Both the quantity and quality of general practitioners (GPs) are two important aspects in human resource management in healthcare, among which the increase, maintaining and loss of the number of GPs is an important indicator for assessing the dynamic planning, management and evaluation in human resource management for GPs, and also is an indicator for assessing the effectiveness of the standardized general practice residency program (SGPRP) . Studying the employment status and associated factors in trainees of the SGPRP will be references for the development of policies and incentives regarding the SGPRP. But there is a lack of such studies in non-targeted admission medical graduates completing the SGPRP.

To understand the employment status of non-targeted admission medical graduates finishing the SGPRP in Henan Province, and to identify the causes of choosing other careers instead of being a GP, providing a reference for the improvement of SGPRP management and incentive mechanisms for human resource management.

In August 2021, multistage random sampling was used to select non-targeted admission medical graduates (n=326) who had been admitted to the SGPRP during 2014 to 2017 and had completed it in Henan Province. They were invited to complete a self-administered survey questionnaire through the platform of wjx.cn for understanding their general information, and self-perceived status of training with SGPRP, current job, and causes of being a GP or choosing other careers.

The survey obtained a response rate of 83.1% (271/326) . Among the respondents, 77 (28.4%) chose GP as a career, and other 194 (71.6%) chose other careers after completing the SGPRP. Multivariate Logistic regression analysis showed that age, education level, type of source and the location of the general practice residency training base were associated with the career choice (P<0.05) . Compared with respondents with a non-GP career choice, those with a GP career choice had higher prevalence of having general practice as the registered major 〔70.1% (54/77) vs 32.0% (62/194) , P<0.05〕, and working at township health centers or community health centers〔49.4% (38/77) vs 6.2% (12/194) , P<0.05) 〕. Among those with a non-GP career choice, the top three careers were internal medicine practitioners〔40.2% (78/194) 〕, emergency and critical care practitioners〔17.0% (33/194) 〕, and surgical care practitioners〔8.8% (17/194) 〕. The three major causes of choosing a non-GP career were appointed by the employed hospital〔34.5% (67/194) 〕, lack of general practice department in the employed hospital〔29.9% (58/194) 〕 and low salary〔26.8% (52/194) 〕.

In these non-targeted admission medical graduates finishing the SGPRP, the prevalence of choosing a GP career was relatively low, which may be associated with age, education level, type of source, and the location of the general practice residency training base. To increase the attractiveness of GP as a career, it is recommended to expand the publicity of the concept of general medicine, accelerate the construction of the general practice department in general hospitals, and improve the salary of GPs.

全科医生数量和质量是人力资源管理的两个重要维度，其中，医生数量的新增、保持和流失，是全科人力动态规划、管理和评价的重要考量，也是全科住院医师规范化培训（简称全科住培）的绩效指标。探讨全科住培学员的就业状况及影响因素，可以为今后住培政策和激励机制的制定提供参考，但目前针对非订单定向全科住培学员的相关研究较为缺乏。

了解河南省非订单定向全科住培学员的就业状况，分析学员结业后未从事全科医学相关工作的原因，从而为完善培训管理和人力资源激励机制提供参考。

于2021年8月，采用分层随机整群抽样法，在河南省选取2014—2017年入培且已结业的非订单定向全科住培学员326例进行问卷调查。问卷由课题组自行设计，主要内容为学员的基本信息、全科住培情况、目前工作情况及结业后从事与未从事全科医学相关工作的原因。问卷通过"问卷星"平台发放，由学员自行填写。

共发放问卷326份，回收有效问卷271份（83.1%）。结业后，从事全科医学相关工作者77例（28.4%），从事非全科医学相关工作者194例（71.6%）。多因素Logistic回归分析结果显示，年龄、文化程度、生源类型、全科住培基地所在区域是学员结业后是否从事全科医学相关工作的影响因素（P<0.05）。与结业后未从事全科医学相关工作的学员相比，结业后从事全科医学相关工作学员注册为全科医学专业的比例更高〔70.1%（54/77）比32.0%（62/194），P<0.05〕，在乡镇卫生院/社区卫生服务中心执业的比例更高〔49.4%（38/77）比6.2%（12/194），P<0.05）〕。194例未从事全科医学相关工作的学员中，从事内科学工作者78例（40.2%），从事急诊及危重症医学工作者33例（17.0%），从事外科学工作者17例（8.8%）。不选择从事全科医学相关工作的前3位原因分别为：单位安排〔34.5%（67/194）〕，所在单位没有全科医学科〔29.9%（58/194）〕，薪酬低〔26.8%（52/194）〕。

非订单定向全科住培学员选择从事全科医学相关工作的比例较低，年龄、文化程度、生源类型及基地所在区域是影响因素。建议加大全科医学理念宣传，加快综合医院全科医学科建设，提高全科医生薪酬待遇，以此增加全科医生的职业吸引力。