最新版大綱來自國家醫學考試中心編寫的《全國醫學博士英語統一考試指南》，該《指南》于 2020 年一月由人民衛生出版社正式出版。

大家復習備考做真題，以 2020 年為分界線，歷年真題的題型是不一樣的，區別主要體現在聽力和作文上。2020 年及以后的真題是按新大綱出的，2019 年及以前的真題是按老大綱出的。

新大綱的試卷結構如下：

從這個試卷結構來看，新大綱有以下四個特點：

考試題型整體穩定

考試時長不變

各單項分值不變

聽力和作文題型略有微調

下面就來給大家深入分析一下新的聽力題型特點，并給出應對策略。

新大綱和 2020 年以前的老大綱一樣，聽力都分成兩個部分，Section A 和 Section B。

Section A

老大綱的 Section A 是 15 則短對話，每則對話一題；新大綱的 Section A 是 5 則稍長一點點的對話，每個對話后面有三個選擇題。

注意，我在這里沒有用“長對話”，而是說“稍長一點點的對話”，因為從樣題來看，改革后的這個對話雖然加長了，但是遠不如現有老大綱長對話那么長。

Section B

老大綱的 Section B 是 1 篇長對話+兩篇短文，每篇 5 題；而新大綱的 Section B 是 5 篇小短文，每篇 3 題。

從聽力的題型變化來看，我認為新大綱聽力的整體難度降低了。

理由如下：

理由 1:新大綱 “長對話” 不長

我們先來看一下新大綱給出的長對話樣題：

W: Can you tell me about yourself,please?

M: Sure, my name's Harry, 18 years old, currently studying biology and chemistry at school. As you are aware, I hope to pursue a career in medicine.

W: Harry,why do you want to be a doctor?

M: Well, everyone in my family is a doctor,so I think I can follow on nicely.

W: Apart from treating patients, what do you think being a doctor is going to require?

M: Well, you also need to be academic and have to be an excellent communicator with your team and the patients.

這個長對話樣題只有三個話輪（對話雙方一人一句、一來一往被稱之為一個話輪）。

其實，近幾年真題的短對話就已經頻繁出現多話輪的了，隨便舉個例子，比如 2016 年真題聽力短對話第一題，就是三個話輪：

M: Can I see the doctor soon?

W: Of course. How about next Monday? There’s a slot available at ten in the morning.

M: But I’m afraid I’m working at ten. Is there anything available after three?

W: Let me see. Not on Monday. But we have a three o’clock opening next Wednesday. Would you like to come in then?

M: No problem. Thank you.

Question: When is the man scheduled to see the doctor?

所以新大綱的對話聽力并不可怕，我們在歷年真題里面早就接觸過。這樣的多話輪對話，我們早就接觸過，而且一直在訓練。兩年前我就在公眾號文章和魔法書里面分析過，“短對話不短”是一個重要的趨勢。這也是為什么我們聽力特訓一百天沒有設置單個話輪的短對話訓練，給大家聽的對話全部是多話輪的。

理由 2：對話的題目多，線索也多

新大綱對話聽力后面的題由 1 題增加為 3 題，大家在試卷上能看到的選項就由 4 個增加到 12 個，選項越多，線索就越多，更有利于我們預測對話內容、掃清關鍵詞。

我們一起來看新大綱上對話后面的選擇題：

1. A. Switching to biology and chemistry.

B. Choosing to be a familyphysician.

C. Going to college.

D. Being a doctor.

2. A. Because of his family's influence.

B.Because of the fact that he's young.

C. Because of the practical skills he has.

D. Because of his love for biology and chemistry. 

3. A. A strong sense of responsibility.

B. Goodcommunicativeskills.

C. Excellent health.

D. Great patience.

根據這些選項，我們不但可以預測，這則對話可能是一個升學或求職的面試場景，而且能在選項中預覽到對話錄音中可能出現的關鍵詞：biology，chemistry，communicative 等等，做到心中有數。

較之老大綱，新題型無疑對考生更友好。很多考生都有這樣的感受，老題型的短對話確實是太短了！一男一女各說一句話，感覺在耳邊一閃而過，還啥都沒聽清，對話就結束了，加之老題型短對話坑多，短短兩句話，就要求大家分辨弦外之音、語氣語調、習語文化，確實有點為難大家。

理由 3：短文聽力篇幅變短，信息點不易遺忘

老題型的短文聽力篇幅很長，比如 2018 年短文聽力第一篇就有 315 詞，涉及的細節多且瑣碎，而大部分考生英語短期記憶能力差，前聽后忘，錄音一遍讀完，已然忘光前面說什么了。

改革后的新大綱短文聽力的篇幅只有 150詞左右，而且每篇后面只有三題，這無疑是重大利好。

以下是新大綱上給出的短文聽力樣題：

We commonly think that our health is affected by our age, gender, lifestyle and genetic factors that we inherit from our parents. However, these factors are only a small part of what affects our health. Other factors include our social relationships, income, education and working conditions.

Let's look at stress for example. Unemployment or poor working conditions create unstable life situations and cause stress, which has negative effects on health. One major factor, education, determines income or employment. However, even if you are employed, some workplace conditions, such as lack of flexibility and control over your workday can cause stress. 

As you can see, many complex social processes and other factors are connected with one another to affect our health. Studying how these factors work together in large populations is a challenge for researchers and that is what we would like to look at next.

正如大家看到的，新大綱短文聽力的篇幅比老題型縮短了將近一半，難度大幅降低。