Standardized Training for Specialists of Zhejiang Hospital

To all departments:

The assessment of standardized training for specialists shall be strictly implemented in accordance with the requirements of the Implementation Plan for Pilot Project of Standardized Training System for Specialists (Trial). The training assessment includes process assessment and completion assessment. Each specialty base shall formulate the process assessment criteria and organize the implementation of process assessment according to the requirements of the Contents and Rules of Standardized Training for Specialists (Trial). The completion assessment is uniformly required and deployed by the Chinese Medical Doctor Association and organized and implemented by the provincial health administrative department, and each specialty committee is responsible for examination questions and examination affairs. For those who have completed the training as required and passed the completion assessment, the Chinese Medical Doctor Association will issue the unified Qualification Certificate for Standardized Specialist Training.

I. Process assessment

(I) Daily assessment

1. A strict attendance and leave system is implemented. The teaching secretary of each department shall perform attendance duties. The Science and Education Department shall randomly check the attendance situation. Those who are absent from work without asking for leave shall be deemed as absenteeism. If the absence period exceeds ten days in the current year, the training period shall be extended by one year. A paper leave application form is required for asking for leave. For leave of less than two days, the applicant shall fill in the leave application form in duplicate, and obtain signature and approval of the director of the rotating department. For leave of more than two days (including two days), the applicant shall fill in the leave application form in duplicate. After being signed by the teacher and the department director and affixed with seal by the Science and Education Department, one copy shall be kept by the Science and Education Department, and the other one shall be submitted to the teacher. After the leave, the applicant shall go to the Science and Education Department to cancel the leave. The leave for academic conferences is limited to once a year. During the training period, the cumulative period of sick leave, personal leave and other leaves shall not exceed 15 days each year. If the leave period exceeds 15 days in the current year, the training period shall be extended by one year. Those who fail to ask for leave, arrive late or leave early during random checks on attendance situation or all kinds of meetings or activities that must be attended shall be punished with the bonus of RMB 100.

2. In case of any of the following situations during the training period, the trainees shall be unqualified in the monthly assessment and annual assessment: (1) The trainees have serious medical ethics and medical disputes during the training period. (2) The trainees disobey the rotation arrangement of the training base and fail to complete the rotation plan as required. (3) The trainees have asked for various types of leaves for more than ten working days in one month.

3. The trainees and teachers shall record the training process and content in the information management platform for specialist standardized training in a timely, accurate and detailed manner as an important basis for training assessment. Data such as the number of specific operation cases and written medical records shall not be falsified, and shall be supervised and managed by the specialist training group.

4. All trainees shall rotate in different departments based on the training plans, and shall not change the training departments without permission. If found, the monthly allowances of the directors and secretaries of both original and rotating departments shall be deducted for the first time, and the training period shall be extended by one year for the second time and the training period shall be extended by two years for the third time.

(II) Departmental rotation examination

According to the Measures for the Administration of Assessment of Standardized Training for Specialists, the departmental rotation examination shall be carried out for trainees in a unified way.

1. Contents of departmental rotation examination. After each rotation of a specialist, the rotating department shall assess the specialist according to the requirements of the rules for specialist standardized training. The assessment contents include attendance, medical ethics, policies and regulations, interpersonal communication skills, professional theoretical knowledge and clinical practice ability.

2. Strengthening the guidance and supervision of departmental rotation examination. The departmental rotation examination shall be carried out in the Medical Simulation Center, and the invigilation shall be jointly carried out by the teachers of the specialty base and the Science and Education Department. The trainees who fail to pass the departmental rotation examination shall take the make-up examination after one month of re-rotation training. Those who fail to pass the make-up examination shall re-rotate for the discipline.

(III) Annual assessment

1. The annual assessment consists of daily attendance assessment, departmental rotation examination performance assessment, daily theory and skills training completion assessment and annual theory and skills assessment.

2. Assessment content and proportion: The final total score of the annual assessment is 100 points, including daily attendance assessment score accounting for 10% of the total annual assessment score, departmental rotation examination performance assessment score accounting for 15% of the total annual assessment score, daily theory and skills training completion assessment score accounting for 15% of the total annual assessment score, and annual theory and skills assessment score accounting for 60% of the total annual assessment score. After summarizing the scores of the whole year, the assessment score ≥ 90 points is considered excellent, the assessment score ≥ 80 points and < 90 points is considered good, the assessment score ≥ 60 points and < 80 points is considered pass, and the assessment score < 60 points is considered fail.

3. The annual theory and skills assessment shall be organized by the Science and Education Department in a unified way and completed before the end of August every year.

4. Those who pass the annual assessment are allowed to enter the next year’s training, while those who fail to pass the annual assessment will be punished with one month’s rewarding performance. If the training in the current year is invalid, the rotation training period will be extended for one year, and the cost for extending the training period will be borne by the individuals.

II. Completion assessment

1. The completion assessment is uniformly required and deployed by the Chinese Medical Doctor Association.

2. The trainees participating in the completion assessment shall complete the training related to standardized training for specialists within the specified period, and pass the training process assessment.

3. The trainees who do not participate in the completion assessment for no reason after registration shall be disqualified from the current year’s assessment, and the registration review shall be conducted again in the following year. Those who fail to pass the written completion examination or clinical skills assessment can register for examination again in the following year. For those who fail to pass such examination twice in total, they will be disqualified from standardized training for specialists after being reviewed by the Provincial Post-graduate Medical Education Commission.

4. The specialists who falsify the contents of training process assessment or the conditions for applying for examination shall not apply for the written completion examination and clinical skills assessment within two years. Disciplinary problems arising from the written completion examination and clinical skills assessment shall be handled strictly in accordance with the relevant regulations on the examination and assessment.

5. Trainees who fail to pass the first completion assessment shall be punished with one year’s rewarding performance. For those who fail to pass the make-up examination, their promotion shall be delayed for one year.

6. If the training task is not completed as required within the specified period, the training period can be extended for up to two years. Those who fail to pass the assessment may apply for a make-up examination, and the number of taking the make-up examination is limited to two.

V. Identification of assessment results

For those who have completed the training as required and passed the completion assessment, the Chinese Medical Doctor Association will issue the unified Qualification Certificate for Standardized Specialist Training, and the certificate will be used an important condition for specialist work.

Measures for the Administration of Funds for Standardized Training for Specialists of Zhejiang Hospital

To all departments:

According to the requirements of the Implementation Plan for Pilot Project of Standardized Training System for Specialists (Trial), the living treatment and social security of specialists during the training period shall be effectively guaranteed. The treatment of specialists during the training period shall be implemented according to the Notice of Zhejiang Hospital on Issuing the Fund Administrative Measures for the Standardized Training for Residents (ZY [2019] No.   ).

Measures for the Administration of Personnel of Standardized Training for Specialists of Zhejiang Hospital

To all departments:

According to the requirements of the Implementation Plan for Pilot Project of Standardized Training System for Specialists (Trial), the Measures for the Administration of Personnel of Standardized Training for Specialists of Zhejiang Hospital are formulated.

I. The specialists in our Hospital shall be managed by the Human Resources Department of our Hospital.

II. For the specialists selected by the entrusted unit, their personnel files shall be managed by the original unit, the entrusting unit shall bear the basic salary of the entrusted personnel and the payment part of the social security unit, and the training base shall give appropriate living allowances. All trainees shall sign the tripartite training agreements among training bases, entrusted units and specialists with Zhejiang Hospital. The daily management shall be carried out by the Science and Education Department of Zhejiang Hospital, and no entrusted trainees shall be retained after the training is completed.

III. The specialists recruited from the society shall sign the bipartite training agreements with training bases. The social insurance shall be paid for them according to regulations and the technical files shall be established. Their daily management shall be consistent with that of specialists of the Hospital.

IV. The specialists shall consciously abide by the rules and regulations of the Hospital during the training period. If there is any violation, they will be punished according to the regulations, and even their training will be postponed or terminated.

V. The Qualification Certificate for Standardized Specialist Training is a priority for the recruitment of senior technical posts in clinical medicine.