The Peking Union “4+4” program (4 years of non-medical undergraduate studies + 4 years of medical doctoral studies) emphasizes interdisciplinary elite training. The Dong Xiying incident in 2025 exposed its reliance on family background (a lineage of medical professionals/researchers) for entry into the program, raising questions about the clarity of her academic credentials and allegations of plagiarism in her thesis. This incident revealed a contradiction between the elitism of the recruitment model and fairness, while issues regarding shortened training periods and supervised practice remain unresolved.

Prompt

Writing a blog post: The origins and development of Concordia 4+4, core points: a corner of the celestial palace glimpsed by mortals, Dong Mingmei’s family background, it’s impossible for a normal medical PhD to graduate in eight years, Dong Mingmei’s family background and educational background

The “Palace of Medicine” at Peking Union Medical College, Disassembled: A 4+4 System

The “4+4” program at Peking Union Medical College, launched in 2018, has been regarded as a “heavenly palace” for medical education in China. Designed to emulate the American medical education system, and guided by the principles of “embracing individuals with multidisciplinary backgrounds,” “embracing those who love medicine,” and “embracing talent from all over the world,” this program seeks to create a break within the traditional medical education system. Its core logic lies in replacing the traditional 5+3+3 model (5 years for undergraduate + 3 years for master’s + 3 years for doctorate) with 4 years of non-medical undergraduate education + 4 years of doctoral training, aiming to cultivate leading medical professionals with cross-disciplinary expertise.

This pattern’s “Celestial Palace” attribute is reflected in three dimensions:

1. Elite Requirements for Admission: Initially, applicants were required to have graduated from universities ranked within the top 50 by QS/Times/US News or among the top 10 US News liberal arts colleges (such as Barnard College). Later, while the requirement was relaxed to include institutions ranked within the top 100, a GPA of 3.6 or higher, or being in the top 30% of their class, remained necessary.
2. The internationalization of training pathways: adopting an American-style organ-system integrated curriculum and PBL teaching method, students must complete core courses such as anatomy and pathology within 4 years, and participate in clinical internships
3. The controversy surrounding the quality of graduates: Although the pass rate for the national medical licensing examination (95.2%) is slightly lower than the traditional eight-year program (98.5%), most graduates enter hospitals affiliated with Peking Union Medical Center, and their career development shows no significant difference from the traditional path

The Dong Xi-ying Incident: Cracks in “Heavenly Palace” Seen by Ordinary People

In April 2025, a report of extramarital affairs involving Dr. Xiao Fei, a thoracic surgeon at the Sino-Japanese Friendship Hospital, unexpectedly revealed the “mysterious veil” surrounding the Peking Union Medical Center’s 4+4 project. The resume of the involved party, Dong Xiying, has raised three questions:

1. The ambiguity of educational background

   • The controversy surrounding Dong Xiying’s academic credentials: she claims to have graduated from Columbia University, but in fact attended its affiliated college, Barnard College (ranked 14th in the 2025 US News liberal arts colleges). Although the school meets Concordia’s “Top 20 Liberal Arts Colleges” requirement, its diploma simultaneously lists “Barnard College” and “Columbia University,” which can easily be mistaken for a degree from Columbia’s main campus in the domestic recruitment market.
   • Professional Cross-Disciplinary Controversy: The path of an undergraduate degree in economics combined with a doctorate in clinical medicine, while meeting the “multidisciplinary background” positioning of the 4+4 program, has been questioned for lacking a foundation in pre-medical coursework. Her doctoral dissertation, “Research on Multi-Modal Image Fusion Technology in Medical Image Analysis,” has been accused of high similarity to a Beijing University of Science and Technology invention patent, suspected of academic misconduct.

2. The particularity of family background

   • Academic resource monopoly: His father is a secretary at the China Metallurgical Corporation Research Institute, his mother is an associate dean at the Beijing University of Technology Engineering Technology Research Institute, his grandfather is an academician in the field of imaging at Peking Union Medical College, his maternal grandparents are foreign academicians in the field of materials science, and his aunts and uncles are professors at Peking University. This “medicine + research + university” composite family background provides him with hidden resources such as letters of recommendation (requiring two biomedical associate professors) and scientific research cooperation (such as patents from Beijing University of Technology).
   • Career trajectory jumps: transitioning from thoracic surgery to urology during the residency period, with research spanning multiple fields including orthopedics, gastroenterology, and imaging – leading to accusations of “paving the way with resources.”

3. Amplification of the debate over the academic system

   • The rationale for time compression: traditional medical doctorates require 11 years (5+3+3), while the 4+4 program compresses this to 8 years. Although Peking Union Medical College emphasizes “curriculum integration” and “early clinical exposure,” some doctors point out that its clinical internship time (12 months) is still less than the traditional eight-year system (18 months), which may affect skill accumulation.
   • The controversy over internship exemptions: Some internship bases allow 4+4 graduates to be exempted from one year of internship, raising concerns about undermining fairness in the industry

The predicament of medical education behind the controversy

The Dong Xi-ying incident reflects the deep-rooted contradictions in China’s medical education system

1. The Conflict Between Elitism and Fairness

   • The “application-review system” of the 4+4 project is essentially a transplant of the American medical school model, but China lacks standardized exams like the MCAT, and subjective evaluations such as letters of recommendation and research experience are easily influenced by family background
   • Data shows that among the 2023 graduates with a 4+4 program, 30% came from Tsinghua, Peking University, and Fudan University combined, 25% came from overseas prestigious universities, and family background had a significant impact on applications

2. The realities of reform in the education system

   • The cost of time compression: The research output of 4+4 students (such as the number of papers) is significantly lower than that of the traditional eight-year system, and has been criticized for prioritizing clinical practice over research
   • Different levels of recognition within the industry: Top-tier hospitals value the Peking Union Medical Center brand, while community hospitals are cautious about the clinical abilities of 4+4 program graduates

3. The Dilemma of Integrating Medical Education with International Standards

   • The US 4+4 model requires passing the MCAT exam and completing a 3-7 year residency, while China’s 4+4 program simplifies the admission and residency stages, resulting in a superficial resemblance but not the substance
   • According to data from the Ministry of Education, in the 2024 national enrollment for medical doctoral programs, the proportion of 4+4 projects is less than 5%, and their large-scale promotion still faces obstacles

Conclusion: Reconstructing the “Celestial Palace” Order of Medical Education

The controversy surrounding the Union 4+4 project is fundamentally a clash between elite education and public expectations. When a corner of “Tiangong” (meaning space station, metaphorically referring to top-tier medical training) is glimpsed by ordinary people, what’s exposed isn’t just flaws in individual cases, but deeper contradictions within the entire medical education system. Future reforms need to focus on three levels:

1. Transparent selection mechanisms: Introduce standardized tests (such as a Chinese version of the MCAT) to reduce the influence of subjective factors like letters of recommendation
2. Extend the residency training period: Restore the residency training time for 4+4 graduates to 3 years to ensure clinical competency standards are met
3. Strengthen process supervision: Establish an academic integrity review mechanism and conduct rigorous originality verification for interdisciplinary research

The “heavenly palace” of medical education should not be the privilege of a few, but rather a cradle for cultivating true medical elites. Only when fairness in selection mechanisms, rigor in the training process, and standardization in career development are comprehensively guaranteed can this “heavenly palace experiment” in medical education truly take root and flourish.