Abstract: To understand the current status and implementation progress of the Opinions on Reforming and Improving the General Practitioners Training and Incentive Mechanisms（〔2018〕 No.3 issued by General Office of the State Council of the People's Republic of China），this paper systematically reviews the documents issued by provinces（autonomous regions and municipalities） in 2018 and typical cases reported in 2019 in China，and analyzes the results of field research in Shanghai，Guangdong，Anhui，Shandong，Hainan，Shaanxi and other provinces（autonomous regions and municipalities） using the relevant data of general practitioners（GPs） in the 2013—2016 China Health and Family Planning Statistical Yearbook and 2018—2019 China Health Statistics Year book.As of December 2018，provinces（autonomous regions and municipalities） in China have issued implementation opinions or plans for GPs，and some of them have made innovations and breakthroughs in policies such as the training of GPs，reforming and improving the salary system for GPs，and expanding the career development of GPs.In 2018，the number of GPs per 10 000 population in China reached 2.22，and 40.6%（13/32） of the provinces（autonomous regions and municipalities） reached the goal of two qualified GPs per 10 000 population in 2020 ahead of schedule.The GP registration rate increased from 33.9% in 2012 to 50.8% in 2018.From the aspect of GP training，the three-stage organic training system for GP college education，GP postgraduate education，and GP continuing education has been further improved in some areas in the past two years.From the aspect of salary system reform，the performance salary of primary health care institutions is approved according to the salary level of public county（district） hospitals，and GP allowance is established internally，and more than 70% of the fee from contracted family doctor service is used for internal distribution in service teams in representative areas.The salary of GPs has been raised.From the aspect of appointment management，some representative regions improve the establishment of a turnover pool system and implement "employed by county and work in township" policy for GPs who have passed the standardized training of resident physicians and practice in rural areas，and give priority to the authorized strength and position to GPs.At the same time，drawing on the experience of representative regions，this article proposes relevant policy recommendations for the weaknesses of GP training and incentive mechanisms，with a view to providing suggestions for the further improvement of the GP system.

Key words: General practitioners；General practitioner system；Education, medical；Salary system reform；Appointment management；Career development

摘要： 为了解全国落实《关于改革完善全科医生培养与使用激励机制的意见》（国办发〔2018〕3号）情况和实施进展，本文系统梳理了全国各省（自治区、直辖市）2018年出台的相关文件和2019年上报的典型案例，同时利用2013—2016年《中国卫生和计划生育统计年鉴》和2018—2019年《中国卫生健康统计年鉴》全科医生相关数据，以及上海市、广东省、安徽省、山东省、海南省、陕西等的实地调研结果进行分析。截至2018年12月，各省（自治区、直辖市）均出台了实施意见或实施方案，部分地区在全科医生培养、改革完善全科医生薪酬制度、拓展全科医生职业发展等政策上有所创新和突破。2018年，我国每万人口全科医生数达到2.22人，40.6%（13/32）的省（自治区、直辖市）提前达到“2020年每万人口2名合格全科医生”的目标；全科医生注册率从2012年的33.9%上升到2018年的50.8%。从培养培训方面看，近两年各地区在全科医生院校教育、毕业后教育、继续教育三阶段有机衔接的培养体系基础上进一步完善；从薪酬制度改革方面看，典型地区基层医疗卫生机构绩效工资按照不低于县（区）级公立医院水平核定、内部分配设立全科医生津贴、家庭签约服务费的70%及以上用于签约服务团队内部分配，全科医生薪酬得到提高；从聘用管理方面看，典型地区完善编制周转池制度，对经住院医师规范化培训合格并到农村地区执业的全科医生实施“县聘乡用”政策，并且编制和岗位优先保证全科医生。同时，本文借鉴典型地区经验，针对全科医学培养与使用激励机制的“短板”和弱项，提出了相关政策建议，希望能为全科医生制度的进一步完善提供借鉴。

关键词: 全科医生；全科医生制度；教育, 医学；薪酬制度改革；聘用管理；职业发展