年輕醫師的徬徨與抉擇－從《青杏》看1950及1960年代臺灣醫學教育、醫師出路及外流問題

Medical Education, Professional Career and the Exodus of Young Doctors in Taiwan during the 1950s and 1960s, an Analysis based on "Qingxing"

許宏彬(Hung-Bin Hsu)

《興大歷史學報》 27期 (2013/12) Pp. 53-81

摘要

1950年代後期起，年輕醫師的大量外流無疑是臺灣近代高等教育及知識發展史中耐人尋味的一環，也是二戰後全球專業人力流動網絡中的一股潮流。與同時期大批赴美的理工學生不同，醫師在日治時期已是個高度成熟的專業且有穩定的職涯發展。二次大戰結束後，由於美援的挹注，臺灣醫學教育脫離原本的德日制並快速地美國化。與此同時，殖民時期以日式教育養成之西醫為尊的醫療市場，也因為戰後醫療政策的轉變而加入了許多新的競爭者而顯得混沌而複雜。在這個特殊的時代氛圍下，戰後新生代醫科畢業生，一方面必須面對且適應醫學教育體制上的重大變革，另一方面也面臨畢業後是否出國深造或留在國內進修開業的難題。本文擬藉由分析1950及1960年代臺大醫學院重要的校園刊物《青杏》，來觀察戰後初期臺灣醫療發展的兩個重要面向。首先，是從教員、醫科生及年輕醫師的觀點來考察美援對戰後臺灣醫學教育的具體影響；其次，本文希望能理解年輕醫師在面對這種劇烈的時代、醫學教育及醫療市場變遷時，如何在種種困惑及徬徨中思索習醫／行醫的意義並規劃職涯的進路。

關鍵字

人才外流 ； 醫療移民 ； 醫學教育 ； 醫療市場 ； 醫學生

並列摘要

From the late 1950s onward, many medical graduates in Taiwan decided to leave the island and pursue their further clinical training and careers in the western countries, especially the United States. Through the articles and letters collected in ”Qingxing”, a widely read college journal for students and graduates of College of Medicine, National Taiwan University, this article hopes to address the structural reasons for this mass migration of young doctors during the post-war period. Three interrelated topics will be discussed. First, the paper describes the dramatic change in medical education in Taiwan under the great influence of the U.S. Aid. Second, it will analyze the changing medical market and expanding human resources during this period. Third, it will examine the professional pathways available to and challenges for medical graduates, and how they struggled to establish their own career against the background of the dramatically changing medical education and market. It reveals that, among a myriad of personal issues that motivated a young physician to leave Taiwan, the lack of resources and the opportunities for medical graduates to conduct more advanced and scientific career, as well as the disordered and highly competitive market loomed very large.

並列關鍵字

brain drain ； physician migration ； medical education ； medical market ； medical student

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