The long-term and stable development of the general practitioner workforce is crucial to the implementation of policies related to contracted family doctor services, the continuous promotion of construction of the hierarchical diagnosis and treatment system, and the realization of national strategic goals for achieving "big health". Whether a general practitioner continues to work in general practice depends primarily on his confidence in the profession. Exploring the perceptions toward general practice as a career among general medical graduates finishing the standardized general residency training program (SGRTP) , can provide a reference for the improvement of training content and relevant policy formulation. However, there are few relevant studies.

To explore the perceptions toward general practice career among non-targeted admission general medical graduates completing the SGRTP, offering insights into how to better retain general practice talents.

In August 2021, stratified cluster random sampling was used to select non-targeted admission general medical graduates who had been admitted to the SGRTP in 10 standardized general residency training bases in Henan Province during 2014 to 2017, and completed the SGRTP as of the survey date. They attended a self-administered survey conducted through an online platform named "Wenjuanxing", using a questionnaire developed by our research group for understanding their general information, standardized training information, current work situation and perceptions toward a career in general practice.

Three hundred and twenty-six cases attended the survey, and 271 (83.1%) of them who handed in responsive questionnaires were finally included, among whom 77 (28.4%) went into the career of general practice after the completion of SGRTP. Compared with their counterparts who did not work in general practice following the completion of training, the trainees who worked in general practice rated the disciplinary position of general medicine and the social position of general practitioners higher (P<0.05) . Moreover, the percentage of them〔80.5% (62/77) 〕 intending to work in general practice in their whole life was higher (P<0.05) . The score for disciplinary position of general medicine rated by the trainees varied by age and whether or not being the only child of the family (P<0.05) . The score for social position of general practitioners rated by the trainees varied by maternal education level (P<0.05) . The score for the career prospect of general practitioners rated by the trainees varied by age (P<0.05) . Age, marital status, education level, maternal occupation, and current work unit were associated with the differences in scores for intending to be a general practitioner in the whole life given by the trainees (P<0.05) . The top three factors limiting the development of general medicine according to the trainees were "inadequate supporting policies" (150 cases, 55.4%) , "low salary for general practitioners" (146 cases, 53.9%) , and "poor equipment in primary care" (137 cases, 50.6%) . The rates of trainees choosing restrictors of the development of general medicine did not vary by whether or not working in general practice following the completion of SGRTP (P>0.05) . The top three advantages of primary care institutions were "better health guidance for residents" (213 cases, 78.6%) , "optimal allocation of medical resources, relieving pressure on major hospitals and avoiding waste of resources" (165 cases, 60.9%) , and "solving the problem of'seeing a doctor is difficult and expensive' among the masses" (162 cases, 59.8%) . The rates of trainees choosing the options of advantages of primary care institutions did not vary by whether or not working in general practice following the completion of SGRTP (P>0.05) . The top three disadvantages of primary care institutions according to the trainees were "low salary for general practitioners" (212 cases, 78.2%) , "poor hardware and equipment" (181 cases, 66.8%) , and "inadequate social security mechanism" (111 cases, 41.0%) . The rate of trainees choosing "inadequate social security mechanism" or "great concern in educational issues for children due to backward development in remote rural areas" varied by whether or not working in general practice following the completion of SGRTP (P<0.05) , but the rate of choosing each of the other options of disadvantages of primary care institutions did not (P>0.05) .

Age, education level, marital status, mother's education level and occupation, whether or not being the only child in the family, and current work unit were associated with the perceptions toward general practice career in non-targeted admission general medical graduates completing the SGRTP. The supporting policies and salary system are main factors affecting the development of general medicine and primary care institutions, and priority should be given to the allocation of hardware and equipment and the education guarantee for children of general practitioners.

全科医生队伍的长久、稳定发展对落实家庭医生签约服务政策、持续推进分级诊疗制度建设、实现国家"大健康"战略目标至关重要。全科医生是否继续从事全科医学职业主要取决于其对全科医生职业的信心。探讨已结业的全科住院医师规范化培训（简称住培）学员对全科医学职业认知情况，可以为今后培训内容改进及相关政策制定提供参考，但目前相关研究较少。

调查已结业非订单定向全科住培学员对全科医学职业认知情况，从而为能够更好地留住全科人才提供参考。

于2021年8月，采用分层随机整群抽样法，选取河南省10家全科住培基地2014—2017年入培且已结业的非订单定向全科住培学员进行问卷调查。问卷由课题组设计，本研究涉及的主要内容包括：学员基本信息、住培情况、目前工作情况、对全科医学的职业认知等。通过"问卷星"发放问卷，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工作者77名（28.4%）。结业后从事全科医学相关工作学员对全科医学学科地位、全科医生社会地位的评分高于未从事全科医学相关工作者（P<0.05）；结业后从事全科医学相关工作学员中，80.5%（62/77）愿意将全科医生作为终生职业，该比例明显高于未从事全科医学相关工作者（P<0.05）。不同年龄、是否为独生子女学员对全科医学学科地位的评分比较，差异有统计学意义（P<0.05）；母亲不同文化程度学员对全科医生社会地位的评分比较，差异有统计学意义（P<0.05）；不同年龄学员对全科医生职业前景的评分比较，差异有统计学意义（P<0.05）；不同年龄、婚姻状况、文化程度、母亲职业、目前工作单位学员将全科医生作为终生职业的意愿评分比较，差异有统计学意义（P<0.05）。学员认为前三位限制全科医学发展的因素依次为：配套政策不完善（150名，55.4%）、薪酬待遇低（146名，53.9%）、基层医疗设备落后（137名，50.6%）。结业后是否从事全科医学相关工作学员对各项限制因素的选择率比较，差异无统计学意义（P>0.05）。学员认为基层医疗卫生机构的优势排在前三位的依次为：能更好给予居民健康指导（213名，78.6%）；能够优化医疗资源配置，缓解大医院压力，避免资源浪费（165名，60.9%）；能切实解决居民"看病难、看病贵"问题（162名，59.8%）。结业后是否从事全科医学相关工作学员对基层医疗卫生机构各项优势的选择率比较，差异无统计学意义（P>0.05）。271名学员认为基层医疗卫生机构的劣势排在前三位的依次为：薪酬待遇低（212名，78.2%），硬件设备落后（181名，66.8%），社会保障机制不健全（111名，41.0%）。结业后是否从事全科医学相关工作学员对基层医疗卫生机构劣势中的"社会保障机制不健全""偏远农村发展落后，子女今后教育问题值得深思"两项的选择率比较，差异有统计学意义（P<0.05）；其他选项的选择率比较，差异无统计学意义（P>0.05）。

年龄、文化程度、婚姻状况、母亲文化程度及职业、是否独生子女和目前工作单位是影响非订单定向全科住培学员对全科医学职业认知的因素。配套政策和薪酬制度是影响全科医学发展和基层医疗卫生机构发展的主要因素，基层硬件设备和全科医生的子女教育保障也需要被关注。