Mon, Aug 13, 2001 page2

• The mystique of med school

  From today's cut-throat competition among cram schools for aspiring doctors to to the days when wealthy parents would match their daughters with young physicians, there is a long history behind Taiwan's craze for medical school

  • By Lindy Yeh / STAFF REPORTER
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  This year's Joint College Entrance Examination is over and students received their results on Thursday. But for the city's bushibans, or cram schools, the battle has just begun.

  A bushiban's reputation rests not simply on the overall acceptance rate of its students into the nation's universities, but also depends on the number of its students who win acceptance to medical school.

  

  On Taipei's Nanyang Street, popularly known as ``Cram School Street,'' a young woman reviews the list of candidates admitted to departments of medicine after the last Joint College Entrance Examination.

  PHOTO: GEORGE TSORNG, TAIPEI TIMES

  In particular, the bushiban which enjoys the highest entry rate to National Taiwan University (NTU) medical school is almost certain to be the year's biggest business winner. With a high acceptance rate to NTU and other medical programs, a bushiban can easily attract bright students who missed the grade, on whom the bushibans thrive.

  "In order to attract the best students, the bushibans offer financial incentives to students whose joint exam results are above a certain threshold [but lower than they hoped for]. Many bushibans offer a program targeted toward these aspiring doctors, called the National Medical School Guarantee Program (國立醫科保証班), which is highly selective and sometimes give full scholarships.

  Buying students

  In some special cases -- such as students who gained admission to second-tier medical departments or schools -- the bushibans might offer them tens of thousands of NT dollars in scholarships to participate in the guarantee program and sit the entrance examination one more time. If these same students gain admission to NTU's medical school, they will sometimes be given an additional bonus from the bushibans, often as much as tens of thousands of dollars.

  Rulin bushiban (儒林補習班) is the largest short-term cram school chain nationwide, with its 10 branches yielding 19 students bound for NTU medical school this September. Rulin sets the threshold for its tuition-free guarantee program at above 495, whereas its biggest competitor, Jianru (建如補習班), sets its minimum score at 490.

  The director of Rulin's guarantee program, Chou Ming (周明), said the reason for setting their minimum five points higher is simple.

  "This year's lowest acceptance score for a medical school [which was for Chungshan medical college] was 495," Chou told the Taipei Times.

  The maximum score on the test is 600.

  Despite the investment the bushibans put into the scholarships for the guaranteee programs, the course yields big rewards for the cram schools as a high rate of medical school admission attracts students cramming for other fields.

  While using financial incentives to attract students is common knowledge, bushibans that offer the incentives are reluctant to speak on the record about the practice because as one school ups an offer, the others are forced to follow, making students more inclined to bargain.

  Playing fair?

  Liu Kuang-heng (劉廣衡), director of the guarantee program at Jianru, which has only a single location in Taipei and boasts 12 students who are headed to NTU medical school this year, told the Taipei Times there are some students he will never able to recruit.

  "We tend to offer less money than other programs which is why we won't be able to attract students who have a tremendous interest in discussing money conditions. But there are some parents who have a skeptical attitude toward what money implies in this business and they are our clients.

  "Times have changed. We must face the reality that children today are thinking differently from those of the past. Don't forget that being a physician is a lucrative career, and that's what our students are striving for," Liu said.

  Chou echoed Liu's remarks.

  "Offering financial incentives is irrelevant in this business. Money-orientated students will never achieve good results. Those bushibans which offer money to attract students have a lack of experience. They don't know what this business is about. A small amount of scholarship money is okay, but can you believe that some will actually give students NT$1 million for gaining entry to NTU medical school just so they can attract other well-performing students?"

  While Liu and Chou's comments suggest students are increasingly business-minded, it's also possible that their condemnation of money-making tactics simply reflects the industry's cut-throat competition.

  Tuition for a course of study at a bushiban is extremely expensive. At Rulin, the first semester costs NT$105,000 and the second term is NT$125,000.

  "Their results are good, because the students they recruit are bright," said a woman surnamed Huang, whose daughter is eligible for the department of Chinese Medicine at China Medical College.

  Huang told the Taipei Times that "since my daughter has been approached by so many bushibans, why shouldn't I try to get the package that is in our best interests? The decision is crucial to my daughter's future life."

  Students from the top two senior high schools in Taipei -- the Taipei Municipal First Girls Senior High School and the Chien Kuo Boys Senior High School -- who were accepted to NTU's medical school this year credited bushibans with their success. The First Girls school had 13 students make the grade, while Chien Kuo will send 16 students this fall, according to the schools' Web sites.

  A time-honored tradition

  The prestige of having a doctor in the family is a long-standing tradition in Taiwanese society.

  In the Tainan area, for example, it was common practice for wealthy parents to seek young male doctors for their daughters. Many prominent families felt that the best way to invest in their daughter's future was to carefully select her husband and they naturally gravitated toward young doctors.

  In fact, some families actually preferred young medical graduates from poor families who could not afford to open clinics on their own. The bride's family would pay for the clinic themselves in the expectation that the future son-in-law would be more obedient and faithful to his wife and her family.

  In addition to the dowry often being a well-located building for their new son-in-law's clinic, the families would also sometimes sponsor the young man's overseas study so that he might become a leading physician in the field.

  The recent engagement of the first daughter, Chen Hsing-yu (陳幸妤) whose family is also from the Tainan area, with Chao Chien-min (趙建銘), an orthopedic surgeon at the NTU Hospital and an NTU medical school graduate, might add to Tainan's reputation as being fond of doctors.

  Tainan, however, is not alone in its admiration of the NTU medical school degree. In medical circles, a position at the prestigious university's hospital is considered to be the pinnacle of a career in medicine.

  Japan's role

  Such respect for education and educational institutions is widely considered to date back to the Japanese era. According to Wu Mi-cha (吳密察), professor of Taiwan history at NTU and vice chairman of the Council for Cultural Affairs (文建會), the education system the Japanese created in Taiwan exactly met the needs of the population.

  When the Japanese colonized Taiwan in 1895, Taiwan was a largely agricultural society.

  "For Taiwanese, being materialistic people, the purpose of education was simply to learn to read, write and be able to count. Only for a few, was the final purpose to participate in the imperial examinations," Wu told the Taipei Times.

  "When the Japanese arrived, the education system they established for Taiwanese was mainly professional training, of which the two cornerstones were normal [teacher's] school and medical school. This met Taiwanese expectations of education perfectly. Through both schools, jobs were secured and the doctors' income was guaranteed " said Wu.

  "Besides, when a young man finished his medical education and returned to his hometown to open a clinic, he was received by the townsmen or villagers as a hero and naturally became a member of the local elite and a community leader as well.

  "They not only saved lives but were also consulted by the townsmen on many kinds of matters. This fact also explains why a significant number of doctors were killed by the KMT during the 228 massacre, because they had to stand up and speak for their townsmen as local political and social leaders " said Wu.

  "The glorious and respected social status of doctors [today] comes from such a historical background."

  The 228 Incident was caused by resistance from indigenous Taiwanese in 1947, two years after the Japanese withdrew and Taiwan was taken over by the KMT.

  Wu also said that a common belief shared today -- that medical study became the favored career choice for Taiwanese because subjects like law and political studies were not allowed under the colonial regime -- is not true.

  "I'll tell you why -- it's because law and political studies were regarded as useless subjects that wouldn't bring a materialistic reward. Look at Koo Chen-fu (辜振甫) [a top Taiwanese negotiator with China and a son of the highest indigenous administrator, Koo Shien-rong (辜顯榮), under the Japanese regime, he graduated from Taipei Imperial University's department of political science in 1940 and later studied financial, industrial and business management in Japan]. He could afford to study subjects regarded as useless, because he didn't need to make a living," said Wu.

  The Taipei Imperial University later became the National Taiwan University.

  The history of NTU's medical school dates back to 1895 when the Japanese established Taiwan Hospital at Tataocheng (大稻埕) in 1895, an old district of Taipei city. In 1897, the Medical Institute ancillary to the hospital was established and recruited 30 students. After several transformations, in 1936 the Medical Department of the Taipei Imperial University was created.

  The next generation

  Today, not only has time changed, but society has also diversified. Children today are interested in various professions, both the old and the new, the outdated and the fashionable, but many of the best students still struggle to go to medical school. Why?

  "It's due to a very conservative and defensive mentality on the part of Taiwanese parents," said Wang Hao-wei (王浩威), a psychiatrist at NTU hospital and a writer. (Wang graduated with a degree from Kaohsiung Medical College.)

  The author of The Taiwan Macho (台灣查甫人) which describes the chauvinistic but fragile characteristics of the Taiwanese male, Wang told the Taipei Times that most of the kids make their decisions under the influence of their parents.

  "Although medicine is a declining profession due to changes in the social structure, for parents, medicine is still the safest job in the sense of social status and income," said Wang.

  When asked what the common characteristics are among young people inclined to become doctors, Wang said that they are usually children whose school grades are good but who lack self-confidence.

  "Since during their studies they were always leading the other [students], in order to keep leading, the easiest choice was to become a doctor. They are youths who don't tend to face challenges or take risks. This is a typical mentality of a victor. Only desperate youths are ready to take risks," said Wang.

  Two years ago, Ho Wen-yong (侯文詠), a writer of bestsellers and a former surgeon of anesthesiology at the NTU hospital, published a novel entitled The Hospital (白色巨塔) which caused a stir in medical circles.

  In this book, Ho depicts a dark and ugly picture of a hospital full of power struggles, corruption and factional infighting.

  Wang, Ho's former colleague, penned the novel's preface. Wang wrote that based on his experiences, he believes the novel draws on the NTU hospital.

  Wang said "the novel didn't exaggerate. It's even too reserved. For a profession in decline, its real face will only become uglier and uglier."
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