Taiwan’s Medical Graduates: Controversy and Compromise

Foreign Medical Graduates Spark Outcry in Taiwan

A wave of protests and contentious debate has engulfed Taiwan’s medical community, igniting strong feelings on both sides of a complex issue: the licensing of doctors and dentists trained abroad.

A Controversial Pathway to Practice

The controversy stems from a 2001 amendment to Taiwan’s Physicians’ Act, which allowed graduates of overseas medical programs to take the first stage of the national licensing exam.
This change spurred the growth of overseas study agencies, advertising English-language medical programs in Europe, often targeting those who couldn’t qualify for highly competitive domestic medical schools.

As more Europeans nations joined the EU, the number of Taiwanese students pursuing medical degrees abroad, particularly in Spain, the Czech Republic, Hungary, and Poland, increased significantly. This influx led to the emergence of a derisive term – “Popo doctors/dentists” – reflecting a growing sense of resentment among some locally trained physicians.

In Taiwan, the path to become a doctor is notoriously demanding. Only the top 1 percent of students who ace the national university entrance exam gain entry into domestic medical schools. These students typically take the first licensing exam during their studies, followed by an internship and the second stage of the exam.

Tensions Rise Over Qualifications and Training

The perceived differences in qualifications and training between local and overseas graduates ignited a major protest on May 31, 2009. Approximately 2,000 doctors and medical students rallied, demanding amendments to the law to limit the participation of overseas graduates in the licensing exam.

Attempts to address these concerns led to an amendment of the Physicians’ Act in 2022, requiring overseas graduates to pass a foreign degree evaluation test administered by the Ministry of Education before they could sit for the first part of the national exam. However, further controversy arose last year when the Ministry of Health and Welfare (MOHW) proposed a draft act.

This proposal would have allowed an unspecified number of overseas dentistry graduates who had already passed the first stage of the licensing exam to enroll in internships, a move that some locally trained dentists and students decried as “opening a backdoor” into the profession.

Adding fuel to the fire, the MOHW also announced a NT$2.4 billion (US$73.94 million) plan for the second phase of a rural healthcare improvement program, set to begin this year. This plan would have opened internship opportunities to overseas dentistry graduates in 55 rural areas.

A Court Case Reignites the Debate

Public anxieties surrounding the qualifications of foreign-trained doctors resurfaced this month after a court sentenced an obstetrician who had studied overseas to imprisonment for negligence causing death. The case inflamed existing tensions, contributing to a climate of distrust.

Adding to the controversy, a list of hundreds of doctors who had studied abroad was leaked online.
Local Chinese-language media reported that 41 out of 69 graduates of a specific medical program in Poland in 2021 were Taiwanese, prompting questions about their qualifications. Many voiced concerns that the system favored those with physician parents or privileged backgrounds, making it feel unfair for those who pursued traditional routes.

Seeking Common Ground: Compromise and Contention

Following the November 24 protest, the MOHW agreed to several key concessions. The annual internship quota for foreign dentistry graduates would be capped at 50, qualifications for both the foreign degree assessment and national medical licensing exam would be tightened, and only local dental graduates would be eligible for internships in 55 rural areas.

However, a local dentist alliance declared that “our revolution has not yet succeeded” and demanded that the MOHW come up with “better solutions”. On the other side of the debate, a group representing overseas graduates appealed to their local counterparts, urging them to refrain from disparaging or harassing foreign-trained doctors.

While the MOHW’s concessions represent a step towards addressing the concerns of locally trained physicians, the issue remains unresolved. Local doctors have put forth suggestions, such as increasing the capacity of domestic medicine and dentistry departments, but finding a solution that satisfies both sides of this complex debate remains a challenge.

What are the concerns ⁣raised by Taiwanese medical professionals regarding the licensing of doctors⁢ trained abroad?

## Interview: Foreign Medical ⁣Graduates and ⁢Controversy in ‌Taiwan

**Host:** Welcome back to the show, everyone. Today, we’re​ diving into a heated ⁤debate taking place in Taiwan surrounding the licensing of doctors and dentists ⁤trained⁤ abroad. Joining us to shed light on this complex issue⁣ is Dr. Lin⁢ Mei, a senior⁤ physician with over 20 years experience at Taipei Veterans General Hospital. Dr. Lin, thank you for being here.

**Dr. Lin:** ‍It’s a pleasure ‌to​ be here.

**Host:** So, Dr. Lin, can you help our viewers⁣ understand‍ why this issue ⁢has become so controversial?

**Dr. Lin:** Certainly. It all stems from changes made to the Physicians’ Act back in 2001, which allowed graduates from international ​medical programs ⁤to take the first part of Taiwan’s⁢ national licensing​ exam. This opened doors for many Taiwanese⁤ students who might not ⁤have ​qualified for domestic ⁤medical programs, which ⁤are incredibly competitive, accepting only the top 1 percent of high school graduates. [[1](https://www.jstor.org/stable/pdf/42002513.pdf)]

**Host:** That sounds like a positive step towards expanding opportunities, but there seems to be significant pushback.

**Dr. Lin:**⁤ Exactly. As more Taiwanese students pursued ‍medical‌ degrees ‍abroad, especially in European countries,‌ this led to a​ perceived disparity in qualifications and training compared to locally trained physicians. The ⁤term ‌”Popo Doctors,” ⁣while informal, reflects this resentment among some local medical‍ professionals.

**Host:** We’ve seen protests and even court cases related to this issue. Can ⁢you give us some examples⁢ of the​ specific concerns being raised?

**Dr. Lin:** Absolutely. One major‍ concern is the perceived quality of medical education in some ⁣overseas programs. There have been concerns about the ​rigor of these programs and whether⁢ they adequately prepare graduates for the demands of‍ practicing medicine in⁣ Taiwan. ‍ Furthermore, the MOHW’s proposal to allow overseas‌ dentistry ‍graduates access ⁣to internships, particularly in rural areas, sparked​ outrage, with claims it would ‘open a backdoor’ into the⁤ profession.

**Host:** It sounds like a difficult situation with strong feelings on both sides. ‍Are there any potential solutions that could‍ address these concerns?

**Dr. Lin:**⁣ Finding a solution will​ require open dialog and compromise. ‌Implementing stricter evaluations for overseas ⁤medical degrees, ⁣ensuring ‍standardized training regardless of where a⁤ doctor was educated, and addressing concerns about rural ⁢healthcare needs are all crucial steps. It’s important to remember that ultimately, the goal is to ensure ​Taiwanese‍ citizens have access to high-quality healthcare, regardless of ‍whether their doctors were trained⁣ locally or abroad.

**Host:** Dr. Lin, thank you for providing such⁣ insightful information on this complex issue. This is certainly a conversation that will continue.