Mao Mengjia gave up a career as a doctor in China because he could make more money selling medicine than prescribing it.
Mao tripled his income after quitting his job at a hospital in northeastern China to work as a medical sales representative in 2009. As many as 14,000 physicians like Mao will join foreign pharmaceutical companies over the next five years, according to Aon Corp.’s Shanghai-based human resources advisory firm.
The new recruits will sell medicines made by companies from New York-based Pfizer Inc. to Paris-based Sanofi in the world’s fastest-growing major drugs market. Their career-switch is curbing the supply of doctors that China’s government wants in rural and regional areas, where inadequate medical care is hampering efforts to cut infant mortality and prevent diabetes.
“The pay for new doctors is low, which makes it hard to survive,” said Mao, who was one of 30 to graduate in 2005 from the medical college he attended in Dalian, 460 kilometers (286 miles) east of Beijing. Nine of his classmates have jobs in pharmaceutical sales, he said.
A newly qualified doctor makes about 2,000-3,000 yuan ($309-464) a month, while a one-bedroom apartment in Dalian, a city of 6 million people, goes for 2,000-2,500 yuan, Mao said. Typically three or four newly qualified doctors will rent a flat together to defray their costs, he said.
The U.S. has one public health professional for every 635 people. The rate in China is one per 7,000, according to Kun Chen, a doctor at Zhejiang University’s school of public health. Moreover, medical demands are surging. The country has 92.4 million adults with Type-2 diabetes and more than half are undiagnosed, a 2010 study showed.
“There is a great lack of doctors at the most primary levels like county and small-city hospitals, and that’s also where it’s hardest to find them,” said Shi Yingkang, dean of the West China Medical School at Sichuan University in Chengdu, and vice president of the Chinese Medical Doctor Association.
After graduation, half of his students spurn local hospitals for better-paying jobs overseas or in drug sales, Shi said. Pay for local rookie doctors starts at 2,000 yuan a month, while medical representatives may get two to three times more, he said.
“To them, the pay does not match the effort put in,” said Shi, who also works as a heart surgeon at the West China Hospital in Sichuan province. His father and grandfather were both doctors, as is his daughter.
China’s health officials are trying to encourage more doctors like the Shis, offering incentives such as free training to entice as many as 300,000 general practitioners in clinics and hospitals in villages and small towns over the next decade.
Hebei province, which skirts Beijing, is offering 1,000 graduates a 2,000 yuan relocation fee and priority placement at major hospitals for those willing to work for two years in a village. Of the province’s 50,000 villages, 6,000 lack a qualified doctor, the official People’s Daily newspaper reported on May 29.
China’s policy-setting State Council, in a session chaired by Premier Wen Jiabao, announced on June 22 a plan to improve medical care by raising education standards for general practitioners. It also proposes to have two or three better- qualified doctors for every 10,000 residents by 2012.
That comes on top of a three-year plan to invest 850 billion yuan ($131 billion) narrowing discrepancies in access to medical care and providing more than 90 percent of China’s people with basic health insurance. The plan is also spurring demand for medicines and people trained to sell them.
Sanofi runs classes for its medical representatives from a center in the 20-story BenBen tower in downtown Shanghai which it calls the Sanofi-Aventis University.
‘Love to Be Trained’
“We brand it as a university, and it does work when we go to campuses and do mass recruitments,” said Freddie Chow, Sanofi’s vice president of human resources in China. “Chinese people love to be trained. The hunger for knowledge acquisition is very high.”
Foreign drugmakers like Sanofi and their local affiliates will hire at least 35,000 sales staff by the end of 2014, Aon Hewitt China estimates, based on a survey of 24 companies. The same employers had 33,000 on staff at the end of 2010. About 30 to 40 percent of people recruited for sales jobs will have a medical degree, said Jarroad Zhang, a consulting director with Aon Hewitt in Shanghai.
“In most other countries, it’s extremely rare to get fully trained doctors as medical representatives,” said Chris Lee, managing director of Bayer Healthcare China, a Beijing-based arm of Bayer AG, Germany’s largest drugmaker. Doctors — followed by pharmacists and nurses — are sought after by drugmakers in China for their medical knowledge, he said.
Lee has already met his 2011 target for hiring 1,000 sales representatives and says he may recruit a similar number next year. China will overtake the U.S. as Bayer’s largest pharmaceuticals market in the next seven to eight years, he says.
“There’s an understanding within the company that we will need to hire to meet that goal,” said Lee, who began his career in drug sales with Merck & Co. in New Jersey.
Pharmaceutical sales grew an average of 24 percent a year in China from 2006 to 2010 and will expand at a 19 to 22 percent annual clip over the next five years, according to the IMS Institute for Healthcare Informatics. The market will probably be worth $115 billion by 2015, the Norwalk, Connecticut-based researcher said in a report in May.