The free training program for rural-oriented medical students (referred to as "bonded medical students" ) is a significant measure to alleviate the shortage of grassroots doctors in rural areas of China and to enhance the overall level of the grassroots medical and health workforce. Previous studies have lacked comprehensive analysis of the current state, methods, and effectiveness evaluations of educational research on bonded medical students across various institutions in China.

To explore the development status, research quality, and future trends of medical education research on five-year undergraduate bonded medical students in China from 2010 to 2023, providing references for subsequent work.

Literature on the training of bonded medical students published from January 1, 2010, to December 31, 2023, was retrieved from seven Chinese and English databases: CNKI, Wanfang, VIP, PubScholar, PubMed, Web of Science, and Cochrane Library. Two researchers independently screened the literature and extracted data according to inclusion and exclusion criteria. The quality of the literature was evaluated and comprehensively analyzed using MERSQI (The Medical Education Research Study Quality Instrument) and NOS-E (The Newcastle-ottawa Scale-education). Descriptive analysis was used to summarize and analyze the results.

A total of 37 studies were included, of which 36 were in Chinese and 1 in English. In terms of research design, the pretest-posttest control design accounted for the largest proportion (46%, 17/37), while single-group posttest and randomized controlled posttest designs each accounted for 22% (8/37, 8/37), and single-group pretest-posttest accounted for 8% (3/37). A total of 97% of the studies were conducted at the undergraduate education level (36/37). The research focuses were mainly on curriculum adjustment (89%, 33/37), teaching method adjustment (81%, 30/37), and training model construction (8%, 3/37). Among them, 3 studies (8%, 3/37) on training model construction and 7 studies (19%, 7/37) on curriculum adjustment specifically designed courses targeting rural areas, primary-level institutions, or general practice. Outcome evaluation mainly focused on students' evaluation of teaching (70%, 26/37) and improvement of knowledge and skills after teaching (86%, 32/37), while fewer studies addressed actual behavior change (3%, 1/37) and benefits to patients and medical institutions (3%, 1/37). The overall research quality was not high, with a total MERSQI score of (10.4±2.4), and a maximum score of 14.0. The main items affecting low scores were the number of sample institutions, the validity of evaluation tools, and outcome indicators. The total NOS-E score was (2.5±1.5), with a maximum score of 5.0, with comparability of control groups and blinding as the main items affecting low scores.

The focus on educational training research for bonded medical students has increased, but there are issues such as generally low research quality, insufficient cross-institutional and cross-regional studies, insufficient incorporation of features specific to bonded medical training in research content and evaluation indicators, and limited attention to postgraduate and continuing education. Future research should strengthen multi-institutional cooperation and international exchanges, improve the quality of research design and methods, and establish a unified evaluation system with rural-oriented characteristics, and strengthen the design of rural-oriented characteristic courses related to rural and general practice, focusing on the continuity and integration of teaching design that includes post-graduate education and continuing education stages.