An Examination of the Protection of Labor Rights and Interests of Residents in Standardized Training

As an important mode of medical personnel training in China, standardized residency training has effectively promoted the development of medical and health care in China. However, at present, China’s standardized residency training system still suffers from unreasonable recognition of training rela-tionships, uncertainty in the identity of residents, and singularity in the main body of labor rights and interests’ protection, etc. There is an urgent need to improve the relevant rules and regulations to protect the legitimate labor rights and interests of residents during their standardized training.

With the continuous development of medical and health care in China, the standardized residency training has also made considerable achievements, and as of December 2018, the total number of residents in China is 400,000, and 130,000 residents with postgraduate status in medicine (National Health and Wellness Commission, 2018), In order to implement the requirements of the "Health China 2030" planning outline, the number of residents participating in standardized residency training will continue to rise each year. In order to implement the requirements of the "Health China 2030" plan, the number of residents participating in standardized residency training will continue to rise each year, and in the face of the huge number of residents, academic research on how to better improve the standardized residency training system is in full swing. The research focuses on how to improve the motivation of residents in standardised training, how to optimise the management model and training mode of standardised residency training, and how to strictly review the qualifications of training bases. However, a literature search reveals that there is a gap in the protection of residents' labour rights and interests. Under the existing medical talent training system in China, if the government, medical schools and medical institutions want to make good use of the standardised residency training system, they must solve the problem of safeguarding the labour rights and interests of residents, and by clarifying the mode of safeguarding labour rights and interests during standardised training and the responsible body; the labour rights and interests of residents will be safeguarded in practice, so as to ultimately realise the training of medical talents. Under the standardised training model, the legal relationship between residents and training bases, residents and their respective units, and how to protect the labour rights and interests of residents are issues that need to be studied and resolved. This paper analyses and discusses these issues from the perspective of labour law, with a view to providing useful reference for the development of standardised residency training. States has since moved towards a unified management of residency regulations (Taradejna, 2007).

The Origins of Domestic Development
In the late 20th century, China began to implement a standardised residency training system, and has made considerable progress since then. 1993-1999, the

Problems Raised
At present, the standardized residency training work has become an important way for medical graduates and doctors in primary medical institutions in China to improve their professional skills, and this medical personnel training system has been gradually converging with developed countries in the world (Yang, Huang, Niu, & Wang, 2010). However, because of the late start and rapid development of the standardized residency training system in China, there are still many problems that need to be studied and solved, especially the problems that exist at the institutional level. The National Health and Family Planning Commission and other seven departments on the establishment of a standardized training system for resident physicians, hereinafter referred to as the "guiding opinions" pointed out that "the original personnel (labor) and salary relations of the training subjects assigned by the unit shall remain unchanged during the training period, and the commissioning unit, the training base and the training subjects shall sign a commissioning training agreement, and the salary paid by the commissioning unit shall be lower than that of the training base. The training base is responsible for paying the part of the salary of the resident with the same conditions. Training subjects with postgraduate status implement the relevant provisions of national postgraduate education, and the training base may grant them an appropriate living allowance according to the training assessment." The Guidelines indicate a formal training relationship between the "unitary" and the training base, at least in a literal sense, by the signing of a commissioned training agreement. "Training subjects with postgraduate status" are directly excluded from the regulations governing residency, stating that they are managed in accordance with the national regulations on postgraduate education, without being explicitly given the status of resident. The ambiguity of the Guidelines regarding labour relations and the avoidance of the issue of status have led to many problems in the operation of the standardised training system.

Standardized Residency Training Is Different from Training in the General Sense
The training relationship is used to describe the social relationship formed be- In summary, it seems that residency training is the same as training in the general sense that trainees are trained to improve their abilities or acquire certain skills. However, there is a difference between the two in terms of the subjects of interest, as there are at most three subjects of interest in the training relationship arising from the act of training, whereas there are at least four subjects of interest in the standardised residency training system. It is not reasonable to ignore the difference between the two interests and confuse them, and there is no theoretical basis for this.

Uncertain Status
The legal status of residents refers to the status of residents as subjects of social relations in the standardized residency training system, which is the unity of subjects with postgraduate status", whether their identity is "students" or "residents". Is their status a "student" or a "resident"? The ambiguity of this status has led to a lack of legal protection of labour rights. In today's society, the rights and interests of individuals are null and void if they are not protected by relevant laws and regulations. In the implementation of the standardised training system, if the identity of the "training subject with postgraduate status" is not clearly defined, the legal remedy and protection function will be hindered or even helpless when their labour rights are damaged, which will also become an obstacle to the establishment of a good relationship between the training base, the school and the student, and will seriously In practice, the "post-graduate training students" are not only motivated to participate in the standardised training, but also hinder the development of the standardised training system for resident doctors in China.
In practice, the status of residents with postgraduate status is overlooked. Schools and training bases overemphasise their status as students and ignore their role as workers, treating the process of standardised training as an extension of the school's teaching behaviour. The labour act is not recognised and there is no decisive condition for talking about the existence of a labour relationship. In the face of the current one-size-fits-all model of determining labour relations, which is "if there is a labour relationship, it is protected, but if there is not, it is not protected" (Li, 2016), the labour rights of medical postgraduates in standardised training will not be protected by the law for a long time. This means that the labor rights and interests of the huge number of medical postgraduates during the standardized training will not be protected.

Single Subject of Labour Rights and Interests Protection
The single subject of labour rights protection is not in line with the value of "who benefits, who pays", which is also a reflection of the basic spirit of the law. The training base is only required to pay back the wages of the "unit" under certain conditions, while the other labour rights and interests enjoyed by the workers are solely the responsibility of the training unit to guarantee their implementation. The training base has become the object of public "envy", a subject with rights but not obligations, the point being that it is a right granted by public authority and exists legally. As two parties whose interests are regulated by the same rules and regulations, the existence of an object of "envy" must be accompanied by the existence of a "poor" individual who makes people feel compassionate. The public is always in the habit of making itself the protagonist of an event, of trying to empathise with the different owners and of expressing its attitude. The commissioning unit is the "poor" protagonist who has aroused the public's compassion, and there is no denying that the commissioning unit does appear to be quite "aggrieved" under such regulations. After all, because the "unit of people" in the standardised training during the implementation of the conduct of the beneficiary subject is not only themselves, the training base is also Q. Chen, L. Feng

Introduce an Apprenticeship Relationship to Give Residents a Proper Name
At present, the road to safeguard the labour rights of residents in China is slightly bumpy. If the rights of residents are defended under the Labour Law, judges are often bound by the determination of the labour relationship between residents and training bases and make judgments against residents or do not accept them at all. When protected by the Tort Liability Law, residents will find it difficult to prove the burden of proof, while tort liability is difficult to clarify.
The author believes that the relationship between residents and training bases should be recognized as an "apprenticeship" in order to repair the legal loopholes and develop a scientific and feasible legal protection mechanism and management system for residents, which is important for safeguarding the legal interests of residents, protecting the legitimate interests of participants in the system and stimulating the enthusiasm of all interested parties to participate. It is of great importance to protect the legal interests of residents, protect the legitimate interests of those involved in the system and stimulate the participation of all interested parties.

The Modern Apprenticeship System
The The main content of the modern apprenticeship pilot work is "enrollment is recruitment, into the school is into the factory, school-enterprise joint training" or "recruitment is enrollment, into the enterprise is into the school, enterprise school double teacher joint training" (Chen & Han, 2015), that is vocational college students when entering the school has been determined, In other words, when students enter the school, they have already decided which enterprise they will work for, and after successfully completing their studies, they can become full employees of the enterprise. At the same time, the dual identity of the apprentice enterprise employee as well as the school student is also affirmed in the

Incorporating Standardised Residency Training into the Modern Apprenticeship System
A distinction is made between the pathway for medical personnel to improve their professional skills after graduation, which is named the standardised residency training system, and the process of familiarising vocational college students with their professional skills, which is called the modern apprenticeship system. In fact, the two are essentially the same, and in my opinion, they are basically the same model of talent training, and it is not appropriate to make detailed theoretical distinctions, but to do so would create some "strange" problems.
Firstly, they both aim to improve practical skills. Residency training is the process by which doctors or postgraduate medical students in primary care institutions improve their professional skills by studying medical knowledge and optimising the management of medical conditions under the guidance of a supervising teacher in a training base as a resident. Modern apprenticeship, on the other hand, is a system whereby students from vocational institutions, after completing their vocational theoretical studies at school, enter a company as apprentices to combine theoretical knowledge with practice and to continuously practice and familiarise themselves with practical operations. Both are guided by others, on the one hand, to expand their theoretical knowledge; on the other hand, to continuously practice and improve their operation.
Then again, both pass through certain bridges in order to enter the unit of study. With the implementation of the standardised residency training system, it is only then that in-service doctors from primary hospitals have the opportunity to study at higher-level hospitals and improve themselves; and postgraduate medical students can therefore learn clinical handling skills at the training base as students, synchronising theoretical learning with practical practice, integrating the two and greatly enhancing the efficiency of learning. It also avoids the awkward situation of having to attend standardised residency training even after completing postgraduate studies, in the context of an effective interface between the standardised residency training system and the postgraduate medical training programme. Under the modern apprenticeship system, students in vocational colleges are identified with the companies they intend to work for after graduation when they enter the school, and once they have completed their theoretical knowledge within the school, they enter the company to learn and familiarise themselves with practical operations. Without the modern apprenticeship system, it would be very difficult for students in vocational colleges to have the op-Q. Chen, L. Feng American Journal of Industrial and Business Management portunity to go to an enterprise for operational learning.
Finally, the labour practices offered by both are somewhat flawed. There is still a large gap between the level of professional competence of primary care physicians and postgraduate medical students and the formal physicians at the training base (Sun, Wu, & Liu, 2012) and because of this lack of competence, the labour acts of both create unequal value for the training base. The value created by the resident's work is lower than that of the regular physician's. The resident needs to be authorised by a superior physician in the department to carry out medical acts independently, and the medical recommendations made need to be reviewed and approved by the superior physician before they can be implemented. In the modern apprenticeship system, the apprentice, after completing the theoretical knowledge in the vocational college, enters the enterprise as a novice with unfamiliar business skills, or even as a stranger to the workplace, and needs to operate machinery and complete work tasks under the guidance of senior employees.
Based on the above comparison between the standardised residency training system and the modern apprenticeship system, it is clear that the two are identical in nature and training methods, and that distinguishing between the two and trying out different systems would cause a lot of unnecessary trouble.

Recommendations for the Protection of Residents'
Labour Rights

Legally Conferred Status
Because of their status, there is a big gap between their treatment in the training base and that of "unit staff", which makes them lack the motivation to work and a sense of belonging ). The legal system for residents should give them the status of resident physicians, so that they can enjoy the same treatment as "unit staff" at the training base and receive equal pay for equal work (Hu, Chen, Wang, & Xie, 2013). At the same time, the dual identity of the resident can be implemented, so that he or she can enjoy the legitimate rights and interests of workers.

Defining the Status of Resident Apprentices
The residency standardized training system is, in essence, a branch of the apprenticeship training model, which belongs to the talent training model in the medical field. Separating residents from their apprenticeship status has caused a lot of trouble, affirming the status of resident apprentices and bringing the residency standardized training system into the scope of the modern apprenticeship training system to address the many loopholes in the current residency standardized training system.

Conclusion
At present, most of the studies on standardised residency training in China focus Q. Chen, L. Feng American Journal of Industrial and Business Management on how to manage the residents in standardised training, how to design the standardised training curriculum and how to conduct assessments, but there are few studies on how to protect the labour rights of residents during standardised training. The author hopes that this study will provide a reference for future research on the protection of residents' labour rights during standardised training.