关键词: 全科医生, 注册, 学员, 影响因素分析, 卫生政策, 收入

Abstract: Background　In countries with a relatively sound healthcare system，general practitioners（GPs） account for more than 30% of the total number of doctors，but in China，the percent of GPs is only 7.5%.By the end of 2017，China has trained 253 000 GPs，but only 98 000 （38%） of them become registered GPs.So it is necessary to investigate the relevant reasons to develop facilitation strategies.Objective　To investigate the barriers for GP trainees becoming registered GPs，and to make corresponding recommendations for government decision-making of improvement strategies.Methods　Participants were GP trainees who received general practice theoretical training in The Second Affiliated Hospital of Nanjing Medical University in October 2018.Individual interviews on the topic of "negative factors associated with choosing general practice as a career" were conducted in trainees selected by dynamic sampling until data saturation was reached.Results　A total of 25 GP trainees participated in the survey.Five main barriers for becoming registered GPs were summarized as follows：health policy level：lack of innovation in the implementation of the related policies，and inadequate supporting policies；GP trainees level：unsatisfactory health literacy and low level of trust in trainers；GP career level：unsatisfactory attractiveness；GPs training system level：lack of effective training mode；professional cognition level：unsatisfactory professional self-identity.Conclusion　GP trainees thought that lack of qualitative development in general practice in the short term is the fundamental reason that impedes their registration as a GP.It is recommended to increase the professional cognition and professional self-identity in GP trainees，and build a good working platform to increase their willingness to be registered GPs.

Key words: General practitioner, Registration, Trainee, Root cause analysis, Health policy, Income