Abstract: Background　As the "gatekeepers" of residents' health and control of medical expenses，general practitioners（GPs） play an important role in the delivery of essential medical services.GPs' service capabilities，incentives for GPs and GP workforce stability are of great significance in the promotion of contracted family doctor services（CFDSs） and in the development of hierarchical medical system.Objective　To obtain a deep understanding of the job competencies and satisfaction in grassroots GPs.Methods　In July 2016，by use of stratified cluster sampling，440 GPs（including TCM GPs） were recruited from 15 community health centers（CHCs） in urban and suburban areas and urban-rural fringe in Shanghai's Pudong New Area，and were surveyed with a questionnaire composed mainly of implementation of CFDSs，job competencies and satisfaction.Results　The survey obtained a response rate of 100.0%.Among the respondents，95.2%（419/440） reported that they could fully/basically deliver first contact services，81.0%（350/432） considered that they were fully/ basically competent for their job in terms of medical knowledge and skills，and 70.2%（302/430） reported that they worked under very/relatively high pressure.GPs' assessments for the level of working pressure and the role of a regional medical consortium in the development of hierarchical medical system differed significantly by the location area of CHCs（P<0.05）．GPs' assessments for the abilities in the management of difficult basic medical problems，challenging chronic conditions，and working pressure，and for the fulfillment of potential as a GP varied obviously by the type of CHCs（P<0.05）．The mean satisfaction scores evaluated by the GPs for the value of a GP，and payment for GP，as well as for collaborative diagnosis and treatment were all less than 3.0 points，but those for working environment，job supports provided by community（residential） committees and teams were greater than 3.0 points.Conclusion　 GPs in Pudong New Area showed high level of competencies for being a GP，which is conducive to attracting residents to community healthcare facilities to receive first contact services，and to chronic disease prevention and treatment and health management.However，in order to promote the development of family doctor system，GPs self-perceived value as being a GP，and payment for GPs should be improved，and regional differences in these two aspects should be narrowed.

Key words: Contracted family doctor services, General practitioners, Community health services, Professional competence, Job satisfaction

摘要： 背景　全科医生是居民健康和控制医疗费用支出的“守门人”，在基本医疗卫生服务中发挥着重要作用，其服务能力、激励机制及队伍稳定性对于推进家庭医生签约服务、建立分级诊疗制度具有重要意义。目的　了解基层全科医生的工作胜任度及满意度。方法　于2016年7月，采用分层整群抽样法在上海市浦东新区抽取城区、城郊、郊区15家社区卫生服务中心的全科医生（包括中医全科医生）440例进行问卷调查，主要内容为家庭医生签约服务开展情况、工作胜任度及满意度。结果　440份问卷均有效回收，问卷有效回收率为100.0%。95.2%（419/440）全科医生表示完全/基本能够顺利进行社区首诊，81.0%（350/432）全科医生表示知识和能力完全/基本能够胜任工作，70.2%（302/430）全科医生表示工作压力很大/比较大。不同区域全科医生对工作压力、医疗联合体是否有利于家庭医生制度推行的评价比较，差异有统计学意义（P<0.05）；不同类型社区卫生服务中心全科医生对能否处理基本医疗中的技术难题、能否处理慢性病管理中的技术难题、工作压力、工作能力能否得到发挥的评价比较，差异有统计学意义（P<0.05）。全科医生对工作价值、工作收入的平均满意度评分<3.0分；对工作环境的平均满意度评分>3.0分；对工作支持系统中社区（居委）配合、团队支持的平均满意度评分>3.0分，对协同诊疗的平均满意度评分<3.0分。结论　浦东新区基层全科医生的工作胜任度较高，利于引导居民社区首诊、慢性病防治及健康管理，但仍需提高其对自身工作价值和工作收入的满意度，同时关注区域间差异，促进家庭医生制度持续发展。

关键词: 家庭医生签约服务, 全科医生, 社区卫生服务, 专业能力, 职业满意