Hypertension 1996 : One Medicine, Two Cultures

The education of Traditional Chinese Medicine in China

Qiao Wangzhong
Beijing University of Traditional Chinese Medicine

1. Preface

Traditional Chinese Medicine (TCM) has a long history in China, it is not only looked upon as a bright pearl, but also a treasure house in Chinese ancient culture. TCM has made great contribution to the health of Chinese people for thousands years, and it became an independent medical system in world medical field with its special clinical effect, rational theory system and rich practice experience.
In Chinese medical history TCM was born, spread and developed along with Chinese people against various diseases, TCM education has also been carried out from one generation to another for thousands years. It is clear that TCM education has its objective basis, that is, TCM science and technology.
To develop TCM and to promote TCM education, there are many problems needed to be discussed and solved. In this paper, a brief introduction and discussion on TCM education will be made.

2. The basis of TCM Education

TCM has been handed down from ancient time to now. The reason for the lastingness of TCM, as being realized by most people, lies in that it has great vitality, that is, TCM has rational property, scientific theory system and rich contents. In this sense, the advantage of TCM is just the basis of TCM education.
TCM applies its special concepts and theory to reveal and interpret the arising and growing of diseases and to determine the treatment principles. TCM has formed a perfect knowledge and theory system. For example, TCM applies Yin - yang, five elements (water, fire, metal, wood and earth), internal organs (viscera), jingluo (Channels and collateral), vital energy and blood, and so on, to explain various physiological phenomena and to illustrate the cause of diseases (pathogeny), the interpretation of the cause (pathogenesis), the diagnosis, treatment and prevention of diseases.
TCM emphasizes the concept of viewing human body's various parts as an organic whole. On the view of TCM, human body, as a microcosm, is connected with the macrocosm. From the concept, there is a close relation between human body and the nature, between human body and society. Although this idea was advanced a long time ago, it has something in common with today's medical model.
TCM emphasizes the idea of determining treatment principles and methods based on the differentiation of symptoms and signs. It is the essence of TCM theory system. This theory has significance to clinical practice, only according this idea to determine diagnosis, principles, prescription and drugs, can treatment get satisfactory effect.
Clinical effect is the real reasons of TCM having vitality, it is also the starting point and the end-result of TCM practice. Now, mankind faces serious harm from AIDS, tumour, cardiac cerebral and other obstinate diseases. In this situation, TCM should make more effort to raise clinical effect of treating these diseases and should further apply modern science and technology to develop TCM theory and to improve TCM practice. In the same time, the endangerment from these serious diseases is also a challenge to TCM education, requesting TCM education to make more effort to develop medical science and technology and to meet the needs of treating and preventing these diseases.

3. History of TCM Education in China

“Family education” and “apprenticeship education” was the main ways of TCM education in ancient and modern China. In Tang Dynasty (618-907 A. D), there was a TCM school to train imperial physicians, called “Taiyishu”, it was the earliest medical school run and managed by government. From then, TCM education was carried out in the three kind of forms. This situation had not been changed until 1950s. After the foundation of the People's Republic of China, a series of policies and measures for promoting TCM education were presented by China government. In 1956, China set up the first group of TCM colleges, including Beijing College of TCM, Shanghai College of TCM, Guangzhou College of TCM and Chengdu College of TCM. This is a great progress in history of TCM education in China. That means TCM education was brought into the higher educational system and China began to practise formal college education of TCM. After that, several TCM colleges were established in succession.

4. Current Situation of TCM Education in China

Higher TCM education has gone through 40 years from the first group of TCM colleges was set up. Up to now, there are 33 TCM colleges and universities all over China, beyond one college for one province, among them, 4 are nationality medicine colleges. There are 30 thousands students taking TCM education in these colleges and universities. Higher TCM education also trains Master and Doctor. Among the 33 colleges and universities, 22 offer Master degree program, 10 offer doctorate program. Beijing University of TCM and other two universities set up post-doctor station. From 1956 to now, these colleges and universities trained about 100 thousands students. Besides, a special program was offered and 5,000 students graduated, they are specialized in the integrated TCM and Western Medicine.
In China, TCM colleges and universities also offer education to foreign students, more and more foreigners come to China to study TCM. According to statistics, among foreign students in China, the part of studying TCM is the most. Over one third TCM colleges and universities admit foreign students and about 2000 foreign students’ graduated or finished study. In Beijing University of TCM, there are 360 foreign students who are studying TCM now, and over 800 students from 80 countries and regions graduated. Sum up the 40 years'experience of higher TCM education, objectively speaking, higher TCM education in China has made historical progress. The main achievements may be summarized as follows.

4.1. Educational System

A comprehensive system of TCM education is set up in China. This system is shown in Chart 1.

4.2.Educational Levels

Various levels of higher TCM education were set up in past 40 years. Compared with the educational level hold at the beginning when higher TCM education was set up, the levels of TCM education have been increased greatly. Especially in recent 10 years, the second Bachelor degree program, the 7-year program and post-doctor station were set up separately, that brought in new levels of higher TCM education. We can say, higher TCM education has all kind of levels now. The present levels of TCM education are shown in Chart 2.

4.3. Programs and Curricula

At present, there are 22 kind of programs of TCM education officially approved by the State Educational Committee and the State Administration of TCM.

The Programs for Bachelor Degree (15 programs):
Chinese Medicine; Orthopaedics and Traumatology of TCM; Otorhinolaryngology of TCM; Surgery of TCM; Acupuncture and Moxibustion; Tuina and Massage; Health Preservation and Rehabilitative Medicine; Documents and Literature of TCM; Chinese Pharmacology; Chinese Pharmaceutical Technology
Resources of Medical Materials; Pharmacognosy; Pharmacology of Chinese Medicine; Traditional Mongolian Medicine; Traditional Tibetan Medicine;

The Programs for Master Degree and for Doctor Degree (22 programs):
Basic Theory of TCM; Chinese Medicine Formulae; Classic of Internal Medicine; Treatise on Febrile Diseases Induced by Cold; Acute Febrile Diseases; Schools of Chinese Medical Theory; Chinese Diagnostics; Chinese Internal Meducube; Chinese Surgery; Chinese Gynaecology; Chinese Paediatrics; Chinese Ophthalmology; Chinese Otorhinolaryngology; Orthopaedics and Traumatology of TCM (include Tuina); Acupuncture and Moxibustion; Documents and Literature of TCM; Ancient Chinese Medical Language; History of TCM; Chinese Pharmacology; Foundation for Integrated Chinese and Western Medicine; Foundation for Integrated Chinese and Western Clinical Medicine.
Besides the programs mentioned above, colleges and universities are permitted to offer new programs based on social needs and own conditions, but it needs to be reported and to be approved. In Beijing University of TCM, 3 new programs: Chinese Health Administration, Chinese Medicine Nursing and Chinese Pharmaceutical Business Management are offered after getting approvement.
The curricula also developed greatly. More and more courses were offered for students. Now, for the 5-year TCM program, 47 courses are offered, the totals teaching hours are 3789. The students of TCM department have to learn both TCM and Western Medicine, the ratio is 6.7 to 3.3. The students still must participate in about 40 weeks'practice. The practice is arranged as thus: in section of TCM internal, 14 weeks; in section of Western Medicine internal, 12 weeks; in section of acupuncture and moxibustion, 8 weeks; in other sections, 10 weeks. For the 4 - year program of Chinese Pharmacology, 36 courses are offered, the total teaching hours are 3276. Besides the 3276 hours courses, students still have 34 weeks time to practise and to work for their graduation project.

4.4. Educational Forms

There have been various forms of TCM education in china through forty years’ practice. To sum up, at present, the forms of training TCM professionals are formal school education, in-service training, continuing education and self-study. These diverse forms make up an educational network of TCM.
Mention in passing, the foreign students who want to take the education of TCM must pass the national examination of general knowledge courses and the test of Chinese language (HSK) or the test of English language. The foreigners will be offered different language teaching, in Chinese or in English, based on the test results. After finishing all courses and passing tests, they will be awarded relevant certificate.

4.5. Tasks of Colleges and Universities of TCM

In China, the colleges and universities of TCM are not only the base of training professionals, but also the centre of research and health of TCM, in other words, the colleges and universities undertake three main tasks education, research and health work.
Colleges and universities of TCM undertake a vast amount of scientific research work. There are some full-time professionals and some part - time researchers. The two parts of persons working in colleges and universities of TCM are main force for TCM research.
Generally, each college or university of TCM has 2 to 3 hospitals, called affiliated hospitals. There are about 500 beds in each hospital. The affiliated hospitals are both the schools'clinical training base and the local health centre of TCM. Besides the affiliated hospitals, each college or university has several teaching hospitals. In addition, most colleges and universities have own experimental pharmaceutical plants as practice bases of Chinese pharmacology students.

5. Problems Existed and Measures

The higher TCM education in China has made historical progress and got great achievement since the first group of TCM colleges were founded in 1956. It should be said that from birth to growing up, higher educational system of TCM was set up and abundant experience was accumulated. Although the progress and achievement are satisfying and encouraging, there are some problems in higher TCM education need to be considered.

5.1. It is necessary to improve the model of professionals training.

The model of professionals training for all the colleges and universities are unified, the unity is too stressed, but the specific character is neglected. The unified model is not advantageous to the professionals training and to the full play of each college's or university’s initiative. It is necessary to change such one colour model of professionals tramping, so that colleges and universities can select the best way according to own factors. To bring about the change of training model, many aspects, including programs, curricula, teaching textbooks, teaching methods, and so on, should take place relevant changes.

5.2. It is necessary to make the students'knowledge structure more rational.

As mentioned above, the courses offered now are mainly TCM courses and Western Medicine courses, lacking courses such as social science, the humanities and modern science and technology. It is suggested that TCM education should pay more attention to the adjustment of course system and the improvement of students’ knowledge structure. For future TCM education, although Chinese Medicine knowledge should be the principle part of the knowledge structure, the social science, the humanities and modern science and technology should occupy more rooms.

5.3. It is necessary to adjust the educational level of TCM.

Although the level structure of TCM education is basically rational, investigation results show that there are some aspects, such as the program, the proportion of diverse levels, need to be adjusted in varying degrees.
Concerning the educational programs, not all the programs are offered according to the social needs, it must be admitted that there is somewhat blindness to set up some programs.
With regard to the proportion of diverse levels, up to now, the proportion is determined in line with someone’s experience and subjective judgement. To maintain the balance of educational levels, colleges and universities should make social investigation regularly, then decide what kind of level would be strengthened or be adjusted.

5.4. TCM education should employ new strategies to face the 21st Century.

On the view of microscope, TCM education should not make adjustment in one aspect only, but should manage to change in all aspects to meet the requirements of the 21st Century.

6. Conclusion

TCM gradually become a part of world medicine. Along with the changes of medical model and the change of health needs of people, TCM will get greater development and play more roles in future.
Higher TCM education in China developed rapidly in past forty years. Although great progress was made, there are some problems need to be considered and solved. The goal of higher TCM education is to set up a modern educational system. Colleges and universities of TCM should sum up past forty years'educational experience, change educational ideas, find problems existed, apply new strategies and adjust some aspects, so as to develop TCM education more rapidly and to meet the health needs of future society.

The medical courses for 5-year TCM Program

Parts one: Common Basis Courses

1. Ancient Chinese Medical Language
2. Foreign Language
3. Computer
4. Latin
5. Medical History
6. Biology
7. Medical Documents and Literature

Part two: Medical Basis Courses

1. Basis of TCM
2. Diagnostics of TCM
3. Science of Chinese Materia Medica
4. Science of TCM Formula
5. Emperor's Canon of Medicine
6. Treatise on Exogenous Febrile Diseases
7. Seasonal Febrile Diseases
8. Synopsis of the Golden Chamber
9. Historical Schools in TCM
10. Experimental TCM
11. Human Anatomy
12. Physiology
13. Biochemistry
14. Pathology
15. Pharmacology
16. Histoembryology
17. Microbiology
18. Parasitology
19. Medical Statistics

Part three: Clinical Courses

1. Chinese Internal Medicine
2. Emergency Case of TCM
3. Chinese Surgery
4. Acupuncture and Moxibustion
5. Chinese Gynaecology
6. Chinese Paediatrics
7. Chinese Diagnostics
8. Modern Internal Medicine
9. Orthopaedics and Traumatology of TCM
10. Otorhinolaryngology of TCM
11. Ophthalmology of TCM
12. Stomatology of TCM
13. Dermatology of TCM
14. Modern Surgery

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Edited by Aldo Campana,