In China, students embarking on the journey to medicine go directly into medical school right after high school, provided they do well on the college entrance exams. Once accepted, they are put into one of several tracks early: Western medicine, Traditional Chinese Medicine (TCM), public health, pharmacology, and dentistry to name the main ones. Subjects like Western medicine can be further subdivided into majors not unlike in the US. The bachelor’s education generally lasts 4 years, with only students on a clinical medicine track (Western medicine and TCM) tracks completing a 5th year of rotations in hospitals. From there, students can choose to either start working as a practicing physician – see patients, diagnose and treat disease, or they can continue their education and apply for a master’s degree.
Although with a bachelor’s degree one is already a fully licensed doctor (after 1 year hospital internship + passing licensing exam), to find work in a reputable hospital or one in a big city, obtaining higher education is almost certainly a must. To be accepted into a master’s program is not easy, as the ones who apply to such programs can already have years of work experience and numerous research publications. About half the master’s students come directly from a bachelor’s program, while others have had experience in the work field. The competitiveness is more intense at the doctorate level, but the general idea is the same.
From there, a student and one hospital come to an agreement that the student will work there for one year in an internship, rotating through all departments. After one year, they can come to an agreement as to which department the physician-in-training will join to complete residency for specialized training.
In the United States, the main differences briefly are that we obtain a bachelor’s degree first, take the prereq classes for medical school along the way and then apply. We all will finish with the same degree – an MD, after which we apply in a national match program to find a hospital and specialty to begin residency training.
The challenges students face in both systems are quite similar: an enormous time commitment – many students will not complete their education and training until their mid-30s, the uncertainty of where in the US one will be during their training (medical school, residency, fellowship, etc), and the sacrifices that come with delaying other priorities and interests, such as family, accordingly. Moreover, the financial commitment is similar in the sense of loss-of-potential-income due to all the years spent in training.