Looking back on the summer two years ago when he encountered obstacles in his job search after graduation, Li Kaixuan still couldn't let go. Dr. Li Kaixuan pursued a major in integrated traditional Chinese and Western medicine during his doctoral studies. At that time, he was very eager to go to a public tertiary comprehensive hospital (hereinafter referred to as "West Hospital"), and the head of the surgical department of the hospital also wanted to receive talents in the field of integrated traditional Chinese and Western medicine, thinking that he was very suitable. Unfortunately, Li Kaixuan did not receive an offer letter and eventually entered a public tertiary traditional Chinese medicine hospital (hereinafter referred to as the "TCM hospital") to work. The direction of integrating traditional Chinese and Western medicine may sound like a win-win situation, but when looking for a job, it is easy to fall into the dilemma of being disliked by both sides. ”Li Kaixuan told reporters that due to tight quotas and cumbersome procedures, it is difficult for doctors in this direction to enter the Western medicine department of the Western Hospital. Li Kaixuan encountered only one of the challenges faced by practitioners of integrated traditional Chinese and Western medicine. During the interview, the reporter found that many problems such as the shortage of high-level talents, the mismatch between traditional Chinese and Western medicine theories, and the lack of exclusive competition tracks are becoming bottlenecks and pain points in the development of integrated traditional Chinese and Western medicine. When the COVID-19 epidemic was raging, the anti epidemic effect of the world was not satisfactory, while China achieved a low infection rate and low mortality rate. Among them, China's unique combination of traditional Chinese and Western medicine has made great contributions. Currently, integrated traditional Chinese and Western medicine still shines in its advantageous areas. In April this year, a 60 year old breast cancer patient suffered from systemic exfoliative dermatitis due to chemotherapy combined with immunotherapy, and serious secondary infection endangered his life. The cancer hospital where he sought treatment was helpless and immediately issued a critical illness notice. Later, the family transferred the patient to the Department of Oncology of Integrated Traditional Chinese and Western Medicine in China-Japan Friendship Hospital. After nearly two weeks of internal and external treatment with Chinese medicine, exfoliative dermatitis was effectively controlled, and the patient was out of life danger and discharged successfully. With the advancement of medicine, malignant tumors are gradually evolving into a chronic disease that can be managed for a long time. "The aging problem of China's population is becoming more and more serious, the disease spectrum has undergone a huge transformation, and chronic diseases have quietly occupied the leading position." Lou Yanni, director of the Department of Oncology of Integrated Traditional and Western Medicine of China-Japan Friendship Hospital, said that a large number of clinical experience shows that integrated traditional and western medicine has shown significant advantages in major chronic diseases and comorbidities such as malignant tumors, cardiovascular and cerebrovascular diseases, endocrine and metabolic diseases, and respiratory diseases. In the future, talents in integrated traditional Chinese and Western medicine will have great potential in these fields, "she said. However, currently there is a shortage of talent reserves for the integration of traditional Chinese and Western medicine, and high-level talents who truly possess the thinking of integrating traditional Chinese and Western medicine are particularly scarce. "At present, there is an 'inverted pyramid' structure in the education of integrated traditional Chinese and western medicine. The proportion of undergraduates is too high, while the scale of postgraduate training is seriously insufficient. This directly leads to the gap between high-end clinical and scientific research talents and restricts the in-depth development of the discipline." Zhang Boli, an academician of the CAE Member and a master of Chinese medicine, is worried about this. According to the "National Compilation of Traditional Chinese Medicine Statistics", in 2021, there were only 52 universities in China offering undergraduate programs in clinical medicine of traditional Chinese and Western medicine. Among the students enrolled in higher traditional Chinese medicine hospitals, undergraduate students accounted for more than 89%, and only 1143 doctoral students. Since the beginning of the 21st century, the country has continued to support the development of integrated traditional Chinese and Western medicine, a "national treasure", including its inclusion in national undergraduate education majors, pilot implementation of a nine-year integrated Chinese and Western medicine education program, establishment of the National Center for Integrated Chinese and Western Medicine, and the formation of a national "flagship" hospital alliance led by 62 leading large-scale comprehensive hospitals. Behind the strong promotion at the national level is the growing demand. China has a population of over 1.4 billion, and with the increasing aging of the population, the demand for chronic disease diagnosis and treatment is soaring. The talent gap in integrated traditional Chinese and Western medicine is bound to further expand, "said Liu Tiegang, Director of the Academic Affairs Office of Beijing University of Traditional Chinese Medicine. The shortage of high-level talents in the integration of traditional Chinese and Western medicine is essentially caused by the disconnect between the medical education system and clinical needs. ”Zhang Boli suggested strengthening graduate education, establishing doctoral programs in the first level discipline of "Integrated Traditional Chinese and Western Medicine", expanding enrollment scale, and piloting undergraduate, master's, and doctoral programs in "Double First Class" universities, such as the joint training program of Traditional Chinese Medicine and Western Hospital; Establish clinical postdoctoral workstations, set up specialized postdoctoral positions for integrated traditional Chinese and Western medicine in tertiary hospitals, and focus on cultivating composite clinical scientists. I firmly believe that the integration of traditional Chinese medicine and Western medicine can form a unique diagnosis and treatment system on the basis of inheriting the essence of traditional Chinese medicine and absorbing the advantages of Western medicine, and make a strong voice in the international medical field with its fusion advantages. ”Bian Yuhong, Dean of the School of Clinical Medicine at Tianjin University of Traditional Chinese Medicine, stated. Promoting the integration of the "roots" and breaking the "two skins" of traditional Chinese and Western medicine, independent medical courses should be "one foundation+one clinical". Traditional Chinese medicine is like this, and so is Western medicine. However, the reporter learned from multiple universities that there is currently a unique phenomenon of "two basics+two clinical trials" or "two basics+one clinical trial" in integrated traditional Chinese and Western medicine. 'Two Basics' refers to offering basic courses in both Chinese and Western medicine separately,' Two Clinics' refers to offering clinical courses in both Chinese and Western medicine separately, and 'One Clinical' refers to only offering clinical courses that combine Chinese and Western medicine. For example, in a leading traditional Chinese medicine university located in a first tier city, the basic courses for clinical majors in both Chinese and Western medicine include elective readings of "Treatise on Cold Damage", "Diagnosis of Traditional Chinese Medicine", "Formula of Traditional Chinese Medicine", etc., while Western medicine courses such as "Anatomy" and "Pathology" do not offer specialized courses on the integration of Chinese and Western medicine. The situation of "two foundations" is widespread throughout the country. At present, more and more universities are trying to develop integrated clinical courses of traditional Chinese and Western medicine, combining the "two clinical" into one. The true integration of Chinese and Western medicine is not a 'mechanical combination' of 'traditional Chinese medicine+Western medicine' or 'Western medicine+traditional Chinese medicine', but rather a breakthrough in the barriers between Chinese and Western medicine, taking into account the strengths of both, and achieving organic integration. ”Liu Tiegang said that the phenomenon of "two skins" in traditional Chinese and Western medicine is still prominent in higher education and clinical applications. He believes that the root cause lies in the lack of integration between traditional Chinese and Western medicine theories - Western medicine emphasizes experimentation and micro level, while traditional Chinese medicine emphasizes the balance of yin and yang and the whole. The two have completely different worldviews and methodologies. At present, the integration depth of traditional Chinese and Western medicine courses in many universities is insufficient. Traditional Chinese medicine and Western medicine knowledge are still presented as independent modules, lacking cross disciplinary courses that organically combine the two, making it difficult to cultivate students' ability to use integrated traditional Chinese and Western medicine thinking to solve clinical problems. ”Zhang Guomin, Secretary of the Party Committee of the School of Integrated Chinese and Western Medicine at Hunan University of Traditional Chinese Medicine, is also quite concerned about this. He called on the education authorities to take the lead in organizing experts to develop national standards for the curriculum of integrated traditional Chinese and Western medicine majors, clarify the reasonable ratio of traditional Chinese medicine and Western medicine courses, and encourage universities to develop interdisciplinary courses in integrated traditional Chinese and Western medicine. The development of integrated traditional Chinese and Western medicine courses relies on the organic integration of theory. So, how do two completely different types of medicine merge from the 'roots'? Professor Zhang Junhua from Tianjin University of Traditional Chinese Medicine believes that at the theoretical level, it is necessary to establish the concept of "the way of traditional Chinese medicine governing the techniques of Western medicine" proposed by Academician Tang Zhaoyou, which is guided by the holistic concept of traditional Chinese medicine, syndrome differentiation and treatment, and disease prevention. At the same time, it is necessary to integrate the methods, techniques, and pathological cognition of Western medicine in order to achieve the integrated development of Chinese and Western medicine. Bian Yuhong pointed out that in terms of methodology, it is necessary to achieve language exchange and bridge the gap between Chinese and Western medical language through top-level design, such as using modern science to explain the mechanism of action of traditional Chinese medicine and the corresponding phenotype terminology of syndromes; Promote innovation in evidence-based medicine and establish evidence-based evaluation methods that are in line with the characteristics of traditional Chinese medicine. As a medical major with strong practical attributes, there are shortcomings in the practical teaching of integrated traditional Chinese and Western medicine. Bian Yuhong stated that there is currently no specialized training direction or base for integrated traditional Chinese and Western medicine in the standardized training of resident physicians. This situation poses significant constraints on the cultivation of long-term talents in the integration of traditional Chinese and Western medicine. Although some universities have attempted to offer related long-term programs, due to the imperfect practical training system, their degree granting is still mainly focused on academic master's and doctoral degrees, and the granting of professional master's and doctoral degrees faces significant limitations. After graduating with an academic master's or doctoral degree, if you want to engage in clinical work, you need to participate in standardized training after joining the company, which undoubtedly prolongs the training period for clinical talents. ”Bian Yuhong suggested that the barriers between traditional Chinese and Western medicine should be broken down through top-level design, and the talent training system should be continuously improved. For example, specialized training bases for the integration of traditional Chinese and Western medicine should be established in tertiary hospitals to provide a coherent and systematic practical training path for talents. Open up exclusive tracks and expand career development space. Search for keywords such as "integrated traditional Chinese and Western medicine" on a certain social platform, and a series of articles such as "how difficult it is to find employment in clinical practice of integrated traditional Chinese and Western medicine" to express the hardships of integrated traditional Chinese and Western medicine employment. Most graduates who share their job search experiences with a combination of traditional Chinese and Western medicine, like Li Kaixuan, have entered the traditional Chinese medicine departments of traditional Chinese medicine hospitals or Western hospitals, and rarely have the opportunity to enter the "circle" of Western medicine. Although current laws and regulations on health and traditional Chinese medicine do not prohibit TCM practitioners from practicing in the Western medicine departments of Western hospitals, the integration of traditional Chinese and Western medicine is generally classified as part of TCM, and many Western hospitals are not inclined to recruit graduates with a background in TCM. ”A source familiar with the matter working at Beijing Third Class West Hospital told reporters. He revealed that there are two reasons for this: firstly, the admission scores for integrated Chinese and Western medicine majors in the college entrance examination are relatively lower than those for pure Western medicine majors, which to some extent means that there is a difference in the quality of student sources; The second issue is that the mentor system for the integration of traditional Chinese and Western medicine is not yet complete. For example, a doctoral supervisor evaluating Western medicine requires a national level project, while a doctoral supervisor evaluating the integration of traditional Chinese and Western medicine only needs a provincial or ministerial level project. This may mean that there is a slight gap in the mentor's ability to guide students in scientific research. The scope of physician practice is not clear enough, which may result in the inability of integrated traditional Chinese and Western medicine professionals to work in the clinical departments of Western medicine in comprehensive hospitals. ”Li Yi, the director of Yueyang Integrated Traditional Chinese and Western Medicine Hospital affiliated with Shanghai University of Traditional Chinese Medicine, stated that practicing physicians in the traditional Chinese medicine category are divided into TCM, integrated traditional Chinese and Western medicine, and ethnic medicine majors. Among them, traditional Chinese medicine is subdivided into 18 sub specialties such as internal medicine, surgery, and gynecology, but the integrated traditional Chinese and Western medicine specialty is not subdivided. Over time, this may lead to a weakening of the development of integrated traditional Chinese and Western medicine disciplines, "she said. Even if they squeeze through the "single plank bridge" of employment, the situation for practitioners of integrated traditional Chinese and Western medicine after joining is quite awkward. The integration of traditional Chinese and Western medicine does not have an exclusive development path independent of traditional Chinese medicine and Western medicine. ”The aforementioned insider told reporters that in the evaluation, promotion, and project applications after joining, the Pure Western Medical Department accounts for more than 70%, and the Pure Traditional Chinese Medicine and Integrated Traditional Chinese and Western Medicine departments share a small number of vacancies. In the fierce competition, some doctors who combine traditional Chinese and Western medicine have been unable to be rated as deputy chief physicians for many years. The evaluation system for the integration of traditional Chinese and Western medicine is also not yet perfect. The insider also pointed out that for Western medicine, when evaluating professional titles, a series of quantitative indicators and fixed standards such as outpatient volume and clinical work time are examined, which is relatively easy to record and evaluate. But for integrated Chinese and Western medicine doctors, problems arise one after another: many integrated Chinese and Western medicine doctors are distributed in traditional Chinese medicine or Western medicine departments. How to define which clinical work falls within the scope of integrated Chinese and Western medicine, and how to include it in work hours; How to quantify the unique value of combining traditional Chinese and Western medicine in diagnosis and treatment, such as improving quality of life and controlling long-term costs... "These are all issues we need to consider," he said. Only by establishing an independent evaluation system