Since October 2020, relying on the teaching resources and experience of Department of General Practice of Sir Run Run Shaw Hospital, a three-stage hierarchical progressive teaching and training of "teacher training-backbone training-continuous training" has been carried out for general practitioners in People's Hospital of Deqing County and 12 subordinate primary care institutions in Deqing County.

To analyze the related efficiency of stratified stepped training for regional general practitioners from October 2020 to November 2021.

The stage competencies of 14 senior faculty members were evaluated prior to participation in training (October 2020), at the end of rotation training of Department of General Practice of Sir Run Run Shaw Hospital (January 2021) and at the end of the 12-month training (October 2021) ; the competency evaluation covers five aspects: general practice occupational competence, general practice clinical competence, general practice skills, general practice teaching competence and general practice professional competence. The stage competencies of 28 core general practitioners were evaluated prior to participation in training (January 2021) and after completing the 12-month training (December 2021), the competency evaluation covers four aspects: general practice occupational competence, general practice clinical competence, general practice skills and general practice professional competence. The stage competencies of 82 junior echelon general practitioners were evaluated prior to participation in training (January 2021) and after completing the 12-month training (December 2021), the competency evaluation covers three aspects: general practice occupational competence, general practice clinical competence and general practice skills.

There were significant differences in general practice occupational competence among 14 senior faculty members (P<0.05) ; among them, the scores of general practice professional competence in the third month and the twelfth month of training were higher than those before training (P<0.05). There were significant differences in the scores of general practice clinical competence and general practice skills among the senior faculty members in different time points (P<0.05) ; the scores of general practice clinical competence and general practice skills in the third month and the twelfth month of training were higher than those before training (P<0.05). The scores of general practice teaching competence of senior faculty members in the twelfth month of training were higher than those in the third month of training (P<0.05). The scores of general practice professional competence, general practice clinical competence, general practice skills of 28 core general practitioners after training were higher than those before training (P<0.05). The scores of general practice professional competence, general practice clinical competence, general practice skills of 82 junior echelon general practitioners after training were higher than those before training (P<0.05) .

This study provides an orderly, robust and sustainable model of continuous training and ability improvement of regional general practitioners after practice with the leading and supporting of general hospitals, which can effectively enhance the competence level and improve job competency of regional general practitioners.