Beijing Hospital Scandal Sparks Debate About Pilot Medical Degree Program

China’s National Health Commission launched an investigation on Thursday into a sex scandal at Beijing's China-Japan Friendship Hospital, a top medical facility. The controversy revolves around Xiao Fei, an associate chief physician dismissed for personal misconduct after allegations of affairs with several women, including a resident doctor potentially connected to a pilot medical degree program. This incident has raised public scrutiny over the fairness and standards of this nontraditional “4+4” medical education path. [para. 1][para. 2]

Attention shifted from Xiao Fei’s conduct to the credentials of a student in the “4+4” pilot program, though her direct link to the scandal remains unconfirmed. Critics have questioned the student’s non-medical undergraduate background before joining the program at Peking Union Medical College (PUMC) in 2019. The “4+4” model allows graduates with any four-year bachelor’s degree to pursue four years of medical training, culminating in a medical degree, contrasting with China’s customary eight-year uninterrupted medical training that starts at the undergraduate level. This approach is inspired by the U.S. graduate-level medical education system. [para. 3][para. 4][para. 5]

The student faced additional scrutiny after being introduced at PUMC’s 2023 graduation as holding a degree in economics from Columbia University. Online users later discovered she studied at Barnard College, an affiliate of Columbia. PUMC has not provided further details about her qualifications, leading to debates about her admittance to the “4+4” track and the duration and quality of her clinical training. [para. 6][para. 7]

The “4+4” model was launched at PUMC in 2018, but similar programs have existed in China since 2002 at Shanghai Jiao Tong University and since 2005 at Zhejiang University. PUMC designed the program to recruit outstanding undergraduates from various backgrounds who possess strong intellectual foundations and a genuine interest in medicine. Advocates argue it addresses the issues of immaturity and lack of motivation sometimes found among high school entrants to traditional medical tracks by selecting older students with diverse experiences. [para. 8][para. 9][para. 10]

However, critics point out that, unlike the American system, the Chinese “4+4” does not require a standardized entrance exam akin to the Medical College Admission Test (MCAT). This omission has led to concerns regarding the fairness of the admissions process, as students bypass the graduate entrance exams required for other advanced degrees in China. [para. 11]

A study published in April 2024 by the Center for Medical Education at the Chinese Academy of Medical Sciences and PUMC analyzed the 172 “4+4” students admitted from 2019 to 2024. It found that 31.4% of these students held non-biology undergraduate degrees. The pass rate for the Chinese medical licensing exam was 95.2% for “4+4” students, close to the 98.5% rate for traditional eight-year students, indicating comparable academic competency. However, the “4+4” graduates lagged behind in clinical ability and research output: they published an average of 2.8 papers compared to 4.1 from eight-year graduates, which the study attributes partly to their shorter period of medical study. Faculty acknowledged that “4+4” students tend to have international exposure and interdisciplinary strengths, but clinical and research skills can vary greatly. Students themselves cited overloaded schedules limiting their practical training. [para. 12][para. 13][para. 14][para. 15]