China, home to the terracotta warriors, “50 shades” of hot pot, and QR codes galore, offers a rich cultural experience. Here is a guide to practicing medicine in China covering the healthcare system, medical registration, finding a job, and immigration.
Most foreign physicians who transition to practicing medicine in China will have a job offer in hand before applying for a work visa and completing their medical registration. It will likely take six months to a year from the time you accept a position before actually moving to China.
China’s Healthcare System
Most Chinese citizens have publicly funded basic medical insurance covering primary, specialty, hospital, mental health care, prescription drugs, and traditional Chinese medicine. Private health insurance is typically purchased by higher-income individuals or by employers for their employees. It is available to cover deductibles, co-pays, and coverage for expensive services not paid for by public insurance.
Private insurance is a growing market, translating to more prior authorizations, proof of clinical necessity, and peer-to-peer evaluations for high-cost services. In the past, ex-pat physicians typically only saw ex-pat patients in private clinics. China’s growing middle class is purchasing private health insurance so now many local Chinese patients obtain care in private clinics as well.
Primary care is delivered in rural clinics staffed with village doctors and community health workers, by general practitioners or family doctors in rural townships or community hospitals, or by doctors and nurses in secondary and tertiary referral centers. General practitioners are not seen as gatekeepers to outpatient specialists. The Family Medicine Physician or General Practitioner, “全科“ or “Quan ke,” is relatively new in the past five years.
Outpatient specialists are employed by and work in hospitals. They typically have a base salary with an additional fee-for-service payment.
Local physicians can order as many tests and procedures as they see fit. It is the patient’s responsibility to determine the copay for these services and decide if they are willing to pay.
Medical Registration
There is no single national governing body which regulates medical registration for international medical graduates. Medical licensure rules, regulations, and privileges vary from city to city and province to province.
Importantly, when working in China, you have to keep your US medical license active. It is your active US medical license that translates into an active Chinese medical license whose expiration dates mirrors the expiration date of your US license. The Chinese medical license you obtain is also location-specific, for example it is specific to the clinic or hospital that applied to it on your behalf.
Often job recruiters or the company/hospital hiring will help you organize and submit the paperwork. Here is the paperwork you will need to gather and prepare in advance.
Documents
Your US State Medical license, both the certificate and the pocket license listing the expiration date, and your medical school diploma need to be notarized, apostilled, and authenticated by the Chinese Consulate. Let’s break this down into each step.
Notary: Obtaining a notary requires the completion of an affidavit or attestation in front of a notary verifying the document is official.
Apostille: The notarized documents need to be apostilled. An apostille is a certificate issued by the Secretary of State that authenticates the document for use outside of the US.
Chinese Consulate Authentication: The notarized-apostilled document must be authenticated by the Chinese Consulate to ensure that these documents will be acknowledged by authorities in China. Your US residence will dictate the Chinese Consulate which will authenticate your documents
Finding a Job
There are several different approaches to finding a job in China.
On Your Own
One strategy is to create a list of all the medical clinics in the city you will be moving to. You can then visit the website of each of these clinics/hospitals to see if any of the physicians are foreign trained, if there is an English version of the website, and if they accept the major private health insurances such as MSH, AXA, AIA, and Cigna. Then email each clinic/hospital directly with your CV and know that further conversations will transition to WeChat – the Chinese multi-purpose messaging, social media, and mobile payment app developed by Tencent.
Also consider joining social media groups for expats such as Nanjing Expats or Suzhou Expats on Facebook and the group will give you an idea of which clinics/hospitals the expats use for medical care. Typically foreign-trained physicians will be most welcomed by clinics/hospitals serving an expat community or those locals with private insurance.
The major medical chains that service an international clientele include Jiahui Hospital, Parkway Health, United Family Health, Global Doctor, and International SOS. That said, do not limit your search to these companies, as many large cities will have several private clinics that want to hire foreign trained physicians.
Job Recruitment Firm
Another strategy is to utilize a job recruitment firm. Below you will find our partner recruitment organization. If inquiring with the organization, please mention that you are with Hippocratic Adventures and send us a message via Contact Us. You will support our community and website.
Head Medical is a leading specialist in international medical recruitment, having helped 1,000s of physicians find new roles in amazing locations including UK, Australia, New Zealand, Singapore, China, the Gulf, Canada and Caribbean. So, if you think you might be interested in a new challenge and a change of scene, please get in touch for a chat with one of their recruitment specialists. Their expert team will support you with your licensing and immigration paperwork and provide practical advice to ensure your relocation goes as smoothly as possible.
Language Requirements
You do not have to be fluent in Mandarin if you are working in one of the major medical chains which caters to the international and ex-pat community. You do have to be fluent in English. These large medical companies have English-Mandarin translators available for Mandarin speaking patients.
As more local Chinese utilize private clinics, there is a growing need for bilingual physicians who are fluent in English and Mandarin. Cantonese is helpful if you are working in a Cantonese-speaking area.
Given the large international community in China there is also a need for physicians who are fluent in languages other than English, such as Japanese, Korean, Spanish, Italian, German, and French.
Immigration
Most foreign physicians will first have a job offer in hand prior to applying for an employment and work (z) visa. This visa is for individual who has been invited for employment in China and their family. It is valid for 1 year and your company will be in charge of renewing it each year.
That said – I have always done things a little differently. Both times that I moved to China, I arrived in China on a visitor’s visa, found a job, and only then transitioned to a work visa.
Bottom Line
Practicing medicine in China offers foreign doctors an opportunity to be immersed in a rich cultural experience. Fluency in Mandarin is not required since most foreign doctors will work in hospitals and clinics catering to the large international community. You do not need to take additional tests or exams and your employer will typically help with medical registration and immigration, making the transition as smooth as possible.
Pinchieh Chiang DO is a family medicine doctor, trained in the United States, living in China, and practicing telemedicine into the United States.
