中国全科医学 ›› 2022, Vol. 25 ›› Issue (22): 2713-2719.DOI: 10.12114/j.issn.1007-9572.2022.0229

所属专题: 全科医学教育专题研究

• 全科医学教育专题研究 • 上一篇    下一篇

订单定向医学生的就业与履约:基于四所医学院校的五年跟踪分析

程晓冉1,2, 张笑天2,*(), 王静雅3, 张众2, 窦丽娣2, 刘晓云2   

  1. 1100191 北京市,北京大学公共卫生学院
    2100191 北京市,北京大学中国卫生发展研究中心
    3341000 江西省赣州市,赣南医学院农村(社区)医学教育研究中心
  • 收稿日期:2022-04-07 修回日期:2022-06-18 出版日期:2022-08-05 发布日期:2022-06-23
  • 通讯作者: 张笑天
  • 程晓冉,张笑天,王静雅,等. 订单定向医学生的就业与履约:基于四所医学院校的五年跟踪分析[J]. 中国全科医学,2022,25(22):2713-2719.[www.chinagp.net]
    作者贡献:程晓冉、刘晓云负责文章的构思与设计;程晓冉负责数据处理与分析,撰写论文并对文章负责;张众、窦丽娣、刘晓云负责研究的实施和管理;程晓冉、张众、窦丽娣负责数据收集与整理;张笑天、王静雅负责文章指导、质量控制与审校。
  • 基金资助:
    美国中华医学基金会项目(CMB 14-201)

Employment and Contract Performance of Medical Graduates from Compulsory Rural Service Directed Free Training Program: a Five-year Follow-up Analysis Based on the Graduates from Four Medical Schools

Xiaoran CHENG1,2, Xiaotian ZHANG2,*(), Jingya WANG3, Zhong ZHANG2, Lidi DOU2, Xiaoyun LIU2   

  1. 1School of Public Health, Peking University, Beijing 100191, China
    2China Center for Health Development Studies, Peking University, Beijing 100191, China
    3Center for Rural Medical Education Research, Gannan Medical University, Ganzhou 341000, China
  • Received:2022-04-07 Revised:2022-06-18 Published:2022-08-05 Online:2022-06-23
  • Contact: Xiaotian ZHANG
  • About author:
    CHENG X R, ZHANG X T, WANG J Y, et al. Employment and contract performance of medical graduates from compulsory rural service directed free training program: a five-year follow-up analysis based on the graduates from four medical schools[J]. Chinese General Practice, 2022, 25 (22) : 2713-2719.

摘要: 背景 培养农村订单定向医学生是改善我国农村地区卫生人力资源短缺的重要举措,目前首届农村订单定向医学生已经完成履约。需要对订单定向医学生的履约情况和影响因素进行分析,以及时改进订单定向医学生培养政策,稳定并提高订单定向医学生的履约率。 目的 了解中西部四所医学院校2015—2019届订单定向医学生的就业及履约情况,并分析订单定向医学生履约的影响因素,以提出进一步完善订单定向医学生培养政策的建议。 方法 选取青海大学、广西医科大学、九江学院、赣南医学院四所医学院校建立订单定向医学生队列,并选取同届的其他临床医学五年制毕业生为对照。毕业前对毕业生开展基线问卷调查,内容包括毕业生的基本信息、家庭信息、工作期望等;此后每年开展一次线上随访调查,内容包括毕业生的就业情况、履约情况等。本研究的开展时间为2021年7月,采用的资料为四所院校2015—2019届毕业生的基线调查资料和2020年9月的随访调查资料,共纳入订单定向医学毕业生2 041例、其他临床五年制毕业生1 579例。比较订单定向医学毕业生与其他临床五年制毕业生就业情况,采用多因素Logistic回归分析订单定向医学毕业生履约的影响因素。 结果 基线调查中,2.26%(46/2 038)的订单定向医学毕业生愿意到乡镇卫生院和村卫生室工作;2020年随访调查中,86.04%(228/265)的订单定向医学毕业生选择到乡镇卫生院和村卫生室工作。2018年对2015届和2016届订单定向医学毕业生的随访调查中,43.67%(290/664)的毕业生表示合同期满后不愿意继续留在乡镇卫生院工作。97.48%(1 546/1 586)的订单定向医学毕业生落实了编制,比例高于其他临床五年制毕业生(P<0.05)。5届订单定向医学毕业生的总体履约率为97.84%(1 589/1 624)。多因素Logistic回归分析结果显示,男性、基线调查时期望的工作地点为农村、工作有编制、履约地点为家乡所在区(县)是订单定向医学毕业生履约的促进因素(P<0.05)。 结论 订单定向医学生就业较为顺利,履约率高。订单定向医学生招生应侧重有农村工作意愿的学生,并尽量与生源地所在区(县)签订合同。

关键词: 全科医生, 订单定向医学生, 就业, 履约, 教育,医学, 初级卫生保健

Abstract:

Background

Compulsory rural service directed medical student free training program is an important initiative to ameliorate the shortage of health human resources in rural areas of China, and the first graduates of the policy have now completed the contract performance. Analysis of the performance situation and influencing factors of these students is needed to improve the policy of compulsory rural service directed medical student free training program in time and improve and stabilize the performance rate of the rural service directed medical students.

Objective

To analyze the employment and performance status of compulsory rural service directed medical graduates of 2015—2019 in four Midwestern medical schools, and to analyze the influencing factors on the performance of the rural service directed medical students, so as to make recommendations to further improve the training policy of the rural service directed medical students.

Methods

A cohort of rural service oriented medical students was established from four medical schools including Qinghai University, Guangxi Medical University, Jiujiang college, and Gannan Medical College, and other five-year graduates of clinical medicine from the same session were selected as controls. A baseline questionnaire was administered to graduates before graduation, which included the basic information, family information, job expectations, and so on. An online follow-up survey was conducted annually thereafter and included graduates' employment, performance status, and so on. This study was conducted in July 2021 using data from a baseline survey of graduates of 2015—2019 from four institutions and a follow-up survey from September 2020. A total of 2 041 rural service directed medical graduates and 1 579 other 5-year clinical students were enrolled. Compare the difference in employment between rural service oriented medical graduates and other five-year clinical students. Multivariate Logistic regression was used to analyze the influencing factors on the performance of rural service directed medical graduates.

Results

In the baseline survey, 2.26% (46/2 038) of the rural service directed medical graduates were willing to work in township health institutes. In the 2020 follow-up survey, 86.04% (228/265) of the rural service directed medical graduates chose to work in township health institutes. In a 2018 follow-up survey of 2015 and 2016 rural service directed medical graduates, 43.67% (290/664) of graduates expressed reluctance to remain in township health institutes after the expiry of the contract. 97.48% (1 546/1 586) of rural service directed medical graduates were allocated as personnel in public institution, a higher proportion than other clinical 5-year graduates (P<0.05). The overall performance rate of 5-year rural service directed medical graduates was 97.84% (1 589/1 624), and the results of multivariate logistic regression analysis showed that male gender, desired job location as rural areas in the baseline survey, job having public institution quota, and contract location as home district (county) were the promoting factors for the performance of rural service directed medical graduates (P<0.05) .

Conclusion

Rural service directed medical students are more smoothly employed with high performance rates, and the recruitment of this type of medical students should focus on students who have willingness to work in rural areas and try to contract with the counties where the students are from.

Key words: General practitioners, Target admissionmedical graduates, Employment, Contract fulfillment, Education, medical, Primary health care