Tong Tong (morningpost.com.cn): It couldn't have been easy for Yu to have stayed in her position and devote herself to her patients for so many years with the full knowledge of the impossibility of earning a promotion without a talent for writing papers.

According to China's current criteria in state-run hospitals, there is no index that is to measure a doctor's clinical capability.

It's OK for hospitals to measure a clinical doctor's professional capability with the number of academic papers, but when papers are taken too seriously, it seems unfair to them. Also, we'll see a strange phenomenon resulting from the current assessment system. Doctors who participate in a high-level research program will be more likely to be published in high-level publications.

The authors of these papers will find it easier to bid for certain medical programs. As a result, some doctors not only neglect their job of treating patients, but are enticed by easy money winning grants from the state.

According to an investigation by the China Association for Science and Technology, only 40 percent of state funding allocated for research and publishing are actually spent as designated.

Yu is an excellent clinical doctor. Her resignation is a loss to her hospital. However, the bigger loss to the Chinese medical circle is the decline of clinical quality and also corruption resulting from the current evaluation criteria.

Bai Jianfeng (www.china.com.cn): Doctors are at liberty to practice at a state-run hospital or to leave for a private hospital. The major reason that dragged Yu out of her hospital, however, is that she is fed up with the doctor assessment system based on the number of academic papers written.

For most doctors, if they work in a big state-run hospital, they'll easily reach higher positions and harvest many resources that a doctor in a small hospital can never have access to. That's why some people try to persuade Yu to give up her decision, because her resignation is a much smaller loss to her hospital than to herself. This is also the major reason why most doctors still choose to stay in big state-run hospitals, although they are bothered by the same problem that faces Yu.

State-run hospitals have monopoly status, with enough funds for scientific research and sophisticated medical equipment. Thus, these hospitals are also full of excellent doctors. With such a high concentration of good doctors, relations in these hospitals are quite complicated. Some of these doctors may even feel cornered and unable to bring their capability or talent fully into play.

Moreover, China's state-run hospitals are bureaucratic to certain degree. Rank determines access to resources and opportunities, so quite a number of doctors try to earn promotions to an "official" position. Meanwhile, someone good at clinical treatment who lacks "official" ranking tends to be marginalized and find it difficult to realize their value as doctors.

To gain rank, the most important index is academic papers. Doctors who have not published in international publications, no matter how excellently they perform clinical treatment, will face great difficulty getting promoted.

Despite the many deficiencies in state-run hospitals, where else can a doctor practice medicine? Private hospitals are rare in China, and compared with state-run hospitals, they lack funding for research and basic welfare insurance. Many doctors who leave end up going back. This is the dilemma facing many Chinese doctors today.

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