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

摘要： 背景　卫生体系较完善的国家，全科医生数量占医生比例的30%以上，我国目前只占7.5%。截至2017年底，我国已培养25.3万全科学员，真正注册全科医生只有9.8万人，仅占总培养人数的38%，有必要调查相关原因，以便决策参考。目的　调查阻碍全科学员注册为全科医生的原因，提出相应的建议，以供决策参考。方法　选择2018年10月在南京医科大学第二附属医院进行理论培训的全科学员作为研究对象。根据“动态抽样”和“信息饱和”原则，对全科学员进行个别访谈，访谈主题为：影响你从事全科医生的顾虑有哪些？结果　共访谈25名全科学员，归纳出阻碍全科学员注册全科医生的5个层面影响因素，分别为：卫生政策层面：执行效果缺乏创新和配套政策未完善；服务接收者层面：健康素养不高和信任度差；全科医生职业层面：吸引力有待提高；全科医生培养体系层面：缺乏有效的培养模式；专业认知层面：职业自我认同感不强。结论　全科学员认为“全科医学在中国短期内无法取得‘质’的发展”是阻碍其注册全科医生的根本原因。建议通过提高全科医生收入、提升学员的专业认知和职业自我认同感及打造好全科医生工作平台等方法来提升全科学员注册全科医生的意愿。

关键词: 全科医生, 注册, 学员, 影响因素分析, 卫生政策, 收入