With the advancement of the tiered medical system and family doctor contracted services, higher requirements have been placed on the job competency of general practitioners (GPs) in primary care institutions. Although standardized residency training has cultivated a number of qualified GPs, a gap remains between their competencies and the actual needs of community practice, particularly in clinical reasoning, emergency management, humanistic communication, and comprehensive application of knowledge and skills. Post-residency training places greater emphasis on primary care needs, multidisciplinary integration, and practical capacity building. Therefore, it is necessary to evaluate its effect on improving the competency of GPs.

To investigate the effect of post-training after standardized residency training on improving the job competency of GPs.

From 2016 to 2018, a total of 24 GPs who had completed the Shanghai standardized residency training program in general practice were randomly selected from eight community health service centers within the Jinqiao Medical Consortium in Shanghai. These participants received post-residency clinical skills training (hereinafter referred to as "post-training") . Before and after the training, their job competency was comprehensively assessed by means of an objective structured clinical examination (OSCE) , which included eight components: comprehensive theoretical knowledge, electrocardiogram (ECG) and X-ray interpretation, history taking, physical examination, medical record writing, case analysis, basic first-aid skills, and doctor-patient communication. The improvement in comprehensive clinical skills before and after the training was analyzed.

After the post-training, the scores of the GPs in basic first-aid skills (84.35±11.26), doctor-patient communication (87.06±13.31), case analysis (75.79±7.84), comprehensive theoretical knowledge (65.47±4.14), and ECG/X-ray interpretation (74.79±8.40) were significantly higher than those before the training (P<0.05) . In addition, the rates of excellent performance in ECG/X-ray interpretation (33.3%), history taking (91.6%), physical examination (87.5%), medical record writing (83.3%), case analysis (37.5%), basic first-aid skills (70.8%), and doctor-patient communication (75.0%) were all higher after the training than before the training (P<0.05).

Post-training after standardized residency training can significantly improve the clinical skills of GPs, enhance their job competency, and strengthen their capacity to provide community healthcare services.

随着分级诊疗和家庭医生签约服务的推进，基层医疗卫生机构对全科医生岗位胜任力提出了更高要求。尽管住院医师规范化培训已培养了一批全科医生，但其能力与社区实际岗位需求仍存在差距，尤其在临床思维、急救处置、人文沟通及综合应用能力方面仍需加强。规培出站后再培训更注重基层需求、多学科整合和实践能力提升，因此有必要评价其对全科医生岗位胜任力提升的效果。

研究实施"规培出站后再培训"对全科医生岗位胜任能力提高的效果。

2016—2018年在上海市金桥医疗联合体内8家社区卫生服务中心随机抽取24名已通过"上海市全科住院医师规范化培训"合格出站的全科医生进行"出站后全科规培医师临床技能再培训"（以下简称"再培训"），在全科医生完成"再培训"前后，采用客观结构式临床考核方式，设置综合理论知识、心电图及X线读片、病史采集、体格检查、病史书写、病例分析、基本急救技能、医患沟通8个项目，分别对其岗位胜任力进行综合考核，分析培训实施前、后全科住院医师对全科综合临床技能的提高效果。

培训后全科医生的基本急救技能（84.35±11.26）分、医患沟通（87.06±13.31）分、病例分析（75.79±7.84）分、综合理论知识（65.47±4.14）分、心电图及X线读片项目考核（74.79±8.40）分成绩高于培训前（P<0.05）。培训后全科医生心电图及X线读片（33.3%）、病史采集（91.6%）、体格检查（87.5%）、病历书写（83.3%）、病例分析（37.5%）、基本急救技能（70.8%）、医患沟通考核（75.0%）优秀率均高于培训前（P<0.05）。

实施"规培出站后再培训"对全科医生临床技能的提高有显著效果，增强岗位胜任力，提高社区医疗保健服务能力。