A research on healthcare market in China covering topics including an introduction of Public Hospital System, Chinese Physicians' Work Condition and Salaries, as well as Continued Medical Education system.

1. Healthcare Market in China
Ziqian WANG
mail@ziqianwang.net

2. Introduction of Healthcare Market in China
An overview of the healthcare market
The hierarchy of the medical system
Public hospitals
Physicians’ work condition and salaries
Outpatient patient consultation
Medical Insurance System in China
The development of the system
Universal healthcare insurance
Continued Medical Education for Physicians in China
CEM policy and credit system
Major issues of CME activities
Accreditation criteria for national CME courses
Table of Contents
2

3. An overview of the healthcare market in China1
• From 2004 to 2011, healthcare market in China increased by 18% annually
• The public expense on healthcare in China is still quite low, accounting for only 5% of total
GDP. This percentage could increase to 6,5 – 7% by 2020.
• The market is largely monopolized by the public hospitals:
44%
18%
38%
Government Other organisations Private
The number of public
hospitals accounts for
62% over the total
number
The total amount of
service provided by
private hospitals only
accounts for 9% in 2011
Only 1% of the private –
owned hospitals are the
so called « Tier 3A
hospitals » in China
3

4. The hierarchy of the medical system in China
National Health and Family
Planning Commission of the PRC1
Provincial Health
Commission
Municipal Health
Commission
Tier 1 hospitals
- Responsible for assessing
the Tier 1 hospitals
- Managed by the Provincial
Health Commission
- Get financed from the
regional government funding
Tier 3 and Tier 2
hospitals
- Get financed from the
regional government funding
Tier 3 A+
- Responsible for assessing
the Tier 3 and Tier 2
hospitals
- Managed by National Health
and Family Planning
Commission of the PRC
- Responsible for assessing
the Tier 3 A+ hospitals
- The top level of the
health management
system in China
4

5. Public hospitals in China1
• The public hospitals in China are not pure non-profit organisations (In reality)
– Public funding only covers part of hospitals operational expenses
– Public hospitals have to and are allowed to generate and keep the profits in order to cover all their
operational expenses.
– However, public hospitals have to declare the total amount of salaries as well as the bonus they distributed
to doctors to Health Commissions. Health Commissions will assess this amount with other relating
governmental departments to set the total amount of salaries that hospitals could distribute to doctors in
the next year. The bonusdistributed under this amount is allowed.
– Hospitals’ research expenses are mainly from some specific public funding, aiming at supporting the
scientific researches. Hospitals can apply for these funds from the National Health Commission or from
other governmental organisations.
• However, in theory, China’s hospitals should be non-profit organisations, meaning that they have to distribute
all their incomes back to the public funding. However, since the financial supports from the public funding are
too limited, which can hardly support public hospitals’ daily operations, it has become an unspoken rule in the
health system in China that public hospitals have to find their waysto generate profits in order to maintain their
day-to-day operation. Different from what the public believes, many public hospitals in China are suffering from
losses everyyear.
• Cash generators in public hospitals
– Registration fees
– Treatment fees
– Inspection fees
– Drug sales
5

6. Classification of Chinese hospitals
• In China, hospitals are classified into 3 tiers, which are Tier 1, 2 and 3.
• Each tier will be further classified into three sub-tiers, which are 甲 (Jia = A), 乙(Yi = B),丙
(Bing = C).
Tier 3 3 B
3 A
3 C
Tier 2 2 B
2 A
2 C
Tier 1 1 B
1 A
1 C
Tier 3 A+2
- Comprehensive or general hospitals1
at the city, provincial
or national level with a bed capacity exceeding 500.
- Responsible for offering specialist service, conducting
scientific research to solve major medical challenges and
providing medical education for 1 and 2 tier hospitals.
- Mainly national and provincial major hospitals or affiliated
hospitals of major medical universities.
- Regional hospitals providing medical services across several
communities.
- Provide medical trainings and limited medical education to
tier 1 hospitals.
- Hospitals mainly affiliated with medium or small cities,
counties or districts in big cities.
- Directly provide medical service to communities regarding
disease prevention, recovering and other health care
services
- Township hospitals in rural areas and community hospitals
in big cities
- Hospitals with the most advanced facilities and able to
provide medical services to the top governmental leaders
- Assessed by National Health Commission
Have very strong
influence on lower
- tier hospitals with
regard to new drug
publicizing
Rarely exist in big
cities such as
Beijing and
Shanghai
6

7. Chinese physicians’ work conditions and salaries1
• All physicians working at public hospitals are salariedby the hospitals.
• The majority of doctors in China (88.4%) are not satisfied with their salaries; 3.8% hold neither positive nor negative
opinions; Only 7.8% are satisfiedwiththeir salaries.
• The doctors in Beijing enjoy the highest annual salaries on average, earning over 100,000RMB annually. Shanghai and
Guangdong are number two and three, withan average of salaries over 80,000RMB annually.
• Doctors’ salaries are composed of basic salaries, hospitals’ and departments’ pay for performance, dividends from
pharmaceutical companies, incomes from training and researches as well as other incomes.
• The top 3 factors that are believed to impact doctors’ salaries most are “hospitals’ and departments’ pay for performance”,
“job titles and working years” as well as “economic context in the region”.
• However, as the amount of basic salaries and pay for performance from the department and hospital in some cases is very
limited, the dividends from pharmaceutical companies and the so called “red package” could be fundamental of physicians’
salaries insome hospitals.
47.70%
27.40%
17.70%
4.40%
1.60% 1.20%
Basic salary Hospital Pay for Performance
Department Pay for Performance Dividends from pharmaceurical companies
Rev from training and research Others
The composition of doctors annual salaries
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
Hospital or department bonus
Job titles and working years
Economic situation in the region
The scale of the hospitals
Workload
Specialty knowledge and medical …
Others
81.2%
60.4%
53.0%
44.1%
33.5%
17.5%
10.3%
Main factors impacting doctors' annual salaries
7

8. Chinese physicians’ work condition and salaries1
0 1000 2000 3000 4000 5000 6000 7000 8000 9000
Cardiothoracic surgery
Neurology
Geriatries
Gastroenteralogy
Intensive Care Medicine
Anesthesiology
Urology
Oncology
Emergency
Internal Medicine-Cardiovascular
Stamatology
Resparitory
Nephrology
General Surgery
Infectious Disease
Orthopedics
Pediatrics
Physical Medicine and Rehabilitation
General Neurosurgery
Hematology
OBGYN
Immunology - Rheumatology
Mental health
Otorhinolaryngology
Imaging & radiology
Endocrinology
Ophthalmology
Dermatology & sexually transmitted disease
General medicine
Surgery
Traditional Chinese Medicine
GPs
8898
8877
8874
8743
8636
8627
8563
8491
8454
8425
8384
8346
8328
8293
8243
8051
8000
7979
7952
7909
7836
7833
7784
7764
7755
7622
7615
7579
7510
7453
6688
5938
• The top 5 departments earning the
highest annual salaries are Departments
of Cardiothoracic surgery, Neurology,
Geriatries, Gastroenteralogyand Intensive
Care Medicine.
• The bottom 5 departments earning the
lowest annual salaries are Departments of
Dermatology & Sexually Transmitted
Diseases, General Medicine, Surgery,
Traditional Chinese Medicine as well as
GPs.
• Moreover, nearly 73% of Chinese
physicians work over 9 hours per day.
• 100% of physicians working overtime at
Tier 3A hospitals in big cities such as
Beijing and Shanghai
Ranking of the departments by annual salaries/ Euros2
27.0%
67.5%
4.9% 0.5%
below 8 hrs 9 - 12 hrs 13 - 16hrs over 16hrs
Physicians’ working hour per day
8

9. Outpatient consultation in China
Step 1
•The patient can briefly explain his/her health problems to the nurse at the consultation
desk, who will provides guidance on to which departments of specialties patients could
go for consultation. However, the final decision will be made by patients. (Optional)
Step 2
•The patient asks an appointment with the physicians they would like to visit and pays for
the registration fees
Step 3
•If it was the first time that the patients come to this hospital, they have to buy a
consultation notebook used for physicians only in this hospital to write down patients’
medical records (This notebook cannot be used across different hospitals)
Step 4
•Waits for the consultation according to the time range given on the registration ticket
Step 5
•After the consultation, physicians will give the prescriptions to patients.
Step 6
•Patients pay for all medicines on the prescriptions in the hospital and take the invoice.
Step 7
•Go to the medicine collection desk in the hospital to collect all their medicines with the
invoice.
Issue 1:
In China, patients don’t go through the
process for the consultation with GPs and
approach to the specialties according to
their guidance. In fact, they ask the
appointments with some specialties based
on the understanding of their own illness,
leading to the waste of professional
resources in many regards:
- Go to specialties to deal with issues
that GPs could deal with
- Approach the wrong specialties due to
the wrong conception on their own
diseases
Issue 2:
Limited Professional Resources vs
Extremely High Demand
- The top physicians are highly
concentrated in a few Tier 3A hospitals
in some big cities such as Beijing and
Shanghai. Patients coming from all the
other regions in the country plunge
into this limited number of hospitals.
Issue 3:
- The consultation fees in China are very
low, normally ranging from 3-70RMB in
public hospitals, an equivalent of 0,35 –
8,25 euros. Due to the lack of public funds
from the gov and the very low
consultation fees, many public hospitals
true to drugs to increase their profits.
9

10. Introduction of Healthcare Market in China
An overview of the healthcare market
The hierarchy of the medical system
Public hospitals
Physicians’ work condition and salaries
Outpatient patient consultation
Medical Insurance System in China
The development of the system
Universal healthcare insurance
Continued Medical Education for Physicians in China
CEM policy and credit system
Major issues of CME activities
Accreditation criteria for national CME courses
Table of Contents
10

11. The development of the medical insurance system in China
• 1950s - 1970s: 1
– Half a billion people
– Most of them are young – 36% age less than 15
– 80% rural
– 1/3 Illiterate
– Living absolutely in poverty
– Rural residences have access to basic health services under cooperative medical schemes
– Urban: work unit based health insurance either through the Labor Insurance System or the Government Insurance
System
• 1980s – 1990s:
– Urban area: implementation of user fees as public funding declined
– Rural area: the dissolution of rural cooperatives and association of cooperative medical schemes with the radicalism
of the Cultural Revolution caused insurance coverage levels in rural areas to drop to 7% of counties by 1999
– The majority of China’s population did not have health insurance between 1980 and 2000
– Supply-side subsidies typically covered less than 10% of provider expenses, with the remainder earned through fee-
for-service payment from uninsured patients.
• Nowadays:
– A population of 1,3397bn by 2010
• Aging: 13,3% over age 60 and only 16,6% below age 15
• Half (49,7%) urban; 96% literate
Demographic change:
11

12. The development of medical insurance system in China
• The transition of disease burden in China
– China’s primary burden of disease has shifted definitively from infectious to chronic non-
communicable disease
– However, the burden for some infectious diseases such as TB remains large
– Cancer, heart conditions and cerebrovascular diseases are now top killers
– Hypertension is the leading preventable risk factor for premature mortality in China, accounting for
2,33 deaths in 2005
– By in 2007 – 2008, the age-standardized prevalence of diabetes among adults in China was 9,7
percent, with the majority of patients undiagnosed and untreated
– China’s health system faces the challenge of transitioning from focus on acute care and control of
communicable disease to a system supporting prevention and cost-effective management of chronic
disease
12

13. Universal
Healthcare
Insurance System
Urban Residence Urban Workers Rural Residence
Other Healthcare
Insurance
Overview of China’s Universal Healthcare Insurance System
Population Coverage:
237 million
Population coverage
rate in 2010: 97%
Target people: Urban
workers and retiring
workers
Population coverage:
194 million
Population coverage
rate in 2010: 97%
Target people: Children,
students, unemployed
urban residence
Population coverage:
836 million
Population coverage
rate in 2010: 95%
Target people: farmers
Population coverage:
2600 million
Population coverage
rate: 100%
Target people: civil
servants and soldiers
13

14. Structure of the universal healthcare insurance system in China1
A
Tax
Public Fiscal
Budget
Public Health
Service
Bed expense, inspection expense,
drug expenses, treatment costs,
proportion of import organ or organ
transplanting expense and other
expenses
- Working employees:
- Personal contribution: 2% wage per month
- Enterprises contribution: 6% wage per month
- The retired: Don’t need to contribute any more
Urban comprehensive
medical care scheme
Personal
contribution +
30% enterprise
contribution
70% enterprise
contribution
Individual
Account
Society Plans
Outpatient expenses or under deductible line or according to lists of illnesses
Inpatient expenses or above deductible line or according to lists of illnesses
Contributions from farmers : Minimum 50RMB (€6) annually per person since 2012
Contribution from village commission : Minimum 240MB (€29) annually per person since 2012
New rural
cooperatives
medical services
Basic medical care and Prophylaxis
B
C
A: Civil Servants & Staff working for public institutions B: Urban workers, C: Rural Residence
14

15. Healthcare insurance policies in China
• All the health care insurance funds are administrated by provincial governments, leading to an issue that
patients have to pay by their own money for all health care costs and cannot get immediate
reimbursement. Sometimes, the reimbursement across provinces can delay by several months.
• The health care insurance policies vary by cities, for example the threshold of the amount that patients
can get reimbursed. It mainly depends on the local economic context.
• Health care insurance policies in Beijing:
– Both industries and public organisations have to pay the medical expenses by individuals until the
expenses reach a threshold (varies by tiers of the hospitals). Patients can get reimbursement when
their medical expenses are over this amount.
– The part of medical expenses covered by Universal health insurance system will be paid by hospitals
first. And hospitals will get reimbursed afterwards.
Hospital Types Medical Expenses Individual Insurance
Tier 3 X - 10 000 80% 20%
10 000 - 30 000 85% 15%
30 000 - 40 000 90% 10%
Over 40 000 95% 5%
Tier 2 X - 10 000 82% 18%
10 000 - 30 000 87% 13%
30 000 - 40 000 92% 8%
Over 40 000 97% 3%
Tier 1 X - 10 000 85% 15%
10 000 - 30 000 90% 10%
30 000 - 40 000 95% 5%
Over 40 000 97% 3%
Health insurance policies for urban workers in Beijing
This is the health care insurance policies
for Urban workers in Beijing (Group B in
the graph on the previous page).
However, the percentage of
reimbursement for this group of people
may be a little different from what it is
shown here. The health insurance policies
to the public institution workers and civil
servants as well as that to rural residences
are different from this one.
15

16. Introduction of Healthcare Market in China
An overview of the healthcare market
The hierarchy of the medical system
Public hospitals
Physicians’ work condition and salaries
Outpatient patient consultation
Medical Insurance System in China
The development of the system
Universal healthcare insurance
Continued Medical Education for Physicians in China
CEM policy and credit system
Major issues of CME activities
Accreditation criteria for national CME courses
Table of Contents
16

17. CME policy in China
• All the doctors and nursesin China are obliged to participate in continuing medical education
• Accreditation distributingauthorities: National CME committees and Department of CME (provincial or municipal)
• Overallstructure of CME system in China
The Ministry of Health
The Bureau of Health
(Provincial)
The Board of Health
(Regional)
Steering Committee of CME (1996)
Academic Subgroups
Department of CME
Academic Subgroups
CME Bases
Office of CME
Office of CME (Hospital)
Chinese
Medical
Association
• Overall Planning & Policy Making
• Approving State Level CME Courses
• Organizing the Development of Teaching
Materials
• Managing Distance Learning System
• Evaluating & Instructing
• Local Planning
• Approving Provincial Level CME Courses
• Managing CME Bases
• Evaluating & Instructing
• Implementing CME Programs
• Running the CME Base
• Courses Arrangement
• Managing Credit
• Organizing Hospital Level CME Courses
• Running the CME Base
• Services
17

18. CME Credit System in China
• According to the policy issued by Chinese National Health Commission, all doctors and nurses are obliged to earn
at least 25 credits annually, including 5-10 credits in category I and 15 – 20 credits in category II. Doctors working
in health care organisations on provincial or municipal levels have to pass the exams and earn at least 10 credits
from CME programme on national level. Credits in Category I and Category II are not interchangeable.
• Credit Categories:
– CategoryI:
1. National CME programme: programmes assessed, authorized and published by national CME commission ;
programmes applied by national CME organisations and published by national CME commission.
2. Provincial CME programme: programmes assessed, authorized and published by provincial CME
commission; programmes applied by provincial CME organisations and published by provincial CME
commissions; programmes applied by the sub – associations of Chinese Medical Association, Chinese
Stomatological Association, Chinese Preventive Medicine Association, Chinese Nursing Association, Chinese
Hospital Association and Chinese Medical Doctor Association and authorised by the associations mentioned
above
3. Promotional programmes: programmes aiming at providing healthcare workers with professional trainings
designed for emergency events and other necessary trainings such as those on professional ethics in the
industry; programmes authorised by national health commission and provincial health commission.
– Category II: self – study, publishing medical papers, conducting medical researches and other academic
activities.
18

19. CME credit system in China
• Category I:
• Category II:
– Self – study on relevant specialties: reflections reviewed and authorised by the dean of the department in
the hospital are eligible for crediting. 1pt = 2000 characters
– Self – study on materials including magazines as well as video and audio materials drawn up by national
CME commission or provincial CME commissions, the credits are assigned according to crediting policy set
by the commission.
– Papers published:
• Foreign publications: 10 – 8 credits
• National publications: 6 - 4 credits
• Provincial publications: 4 – 2 credits
• Internal publications: 2 – 1 credits
Participants Key speakers
National Programmes 1pt = 3hr 2pt = 1hr
Provincial Programmes 1pt = 6hr 1pt = 1hr
National eLeaning Programmes 1pt = 3hr
19

20. CME credit system in China
– Authorized scientific medical researches: credits will be assigned to researchers based on their ranking in the scientific
researches by their responsibilities:
• National researches: Ranking: 1, 2, 3, 4, 5 – Credits: 10, 9, 8, 7, 6
• Provincial researches: Ranking: 1, 2, 3, 4, 5 – Credits: 8, 7, 6, 5, 4
• Municipal researches: Ranking: 1, 2, 3, 4, 5 – Credits: 6, 5, 4, 3, 2
– Publish medical literary work
• Reports on international and national medical conferences: 1pt – 3000 characters
• Publish medical translating articles: 1pt – 1500 characters
– Scientific conferences, instruction on operations and promotion of new technologies organised by the health
organisations where health workers work: (Participants can only be granted up to 10pts per year)
• Speakers: 2pt – 1 time
• Participants: 0,5pt – 1 time
– Clinical Pathology Symposium, case study organised by several departments: (participants can only be granted up to
10pts per year)
• Speaker: 1pt – 1 time
• Participants: 0,5pt – time
– How credits assigned in eLearning medical education is based on the specific regulation set by provincial or municipal
health commissions.
• Authorised medical training in superior medical organisations (including training abroad) over 6 months:
– If the concerning people pass all necessary exams, it is regarded that they get all the required 25 credits in the year.
20

21. Credit registrations and distribution of CME medical certificates
• Creditsregistrations:
– The organisers of the programmes grant credits to the participants. Participants’ working organisations are
responsible for registration.
– Provincial and municipal health organisations are responsible for printing and distributing the CME
registration cards or implementing the electronic information system, both of which should include the CME
programme number, data, name of the programme, entities of the concerning organisations, credits, results
as well as the corporate stamps. The registration cards should be under the management of physicians or
nurses themselves and could be used as the proofsfor their enrolment of the CME activities.
– Organisations responsible for CMEs should make a record of participants’ performance and the total number
of credits they earn. This record should be taken as one of the most important criteria in the annual
appraisal. The qualification of CME should be the prerequisites amid of the recruiting, promotion, and re-
registration.
• Supervision on creditsregistrations:
– Certificates to national and provincial CME programmes are made respectively by national or provincial CME
committees. Authorized associations or organisations could also make such certificates, but based on the
format regulated by the national CME committee.
– Regarding the certificates to Distance Learning of CME in category I, organisers should first provide
participants with relevant learning materials. After the materials have been evaluated by the Department of
CME on provincial level, the Department could grant the certificates to the concerning participants.
– The CME activities, which are organised on national level or by the authorized associations and are
published by the national health commission, should be under the supervision of the Department of CME in
the particular province where the events are held. The organisers are obliged to report the CME materials to
the Department. 21

22. CME coverage in China
• The coverage rate of CME has reached 85% by 2010,
successfully achieving the goal of the 11th 5-year national
plan in China. It is expected that this rate will reach 100%
by 2015 according to the 12th 5-year national plan. 1
• It is also expected that the rural doctors’ pass rate in CME could reach 80% by 2015, and this rate
could reach 70% for those in remote rural areas or in western part of China.
• Until the end of 2011, there were up to 750,000 health workers are enrolled into the national
Distance Leaning2 CME programmes. Alongside the national programmes, over 3,000,000 health
workers participate into the provincial or municipal Distance Leaning CME activities.3
• According to a survey, 95% of clinical health workers say that Internet CME is the most preferred
way forthem to get involved into the CME activities. 3
• To develop Distance CME activities in China:
– Only five units are licensed by the Chinese Ministry of Health for the Distance Learning of
CME. (National Level of distance CME activities)4
– Credits earned on Internet CME websites that are authorised on provincial or municipal level
may be authenticated in other provinces or cities.
70%
80%
90%
100%
Y2010 Y2015
85%
100%
22

23. Distance CME activities
• Internet CME courses
• Satellite transmission
23

24. 618
554
357
224
203
137
118
111
110
92
85
83
4 4
0
Geography Distribution of CME Courses,2009
Major issues of the current CME systems – Imbalance
Development Among Different Provinces
24

25. Major issues of the current CME systems
Major complains to CME course among 700
physicians in Beijing
• Monotonous content
• Few consideration of the differences in physicians’ knowledge level
• Backward teaching methods
• Outdated knowledge
• Few apply of educational theories
• Insufficient of patient – centred
related courses
• Challenges in Rural Area
– Staff aging: Transform from
barefoot doctor; Lack of staff
recruiting
– Low academic level
– Geographically dispersed
0%
5%
10%
15%
20%
25%
30%
Not related to
current clinical
practice
Low accessibility
to Base
Course out of
date
Dull teaching
methods
26%
24%
14%
10%
25

26. Accreditation criteria for national CME courses
• The prerequisite requirements to apply for the national CME courses (the courses must fulfil one of the
requirements below): Category I CME courses
– Courses introduce the most advanced in the field with China or around the globe
– The latest progress of interdisciplinary
– The introduction and the publicisation of the advanced international technology or research results;
Or the introduction and publicisation of the advanced technology or research results in China.
– Training and programmes designed for coping with the public health emergencies or fulfilling the key
demands emerged amid the revolutionary developments of the Chinese health system.
– Courses could compensate for the blank in a field in China and focuses on a technology or method
that could generate significant social and economic benefits
• Eligibility for candidates to apply for developing the national CME courses
– Health medical, educational and scientific organisations could apply for developing the national CME
courses by following the application procedure. Other organisations have to first get the application
eligibility first from the National CME Committee.
– People in charge of the national CME courses should have Deputy Senior professional positions. The
programmes for which they are responsible should be related to their specialties. One person can
apply for at most 2 national CME courses under his/her charge in the same year.
26

27. Accreditation criteria for national CME courses
• Procedure to apply for the national CME courses
– The organisation should first hand in the application forms to the provincial or municipal CME committees.
After the assessment, the provincial or municipal CME committees will recommend the CME programmes to
national CME committees.
– Associations already having the qualifications to apply for the national CME courses, such as Chinese
Medical Association, Chinese Stomatological Association, Chinese Preventative Medicine Association,
Chinese Nursing Association, Chinese Hospital Association, Chinese Medical Doctor Association and the CME
Committee of Health of Ministry, should hand in their proposals of the next year CME courses to National
CME Committee; The affiliated organisations of National Health Commission should directly apply for the
next year CME courses to National CME Committee.
– Programmes initiated by National CME Committee, National Health and Family Planning Commission of PRC
in the need for the public health emergencies and revolutionary development for Chinese health system
should be directly applied to National CME Committee.
– The eligibility for the accreditation of the national CME courses is 2 – year. If the courses are held in the
second year, the organiser should hand in an application to national CME committee in order to reserve
their eligibility to organise the course in the next year.
– The application time for all national CME courses is between July and September. The organiser should fill in
the application form and apply for the eligibility to conduct the courses according to the application
procedure.
• Accreditation
– National CME Committee and National Health and Family Planning Commission will review and publish the
accreditation results.
– National CME Committee will publish the results of the accredited national CME courses from the end of the
year to February in the next year.
27

28. Accreditation criteria as an organisation to provide national
distance CME activities
• The prerequisite requirements
1. The organisation must have acquired the authorization of the relevant governmental
departments to work in the field of reporting health related information.
2. Have at least 2 year experience to develop and organise online CME courses
3. The CME system (developing system, education operational system, learning support
system, education management system, internal quality assurance system) is already
established and under the operation.
4. The organisation has enough resources to meet the education demands. The
organisation should possess the online media library, courseware library, question
bank, and learning – material database.
5. Possess a team of educational staff with different expertise, including instructors, tutors,
editors and developers.
6. The distance education platform should be able to adapt to the continuing development
needs of CME, possess optimised technology, and effectively develop the interactive
teaching method.
• Application time
– Each year, candidates should hand in the applications from 1 March to 15 May to the
National CME Distance Educational Centre.
28

29. • Accreditation Procedure
– The assessment of the candidates will be organised once every year and the procedure
includes material audit, site evaluation and result verification.
1. Material Audit: applications are regarded as invalid in the situations below
• It is impossible to have a knowledge of candidate organisation’s basic situation, or
the candidate organisations don’t fulfil will all the prerequisite requests
• The application materials are different from the proof materials
2. Site evaluation
• The ministry of health will send professionals to the organisations to evaluate the
real situation.
3. Results verification
a) The National CME Distance Education Centre will publish the organisations that
have successfully passed the assessment. And the organisation can acquire both
the eligibility to apply and organise the distance CME activities.
b) Organisations not passing the assessment don’t have the eligibility to apply for the
National Distance CME activities.
c) Organisations not passing the assessment have to reapply for the eligibility after
one year.
29
Accreditation criteria as an organisation to provide national
distance CME activities