#storiesfromfan

While talking with Fan this Saturday, we discussed some interesting things.

One of which was the “Affirmative Action” of China

Apparently, China has a law that requires universities to let in a certain quota of minority students. If you don’t know, China has about 52 defined minority groups, most of which live in the middle or west of China. The majority Han population also happens to be heavily concentrated in the East (where most of the population is concentrated).

Additionally you may or may know that China has a HUGE range of wealth and education levels. The 1st tier cities like Beijing and Shanghai live at a very high standard of living, a high level of modernity, and generally pretty high public education (especially Shanghai whose students have tested very high on an international test called PISA). However, the interior of the country has a lower level of education and especially rural areas are still considered “third world” areas. Thus, education in rural provinces can be QUITE poor.

But, China’s college entrance process is based almost entirely off of student’s scores on a test known as the gao kao  (translation: high test). So if students have a lower education level, it’s difficult to get a score as good as a student from a big city. Not only are the fundamental education levels lower, but the poorer family lacks money to send students to extra tutoring for the exam.

So, all of this background brings us down to the fact that Chinese universities are required to except a certain amount of minority students and the students don’t have to have the same scores as their majority peers. For instance, if the regular standard is 800, the minority students could get a 600 and still get admitted. (Numbers are example only. The disparity is not clear.)

Okay. This is pretty standard. Trying to compensate for unequal distribution of societal resources by giving students with these lower circumstances a break. We essentially try to do the same thing with Affirmative Action in the USA.

Fan said that while he thinks the policy makes sense on a societal level, it’s really hard as a professor to have students with drastically different levels of ability.  Which makes sense.

But this is where it gets really interesting.

The standard stays different in college for their graduation requirements.

While majority students have to have a 70% to pass a class, minority students are allowed to pass with a 50%.

Think about this. Minority students are allowed to graduate while not having succeeded as well in their classes.

I asked Fan. I said, aren’t universities worried about sending sub-par students out into the workforce and having some companies not respect their quality of student?

Short answer: No.

Why? Because most of minority students are expected to go back to their home provinces and work. The idea is that even a sub standard education from a really good university in Shanghai or Beijing is better than a “normal” education at a university in their home province. Apparently, even only passing all your Shanghai university classes by 50% still gives you a better education than passing all your lesser universities classes by 70+%.

My second question was: why do you need this double standard. Can’t you just expect the students with a lower education level to have to study more? No, says Fan. The education disparities are so large that the students can’t necessarily compensate for it. He says some of the information that they should have learned in middle school is not the same, not information that can be fixed with some extra time in professor’s office hours. While interesting, this is frankly extremely sad.

Specifically five year olds.

At dinner a couple weeks ago, Old Fan told me that Adrianna had stayed home from school for the past two days because a student in Adrianna’s kindergarten class had been sick and they wanted to keep her home (apparently ten other children had gotten sick too).

They proudly announced to me that Adrianna was in general a very healthy child who was never sick.

In fact, the last time she was sick was when she was three. They were in the United States at the time.

Zhang started laughing. She said that they had planned to go to Disneyland with Adrianna but she was sick so she had to stay home in the hotel room with her mom while Fan and Zhang went to Disneyland to ride on all the rides.

“You’re kidding?” I said, “You guys went to Disneyland without her?!”

“Oh yes, we went on all the rides.” They were positively gleeful.

At this point, Adrianna burst into tears. “I WASN’T SICK! STOP TALKING ABOUT IT!” She got up from the table and ran into the other room.

what.....

“haha Adrianna doesn’t like to admit that she was sick” they explained.

“I WASN’T SICK!! I WANNA GO TO DISNEYLAND” screamed the irrational child as she ran into the other room.

The crocodile tears were in full swing.

I was still confused... “She doesn’t want to admit that she was sick? but she was three? I bet she doesn’t even remember it.”

“I DO REMEMBER IT! AND I WASN’T SICK. DON’T TALK ABOUT IT. DON’T TALK ABOUT IT. I WANTED TO GO TO DISNEYLAND”

“Well Adrianna, there is a Disenyland opening up in Shanghai this spring” we explained. “And it will be NEW. Newer is always better. You don’t want to go to the one in California, its old. Shanghai will be so much better.”

“NO. I WANTED TO GO TO DISNEYLAND. AND I DON’T GET SICK.” She was yelling in a combination of English and Chinese. Her grandfather and grandmother were laughing while I had my hands buried in my face whispering “Xiao haizi feng kuang le 小孩子疯狂了“  (Small children are crazy, small children are crazy)

They finally got her calmed down, but they had to promise not to mention Disneyland or her being sick. Remarkably, the tears dried up very quickly the moment they promised not to mention her darkest shame (being sick two years ago).

Remember when I went to that hospital?

Well I talked to Young Fan about the experience and he told me some enlightening information about the Chinese medical system.

1) This was mid-high level tier hospital.

We thought it looked pretty bare bones, but apparently it was actually relatively high quality.

Chinese hospitals come in different tiers: low, middle, high.

According to Fan, the low level tiers are very very busy because they are so cheap, but the skill of the doctors is also pretty low.

The mid levels are better because they’re less crowded and the doctors actually have skill.

And then the really high level ones are great, but crowded because people who can pay for the best care and the nicest facilities will.

2) Chinese doctors are good at surgery, but not all the other stuff. 

This is what Fan said. (Btw, he’s a doctor-who has been to the US too so he actually knows what he is talking about)

He explained that he believes Chinese doctors have a high level of technical skill in surgery, and he’d trust most of them with complicated procedures, but their knowledge of post-op care is lacking.

There is not a lot of attention given to patient recovery, patient mental health,  side effects or other problems. He said even for recommending surgeries, they just say: oh you need this. There is not a lot of discussion of pro and cons, possible long term ramifications.

Likewise with medicine prescription, they just give it to you. They don’t tell you about potential side effects, so patients are just left to deal with them on their own.

Likewise, Fan said that the diagnosis in lower tier hospitals isn’t very good. The doctors just know problems out of the textbook. There isn’t a lot of thinking done outside of the box--and obviously not all problems people have are cut and dry textbook situations.

3) Interns have a different role.

US hospitals use interns as staff to check on patients (and follow residents and attendings around to learn).

(I should tell you that most of my knowledge about US hospitals comes from watching Grey’s Anatomy)

But Fan says that in Chinese hospitals, there are fewer nurses on staff, and so the interns are used to record medical information in the records. Apparently they spend most of their day doing paperwork--so this means that there is less patient-doctor interaction/ patient-nurse interaction.

I wrote this before, but family members take care of the patients basic need (and wheel their gurneys from department to department).

4) No traditional Chinese medicine at Chinese hospitals.

I asked Fan about his views on Chinese medicine. He never prescribes it, he personally doesn’t believe in it.

However, if his patients tell him that they have been using something already, and he doesn’t see anyway that it can hurt them, he doesn’t mind if they keep using it.

I was curious about this because when Western enthusiasts of Eastern medicine talk about Chinese traditional medicine, they say that it is really good for certain things like pain management, nausea, headaches, diabetes, and insomnia, where as Western medicine has a lot of success with slice-and-dice problems. So I was curious if Chinese doctors were at all open to using both treatment methods ...which according to Fan they are not.