The Analysis to the Diathesis of China Cultivated TCM Talents from Oversea TCM Working Experience

Liu Zi-li  (Yunnan TCM University, 88 Baita Rd, Kunming ,P.R China 650011）

Abstract:According to overseas working experience, the author analyzed and contrasted the difference in knowledge structure of China cultivated TCM talents and those needed by overseas market and pointed out current shortcomings of domestic higher TCM education and corresponding improvement opinions so as to meet the needs of international TCM job market.

Key Words: International TCM Market, TCM Talents, Diathesis Cultivation

Had been Working and giving lectures in Thailand and Spain in the two and a half years from April 2000 to December 2003, I have learned some about the difference between diathesis cultivation of domestic TCM talents and knowledge structure of TCM talents needed by overseas market. Nowadays,As education is integrated with the world market and becomes world-oriented and Acupuncture is accepted widely in the world, Traditional Medicine, especially TCM, will be gradually popularized worldwide and become an integral part of regular medical systems. The employment of graduates of China domestic TCM universities & colleges will show a more obvious worldwide trend. I’d like to talk about my opinion on how to adjust knowledge structure of TCM teachers and students so as to make student enrollment and Graduation assignment enter a virtuous cycle based on the international TCM market. Hope those opinions can be useful and effect better ideas

1. Due to the breadth and diversity of diseases in overseas practice, community-type general TCM practitioners are needed.

1.1 Breadth and diversity of diseases in overseas practice

Compared with China domestic TCM practitioners, overseas TCM practitioners encounter a much broader range of diseases, including almost all sections, such as internal medicine, external medicine, pediatrics, gynecology, traumatology, ENT, dermatology, and acupuncture. According to my working experience in the TCM Dept. of Dr. PanYa General Hospital in Bangkok, Thailand and my investigation during the period when I gave lectures in the Spain 3 Colleges of Europe TCM foudation and its affiliated clinics, the following diseases were found frequently: Psychosomatic internal diseases, such as insomnia, headache, depression ,hypertension, chronic fatigue syndrome, coronary disease, digestive system diseases; Endocrine and metabolic diseases, such as gout, obesity, hyperlipemia, diabetes mellitus; Acupuncture and traumatology diseases, such as sequelae of stroke, cervical spondylosis, rheumatism, cold joint pain, back pain, knee joint disease, heel pain, etc.Immune disorders and skin diseases such as glomerular kidney disease, lupus erythematosus, urticaria, eczema, acne, Gynecological diseases such as irregular menstruation, dysmenorrhea, myoma of uterus ,ovary cysts; Pediatric such as tonsillar hypertrophy, diarrhea, fever, cough, pediatric mental hypoplasia, such as autism, cerebral palsy,Infectious diseases, such as AIDS, hepatitis, cirrhosis of the liver; Oncologic diseases, such as prostate cancer, liver cancer, stomach cancer, lung cancer, lymphoma, pituitary adenoma; ENT diseases, such as allergic rhinitis, Meniere's Disease, tinnitus and deafness; Neurological and geriatric diseases, such as facial paralysis, Alzheimers, Parkinson's disease, aging prevention and healthcare, etc.

For treatment of the above diseases, doctors must have a wide range of knowledge. Thus community-type general TCM practitioners who can solve practical problems are needed. However, most domestic TCM hospitals have specialized departments, such as Dept. of Internal Medicine, Dept. of surgery, Dept. of Pediatrics, Dept. of Gynecology, Dept. of Acupuncture, Dept. of Traumatology & Orthopedics, Dept. of Dermatology, Dept. of Rheumatism, and Dept. of Neurology. A doctor can only practice  in one specialized department to cure a limited number of diseases. For example, Department of Acupuncture is mainly responsible for curing all kinds of pain syndrome, facial paralysis,  sequelae of stroke, etc. Doctors of a single department only probes deeply into several kinds of diseases. Thus they would feel utterly dazed when facing a variety of diseases in overseas practice.

1.2 International practice requires highly-effective and diversified TCM treatment means

1.2.1 High efficiency: the working rhythm in overseas market economy countries is fast and the medical expense of western medicine is relatively high. Since TCM has character of simple, lower cost and effective and shows a uniqueculture and holistic treatment mode, it is good for treatment of modern civilization diseases. However, due to the difference of social and cultural background, overseas patients always expect a desired effect after the first or second treatment, unlike Chinese patients who know that TCM takes effect slowly and patients need to receive persistent treatment patiently. So doctors must be high TCM attainmentsand show a high “hit rate” and “faster effect” otherwise it is hard to maintain a high subsequent visit rate among patients.

1.2.2 Diversified treatment means

In order to show high efficiency and holistic TCM treatment in overseas practice, a doctor must have a comprehensive quality and can use different treatment means, such as acupuncture, Tuina (massage), oriental-type osteopathy, oral administration, external herb usage, and diet therapy, according to different patients’ demands and conditions of illness. I made a study of TCM doctors who were sent abroad by my university and other TCM universities to practice TCM jobs in Thailand and Spain cooperation hospital or clinics and found that these doctors’ knowledge structure have some defects because of their different college & university backgrounds and different specialties or majors.

For example, doctors majoring in Acupuncture and Tuina are good at acupuncture and Tuina but weak in medical prescription. Those majoring in TCM can write a good prescription and can  use acupuncture for treatment but  Tuina therapy is their weakpoint. Those majoring in Orthopedics and Traumatology can use Osteopathic therapy but are weak in dealing with internal diseases. As a result, the source of patients is limited.

Due to the difference in life & working rhythm and cultural background, overseas patients, especially patients in western countries, have a partiality for Chinese patent medicines, such as Liu Wei Di Huang Wan (pill of six ingredients with rehmanniae) Water Pills and capsules, but they dislike TCM decoction.

Therefore I think, in the face of fierce competition overseas TCM market, domestic undergraduate and postgraduate education should not just focus on a limited number of specialties but should develop "wide caliber" talents, i.e. general TCM practitioners.

Such general TCM practitioners should be versatile persons who are proficient inacupuncture, treatment of orthopedical and Traumatological diseases, TCM prescription, and Tuina, know well about medical psychology, have a good command of diet therapy and healthcare knowledge, and have certain ability in drug preparation (e.g. prepare drugs for external use and oral administration, such as TCM capsule, pill, etc.). It is better if they know Qigong, tai chi, TCM herb identification, and international marketing, etc. In this way they can adapt to the competition in the international TCM employment market in a better way.

2. Requiring specialist or specialty brand characteristics

TCM education emerges throughout the world gradually. In the context of TCM education internalization, TCM practitioner who received different trainings level participate in overseas practice. Some foreign doctors established a clinic just after learning acupuncture and Tuina in China for three months. however, there are some experienced TCM practitioners. The competition in overseas market is fierce, just like the situations in China. Common acupuncture and Tuina practitioners exist everywhere in today’s international TCM market. Overseas TCM practitioners can make a success only when they develop their own specialty based on a general mode and build their own specialty brand.

If they have their own unique effect, establish a strong specialty brandin the treatment and healthcare of some difficult and complicated diseases in western countries, such as obesity, coronary disease, AIDS, depression, chronic fatigue syndrome, diabetes, skin disease, common diseases of orthopedics and traumatology, such as pain in low back and legs, cervical vertebra diseases, and senile diseases, then they can surely adapt to the survival competition of market economy.

For example, Doctor Luo Dinghui, graduated from Guangzhou University of TCM, is good at curing eczema in London, UK. After her treatment prescription was published in The Lancet, a well-known British journal, her clinic was crowded with patients. During professor Guan Zunhui of Kunming city TCM Hospital was giving lectures in Canada, he had visited one TCM specilist who,treat more than 60 patients per day. When I was giving lectures in Spain, I saw a TCM doctor from Nanjing Hospital of TCM, whose surname is Huang,  more than 28 persons on average were treated within a half day. Professor Cheng Zhicheng of Shanghai University of TCM, who worked in the TCM Dept. of Overseas Chinese Hospital in Thailand, applied acupuncture to up to 100 patients per day. Thus it can be seen that the curative effect of TCM is self-evident.

3. The knowledge structure with combination of TCM and western medicine is Necessary and indispensable

The Yellow Emperor's Classic of Internal Medicine (Huangdi Neijing) collected almost achievements of all fields of natural science at that time. As natural science is now used for studies and development of TCM, it is necessary to combine TCM and western medicine to diagnose diseases. we found during our teaching in Europe and guidinging British, German, French, and Spain TCM students in China that, By reason of the equipments and other limited conditions of Western private TCM schools, combined with strict distinction of measures between Chinese and Western licensed doctors, as well as legal restrictions, most of the trainees, except that who has a background of western medicine, have a weaker foundation in Western medicine, than the Chinese graduate of same profession  or major, and fall short of the clinical model which integrates TCM and western medicine. Take acupuncture doctor as an example, if he/she doesn"t have a solid foundation in regional anatomy and acu-point topography, medical negligence even fatalities will more likely to happen during their practices. Thinking in both Chinese medicine and Western medicine ways is necessary for the practitioner of traditional Chinese medicine. In this way, they can take the advantages of traditional Chinese medicine legitimately, make a right diagnose and further more avoid medical negligence or accident. For example, in the therapy of cancer, it"s necessary to combine traditional Chinese and Western medicine. Take another example of  the extrauterine pregnancy, someone would mistakenly diagnose it as the indication of acupuncture, which will causes medical lawsuit.Besides, it’s important for the knowledge structure with combination of TCM and western medicine in self-protection against AIDS and acupuncture disinfection in overseas practice, disposable needles are widely used in the world. Strict “needle cleaning” test is carried in the USA acupuncture practice examination in order to guarantee patient’s safety. However, some domestic acupuncture doctors still remain in the "original acupuncture" stage whohaven’t use one time diposal needles, when they do the insertion lifting and twisting method, the needle may contact a patient’s tissue fluid.but those doctors disinfect their fingers only once during their working hours and carry out acupuncture to dozens of patients. Since such practitioners have a weak disinfection and sterilization sense, their safety problems keep patients away.

4. Good foreign language ability and having a good handle of local cultural background  

Good Language ability is a basic condition for overseas practice because a practitioner has to know well about local customs in order to obtain the trust of patients and communicate well with patients,Language is very important in acupuncture and TCM license test in the country where you practice . For example, if you do not takeacupuncturelicensingexam in English in the USA, you must take part in TOEFL test else.TCM higher education is emerging gradually throughout the world. In addition to a lot of private TCM colleges and universities, the Middlesex University in UK, Royal Melbourne Institute of Technology University, Canberra Institute of Technology, Victoria Institute of Health (TCM Dept.) in Australia⁽⁴⁾, and Li Shizhen TCM University in Austria⁽⁵⁾are all officially-established TCM higher education institutions. With the localization of Foreign TCM doctors or practitionergradually, Though they know little about TCM herb and prescription,but  they are familiar with acupuncture and have an advantage in language and culture, thus they can challenge Chinese graduates of TCM higher education institution who work abroad to some extent. In recent years, the foreign language teaching has been improved greatly in China. However, attention should be paid more to practical intensive English training, advocating survival-based foreign language teaching instead of text-based teaching, besides, students  should study more knowledge on the history , social and cultural background of that foreign language country . Currently, Most domestic TCM Universities and collegesare mostly concentrated in "English" as one kind of main foreign language is extremely limited,AsEnglish-speaking Chinese professionals will gradually to a "saturation" tendency,If several foreign languages, such as French, Spain, German, Arabic, are taught in these schools, TCM talents will adapt to worldwide needs. The above is my personal views. In case of inadequacy, you are welcomed to make corrections.

References:

［1］TCM Development around the World   http://www.cintcm.com 2001／4

［2］Ding Liling, Guo Cuiping, et al., Xing Lin Cai Ye – Collection of Guan Zunhui’s Acupuncture Medicine and Popular Science Works [M], Yunnan: The Nationalities Publishing House of Yunnan, 1^stedition in January 2002, P174

［3］Summary of Global TCM, Regulations of the USA on Acupuncture Examination Methods and Acupuncture License

http://www.zgdyf.com 2002／11／15

［4］TCM Higher Education Goes Abroad and Takes Root in Many Overseas Countries

http://www.news.eastday.com2003／3／13

［5］European Official TCM University: Li Shizhen TCM University Was Established in Austria

http://www.sina.coin.cn 2003／10／08

Above Script come from “The World federation of Chinese Medicine Societies The First Forum Of the Globalization Of TCM and Public Health KunMing ,YunNan ,China ,April 16-17, 2011,P183-190