Abstract: Background　Traditional Chinese medicine（TCM）is of great significance in alleviating the problems of difficult and expensive access to medical services among the masses.There are few investigations on the work tasks of TCM general practitioners（GPs）in primary medical institutions in China.In order to better serve the professional TCM education at the junior college level，our research group conducted sampling surveys in Chongqing Municipality，Yunnan and Guizhou Provinces in western of China.Objective　To explore the job duties of TCM GPs in primary medical institutions in Chongqing，Yunnan and Guizhou，and to provide a basis for the development of TCM education at the junior college level.Methods　This study was conducted during June to August，2017.By use of random sampling，researchers of our group（3 working in Chongqing，1 in Chuxiong，Yunan Province and 1 in Tongren，Guizhou Province）selected 1 district/county from the city that they worked，respectively，and from the district/county，4 primary medical institutions in urban and rural areas were selected randomly，respectively.All the TCM GPs（n=102）in the sampled 12 institutions were enrolled.We surveyed them with a self-developed questionnaire for collecting the general personal data，major job duties（major basic medical services，major basic public health services，most frequently encountered diseases，most frequently encountered symptoms，basic medical services in detail，basic public health services in detail）．All of them returned responsive questionnaires，achieving a response rate of 100.0%.Results　Most of the respondents had a junior college degree（42.2%），and less than 10 years of practice（52.0%），33.3% of them worked in TCM department and 24.5% in rehabilitation department，and 24.5% had on-the-job training certificate for GPs.Major basic medical services accounted for（75.3±21.7）% of the total daily workload of the respondents，and the top 3 services were TCM prescription therapy（65.7%），acupuncture and moxibustion and massage treatment（58.8%），and chronic disease management（39.2%）．Major basic public health services accounted for（24.7±21.7）% of the total daily workload of the respondents，and the top 3 services were health education（55.4%），TCM health management of people aged over 65 and children aged 0-6 years old（54.0%），and health management of patients with chronic diseases（59.0%）．The 5 diseases most frequently encountered by the respondents were upper respiratory tract infection，diabetes，hypertension，digestive tract disease，injury（fracture，etc.）and poisoning.And the 5 symptoms most frequently encountered were joint pain，headache，cough，abdominal pain and insomnia.On average，the respondents served（66.0±49.2）patients per week，spent（25.4±13.6）minutes on treating per patient，and spent（5.7±2.3）hours on consultations per day，and transferred（2.7±1.4）patients per month.20（19.6%）of the respondents had made home visits，with an average monthly number of（2.6±1.8）．The main reason for home visits is that it was inconvenient for patients to go out（the average monthly number of such home visits was 35，accounting for 67.3% of the average monthly total number of home visits）．Oral administration was the first choice of most of the respondents（60.8%）for treating patients with fever.Of the respondents，64.7% performed a physical examination for the residents，64.7% identified residents' TCM physical constitution，60.8% carried out TCM health education，58.8% gave TCM healthcare advices for residents，54.9% participated in chronic disease management and gave corresponding advices for residents，45.1% established health records for residents，29.4% treated children with TCM-based food therapy，and 27.5% taught massage techniques for children.Conclusion　The main duties of the GPs in primary medical institutions in the 3 regions are basic medical services，but they also need to deliver some public health services.Prevention and treatment of the common diseases and frequently-occurring diseases accounting for most of the total basic medical services workload，and to do these adequately，good mastery of the knowledge and techniques of Chinese and western Medicine，and good capabilities of delivering family medicine services and identifying critical and acute illnesses are needed.To train TCM GPs with a junior college degree and to improve their competencies for the role of TCM GPs in primary care，the concept of “task-oriented training with integration of theory and practice learning” should be adhered，and the training program and curriculum system should be revised according to the job duties and capabilities of GPs required by the primary care and the strengths of college education and master-apprentice education.

Key words: Workload；Community health services；General practitioners；Medicine, Chinese traditional；Questionnaires

摘要： 背景　中医药对缓解人民群众“看病难、看病贵”等问题具有重大意义，国内对基层中医全科医生岗位工作任务调查较少，为了更好地服务专科层次中医学专业教育，本课题组在西部地区重庆市、云南省和贵州省进行了抽样调查。目的　调查重庆、云南、贵州三省市基层中医全科医生岗位工作任务，为开展专科层次中医学专业教育提供依据。方法　2017年6—8月在研究者所在的西部3个城市（重庆市、云南省楚雄市、贵州省铜仁市），采用随机数字表法各抽取1个区/县，每个区/县按城乡分类随机抽取4个基层医疗卫生机构。选取上述12个基层医疗卫生机构中的所有中医全科医生102例为调查对象。采用自制问卷进行调查，调查内容包括调查对象的一般资料、主要工作任务（包括基本医疗工作、基本公共卫生服务工作、接触到的最常见疾病、接触到的最常见症状、基本医疗服务情况、基本公共卫生服务情况）。共发放问卷102份，最终回收有效问卷102份，有效回收率为100.0%。结果　中医全科医生以专科学历为主（42.2%），从业年限以<10年为主（52.0%），科室以中医科（33.3%）、康复科（24.5%）为主，有全科医师岗位培训证书者占24.5%。基本医疗工作占中医全科医生日常工作量的比例为（75.3±21.7）%，其前3位分别为中药处方治疗（65.7%）、针灸推拿治疗（58.8%）、慢病管理（39.2%）。基本公共卫生服务工作占中医全科医生日常工作量的比例为（24.7±21.7）%，其前3位分别为健康教育（55.4%），65岁以上老年人、0~6岁儿童中医药健康管理（54.0%），慢病患者健康管理（59.0%）。中医全科医生接触到的最常见疾病前5位依次为上呼吸道感染、糖尿病、高血压、消化道疾病、伤（骨折等）及中毒，接触到的最常见症状前5位依次为关节痛、头痛、咳嗽、腹痛、失眠。中医全科医生平均每周服务人次（66.0±49.2）人次，平均每例患者服务时间（25.4±13.6）min，平均每天用来看病的时间（5.7±2.3）h，平均每月转诊人次（2.7±1.4）人次。20例（19.6%）中医全科医生曾经到患者家出诊，平均每月出诊人次（2.6±1.8）人次；出诊的原因主要为患者出门不方便（平均每月出诊35人次，占平均每月总出诊人次的67.3%）。中医全科医生接诊发热患者时的首选给药方式主要为口服（60.8%）。102例中医全科医生中，针对居民开展过体检的有64.7%，开展中医体质辨识的有64.7%，开展中医药健康教育的有60.8%，开展中医药保健指导的有58.8%，开展慢病管理和指导的有54.9%，开展居民建档的有45.1%，开展儿童中医饮食调养的有29.4%，开展儿童按摩传授的有27.5%。结论　重庆、云南、贵州三省市基层医疗机构中医全科医生主要工作以基本医疗为主，还需承担部分基本公共卫生服务，医疗工作多为常见病、多发病的防治，需较强的中西医知识和技能，以及一定的家庭医疗服务能力和危急重症判断能力。专科层次中医全科医生培养应秉承“任务驱动，工学交替”的理念，根据基层中医全科医生的岗位任务和能力需求，融合院校教育和师承教育各自的优势，重新制定人才培养方案和课程体系，提高培养的基层中医全科医生的岗位胜任力。

关键词: 工作负荷量；社区卫生服务；全科医生；医学, 中国传统；问卷调查