Due to the increase in global life expectancy and population ageing, the demand for medical services and healthcare has increased significantly worldwide. In China, traditional postgraduate education in clinical medicine has prioritised the cultivation of academic skills, but the clinical proficiency of postgraduates in clinical medicine has failed to meet the increased demand for social healthcare (1). Due to the rapid development of medical services, healthcare, and higher education, China, which is the second most populous country in the world, has established a professional degree in clinical medicine to cultivate students’ applied medical skills, strong professional ability, and humanistic qualities, leading to better engagement in clinical work and healthcare (2). According to the recommendation of the Ministry of Education in China regarding the differentiation of “academic” and “professional” degrees, academic degree programmes aim to cultivate research-oriented personnel by training medical postgraduates in scientific research. In contrast, professional degree programmes aim to train individuals with outstanding skills who have received formal, high-level training in specialised technology (2, 3).

In China, postgraduates who pursue master’s degrees in clinical medicine need to complete postgraduate curricula and clinical rotations that last for 33 months (standardised residency training, SRT) and must write a dissertation (4, 5). Traditional SRT is designed for 5-year medical undergraduates with a bachelor’s degree followed by 3 years of residency training. Compared with traditional SRT, the combined training model for a clinical professional master’s degree requires postgraduates to develop skills in clinical research or literature reading to complete their dissertations. These programmes require students to have a strong learning ability to coordinate clinical rotations and scientific or clinical research plans. Therefore, the objective of curriculum construction for the clinical professional master’s degree should match the demands of clinical rotations, literature reading, and dissertation writing. Hence, most colleges in China have established online public alternative curricula to assist postgraduates who are pursuing professional master’s degrees by enhancing their performance in their research programmes (6).

In recent years, new designs for curricula for medical students have been developed, but nearly all of these reforms have focussed on undergraduate medical education. Clinical professionals in China rotate through different clinical departments for SRT, most of which are public or affiliated hospitals of medical universities (7). Hence, there are limited opportunities for centralised courses in professional clinical master’s programmes. Many medical universities, such as Chongqing Medical University (CQMU), offer most of their public courses for clinical professional masters online. There is limited information about the attitudes of professional postgraduates towards their curricula. Therefore, in recent years, reforms have focussed on curriculum design and reorganisation for clinical professional masters. Given this context, it is essential to understand clinical professional masters’ opinions of their courses, as well as their supervisors.

A large-scale survey was conducted by CQMU to investigate (1) the positive impact of courses on research, (2) the requirements for elective course content, and (3) the preferred organisation of curricula from the perspective of clinical professional masters and their supervisors. By investigating both supervisors and postgraduates, we intend to provide data for the future reforms of curricula for clinical professional master’s programmes in China.

Ultimately, 544 clinical professional master’s degree students and 220 clinical professional supervisors completed the questionnaire. As shown in Table 1, the ages of the postgraduates ranged from 23 to 28 years (95.41%), and the majority of the students specialised in internal medicine, surgery, or paediatrics (93.21%).

In recent years, most medical colleges have paid less attention to postgraduate curricula than to undergraduate curricula. The underlying reason for this gap is that postgraduates have a certain degree of knowledge reserves. In the opinion of most educators, the main task of postgraduates is to complete research projects with their supervisors (13, 14). Currently, clinical postgraduates pursuing professional master’s degrees account for the majority of clinical master’s students in China (15). However, few studies have compared feedback from clinical professional master’s students and their supervisors with regard to postgraduate curricula.

In terms of the functional division of postgraduate curriculum design, public courses are designed for postgraduate research and dissertation preparation, while the professional curriculum places more emphasis on improving clinical thinking, professional skills, and abilities (16). One of the meaningful findings of this investigation is that compared with the positive impact of public courses on research, the positive impact of professional courses on clinical work is more significant according to the opinions of clinical postgraduate students. The answers to questions about whether there is a difference between the content of postgraduate public courses and the established knowledge system of undergraduate courses might partially explain this difference. In addition, compared to public courses, professional courses highly focus on specialised knowledge and clinical skill training, which complies with the SRT requirement of the clinical postgraduate (17). To address knowledge duplication in undergraduate courses, some medical colleges combine multiple forms of public curricula, such as traditional lectures, topic discussions, multidisciplinary seminars, scientific research training, and auxiliary teaching (16). In these public courses, clinical training and multidisciplinary seminars are the major components, which are quite different from the organisation of public courses at CQMU. With respect to the delivery of public courses, nearly half of the postgraduates preferred online courses, and surgical postgraduates were more inclined than internal medical postgraduates to select online courses. This phenomenon might be attributed to the time conflict between public courses and clinical work (18). In fact, to avoid conflict with clinical work, CQMU schedules the majority of public courses on weekends or after-work hours as much as possible. Individual semi-structured interviews with several postgraduates suggest that another major reason for the preference for online courses is that clinical postgraduates in different SRT hospitals must spend additional time travelling to colleges for public courses after work. Therefore, online public courses may be more acceptable for clinical master’s degree students. In contrast, fewer than 20% of the supervisors chose online teaching, and nearly half of them chose mixed online and offline learning approaches. Individual semi-structured interviews with several supervisors suggested that this disparity is mainly due to concerns about the effect of purely online courses. The combination of offline and online components can increase interaction with postgraduates and improve teaching quality (19, 20). Since the epidemic of COVID-19, online teaching has been widely used. For example, interactive online learning, which is derived from online teaching, and goal-oriented small private online courses (SPOCs), to some extent, have increased students’ interest in learning and the quality of online teaching (21). Therefore, diverse and thematic SPOCs may be a popular form of public courses for clinical professional students pursuing a master’s degree (22).

In terms of public alternative courses, “mental and health emotion management” and “employment and entrepreneurship guidance” have the highest level of demand among clinical postgraduates and supervisors due to pressure from the combined-training model, in which clinical postgraduates with professional master’s degrees need to complete SRT and postgraduate degree research within 3 years (23). Although the career direction of clinical professional postgraduates is clear, some of these students have difficulty in finding a satisfactory job. The underlying reason may be the dual structure of urban and rural areas in China, which results in an urban–rural split in terms of economics, education, and medical care. Furthermore, few clinical professional masters select rural medical institutions or primary medical institutions as their first choice after graduation (24). In addition, insufficient opportunities, limited availability of training positions, and the lack of adequate teaching by supervisors during SRT are the possible explanations for difficulty in finding a satisfactory job, to some extent (17). Therefore, problem-oriented micro-lectures associated with psychological counselling and employment guidance are needed.

Another important finding of this investigation is that, from the perspective of postgraduates, the most efficient method for improving their self-knowledge and capability is to “participate in research projects.” Supervisors are more concerned with improving the professional ability of postgraduates through professional lectures and initiatives in academic conferences and discussions. As a goal-or outcome-oriented learning mode, participating in clinical research is an efficient way to improve the professional capability of clinical postgraduates. Traditionally, clinical postgraduates’ participation in clinical research should be preceded by the completion of theoretical courses or lectures to obtain sufficient knowledge and pass topic selection. From the perspective of goal-or outcome-oriented learning, early experience in a research programme with guidance from a supervisor might also be an efficient learning mode (25), especially for clinical postgraduates pursuing professional master’s degrees who spend the majority of their time in SRT. Further research on clinical postgraduates with professional master’s degrees may focus on the design of outcome-oriented professional micro-lectures in which supervisors participate. Encouraging early participation in and conducting clinical research may be a suitable method to effectively improve the professional skills of clinical postgraduates.

Our study comprehensively surveyed the attitudes of clinical professional masters and their supervisors towards the curriculum. However, this study has several limitations. First, questionnaires were not recovered from all clinical professional masters at CQMU. Second, the postgraduates surveyed in this study experienced the COVID-19 pandemic. During the COVID-19 pandemic, several courses have to be performed online, which may have potentially influenced the postgraduates’ attitude towards the curriculum. Third, the survey was administered at CQMU, a single centre in China. Multicentre surveys with larger samples may be necessary to further verify our conclusions.

The major conclusions of our survey are as follows. (1) There are several differences between clinical postgraduates pursuing professional master’s degrees and their supervisors in terms of their attitudes towards public and professional curricula. Diverse and thematic small online courses might be popular among clinical masters. (2) “Mental and health emotion management” and “employment and entrepreneurship guidance” are the two most preferred alternative courses among both clinical postgraduates and supervisors. (3) Encouraging early participation in and conducting a moderate amount of clinical research may effectively improve the professional skills of clinical postgraduates.