Under the process of improving the capacity of primary health services, promoting hierarchical diagnosis and treatment, and realising the integration of medicine and prevention, the state has introduced a series of policies to support the cultivation of general practitioners, and to promote the rational distribution of general practitioners' resources. However, at the present stage, the study on the equilibrium of the distribution of general practitioners is still not comprehensive enough, and lacks the attention to both primary health care and disease prevention.

To set up indicators more comprehensively on the basis of previous studies to evaluate the characteristics and equilibrium of the distribution of general practitioners between provinces in China, and to provide theoretical support for the optimal distribution of general practitioner resources.

We collected data from the 2018-2022 China Health Statistics Yearbook, the 2018-2022 China Statistics Yearbook, and the 2021 China Urban Statistics Yearbook from the websites of the National Health Commission, the National Bureau of Statistics, and offline libraries in April 2023, measured interprovincial general practitioner distribution on an absolute level using five indicators: general practitioners per 10 000 population, general practitioners per 10 square kilometres, the general practitioner-inhabitant disposable income ratio, the general practitioner-primary care institution ratio, and the general practitioner-disease prevention institution ratio, combined with descriptive statistics; The GINI coefficient of the five dimensions of population, area, income, primary health care and disease prevention, combined with the Lorenz curve, were used to preliminarily evaluate the provincial relative distribution gap of general practitioners; Further measured the equilibrium of the distribution of the number of general practitioners among provinces by using the five dimensional DAGUM decomposition GINI coefficient, including inter-group GINI coefficient, intra-group GINI coefficient and inter-group GINI coefficient within each region, combined with the analysis of the agglomeration degree of population and area.

During 2017 to 2021, the number of general practitioners in China had been growing rapidly. In 2021, the average number of general practitioners per 10 000 population was 2.93, the median was 2.80, and the standard deviation was 0.87; The GINI coefficient of the five-year population dimension was (0.195±0.047), the area dimension was (0.608±0.019), the income dimension was (0.401±0.015), the primary health care dimension was (0.318±0.058), and the disease prevention dimension was (0.393±0.033) ; The annual Lorentz curve of the population dimension deviated slightly from the 45° line, the area dimension and income dimension deviated significantly, and the Lorentz curve of the primary health care dimension and disease prevention dimension deviated moderately; In the result of DAGUM decomposition GINI coefficient, the contribution rate of GINI coefficient between groups was (59.863%±8.785%), the gap between groups was the main reason for the overall gap, and the hypervariable density was (25.959%±10.052%), and the gap within each regional group could not be ignored. Further decomposition results showd that within the region the inter-group GINI coefficient in the area dimension of East China and North China were higher, 0.570 and 0.504, respectively, and the inter-group GINI coefficient of the income dimension in North China was higher, 0.413, and the gap was mainly from Beijing, Tianjin, and Shanghai and the other provinces in the region; The results of agglomeration analysis showd that the values of Qinghai, Henan, Anhui, Guangdong and Jilin provinces were closer to the reasonable value 1, the values of other provinces were different, but they were close to 1 except for Tianjin, Shanxi, Inner Mongolia, Fujian, Hubei, Ningxia and Xinjiang provinces.

In absolute terms, the number of general practitioners in China has reached the established development goal. The construction of general practitioners has made remarkable achievements, but the relative number gap between provinces is still large. Although the polarization of agglomeration degree is improving, it still exists. The equilibrium of the distribution of general practitioners needs to be further optimized. We should continue to strengthen the training efforts to promote the growth of the number of general practitioners, At the same time, we should rely on information technology to encourage cross regional assistance and resource sharing.

Rare diseases, characterized by low prevalence and significant challenges in diagnosis and management, have increasingly gained attention in recent years due to advancements in medical technology. As gatekeepers of health and managers of patient and family health, general practitioners in many countries are now being integrated into the framework for managing rare diseases. The article discusses the current status of general practitioners in the diagnosis and management of rare diseases, including their role in the management process, efforts made, and the lack of knowledge about rare diseases. It highlights that despite challenges in recognizing rare diseases, most general practitioners are willing to improve their awareness and training. They can effectively participate in the comprehensive management of patients with rare diseases, playing a vital role in early identification, coordinating treatment, and providing integrated services.

General practitioners of traditional Chinese medicine (TCM), known as the "gatekeepers" of residents' health, provide continuous services to them. Recently, China has rolled out a series of policies aimed at supporting the growth of the workforce of TCM general practitioners and has made it a key development indicator, which holds great importance for advancing the TCM cause.

In alignment with the development goals outlined in the "14th Five-Year Plan" for the Development of TCM, this study analyzes the current status of the TCM general practitioner workforce in China, explores the optimization of statistical methodologies for TCM general practitioners, and proposes corresponding countermeasures and suggestions.

Based on data from the China Health Statistics Yearbook from 2021 to 2023 and special survey data, the difference between the actual number of TCM general practitioners in 2020 and 2022 and the planned number for 2025 was calculated. The completion rate of the planning targets was then computed based on these differences. A comparative method was used to analyze the data.

In 2022, the number of TCM general practitioners per 10 000 population was 0.75, representing an increase of 13.27% compared to 2020, with an average annual growth rate of 6.43%. There were significant regional disparities in the distribution of TCM general practitioners per 10 000 population, with the eastern, central, and western regions decreasing in that order, at 0.88, 0.68, and 0.61 respectively. The national completion rate for the TCM general practitioner workforce plan was 66.76%, indicating good overall progress. A total of 17 provinces (municipalities, autonomous regions) achieved a completion rate of 40% or higher for their TCM general practitioner workforce planning targets, with 11 of them exceeding their targets. Additionally, 14 provinces (municipalities, autonomous regions) made slower progress, including 9 provinces where the completion rate was negative. Based on special assessment data, calculations were made for TCM general practitioners from the perspectives of functional positioning and scope of practice, with 9 provinces and 20 provinces achieving their planning targets ahead of schedule, respectively.

Currently, the statistical count of TCM general practitioners is directly influenced by the number of general practitioners, leading to significant impacts on the count of TCM general practitioners when there are changes in the statistical criteria for general practitioners. It is necessary to further clarify the definition and statistical scope of TCM general practitioners, and strengthen the monitoring and evaluation of TCM general practitioner indicators to ensure the smooth achievement of planning targets.

General practitioners are the "gatekeepers" of residents' health, and their job satisfaction largely affects the quality and efficiency of primary healthcare service, which shows that it is of great significance to establish a job satisfaction evaluation system of general practitioners suitable for Chinese national conditions, and to improve the job satisfaction of general practitioners in order to promote the reform of the primary healthcare service system.

To conduct a systematic review of the job satisfaction of general practitioners and its influencing factors in China, to analyze the commonalities and differences in evaluation indexes and research results of the job satisfaction of general practitioners and their influencing factors in different studies, in order to provide reference for the establishment of a general practitioners' job satisfaction evaluation system suitable for Chinese national conditions.

PubMed, Web of Science, Embase, National Knowledge Infrastructure, WanFang Data and CQVIP were searched to obtain cross-sectional studies on job satisfaction and influencing factors of general practitioners from inception to June 12, 2023. Two researchers independently screened the literature and extracted the authors of the included literature, the time of the survey, the area of the survey, the sample size, the dimensions and indicators of the evaluation of job satisfaction, and the influencing factors of job satisfaction, and other information. The descriptive analysis method was adopted to summarize, analyze and compare.

We included 19 Chinese studies, including 15 354 general practitioners. The evaluation of the job satisfaction of general practitioners mainly involved four dimensions: material satisfaction, relationship satisfaction, growth satisfaction, and overall satisfaction, of which 19 articles mentioned income and interpersonal relationship, 14 articles mentioned working environment, job promotion, and personal value, and 8 articles mentioned training. The influencing factors of job satisfaction of general practitioners included income level, gender, age, title, education, work pressure, workload, promotion opportunities, employment methods, work environment, length of service, interpersonal relationship, welfare benefits, type of unit, social recognition and so on.

The overall level of job satisfaction of general practitioners in China was not high, and was affected by income level, gender, age, title, educational, workload, work pressure, promotion opportunities, employment methods and other factors.

There is a significant shortage of general practitioners at primary healthcare institutions in China, and their low job satisfaction is a crucial factor leading to the scarcity of talents.

To understand the job satisfaction and related factors among general practitioners (GPs) from primary healthcare institutions in Chengdu.

From December 2018 to January 2019, a questionnaire survey was conducted on all registered general practitioners working at primary healthcare institutions in Chengdu (n=1 549). The questionnaire included their basic information, job satisfaction, and their suggestions for improving job satisfaction. Multivariate Logistic regression was used to analyze the factors influencing job satisfaction among GPs.

A total of 1 539 valid questionnaires were collected, with an effective response rate of 99.35%. The overall job satisfaction of general practitioners was (114.0±17.2), indicating a "moderate" level. The average score of job workflow dimensions was the lowest (10.6±2.5), indicating "dissatisfaction". Other dimensions scored at a "moderate" level. The scores for salary and welfare dimension were relatively low at (11.8±2.8) and (11.6±2.8) respectively. There were statistically significant differences in overall job satisfaction among GPs of different genders and age groups (P<0.05) ; however, no statistical significance was found among GPs with different educational backgrounds, titles, and years of work experience (P>0.05). The results of multivariate Logistic regression analysis showed that age was a significant factor affecting overall job satisfaction of GPs (P<0.05). GPs aged 30-39 [OR (95%CI) =0.132 (0.035-0.494) ] and 40-49 [OR (95%CI) =0.207 (0.065-0.664) ] had lower job satisfaction compared to those aged 50 and above (P<0.05). A total of 419 individuals made suggestions for improving their job satisfaction, resulting in a total of 427 suggestions. Among these, "improving benefits" ranked the highest (25.53%, 109/427) .

The overall job satisfaction of GPs in primary healthcare institutions in Chengdu is generally moderate, with the least satisfaction regarding workflow and the greatest desire for improved benefits. Age is a factor influencing job satisfaction among GPs. It is recommended to take effective measures to enhance job satisfaction among GPs by addressing their areas of dissatisfaction, such as streamlining workflow and implementing a system of "fair distribution according to work performance".

First contact in the primary care setting and the development of a gatekeeping system are crucial for the implementation of a hierarchical medical system. Additionally, the implementation of first contact in the primary care setting depends on the serving capacities of primary care practitioners.

This study aims to assess the capabilities of primary care general practitioners in diagnosing and managing common diseases, referral practices, and evidence-based practice; and to explore their training needs to inform demand-driven training programs in Hunan Province.

From April to May 2023, a convenience sampling method was used to recruit primary care general practitioners who participated in the residency training or general practitioner transfer training at Xiangya Hospital, Central South University. A self-developed questionnaire consisting of four sections was used, covering basic characteristics, self-assessment of the capabilities for common diseases diagnosis and treatment, and evidence-based practice, and demands for capabilities improvement. Questionnaire Star platform was used to collect data, and descriptive analysis was used to present the results.

A total of 337 valid questionnaires were collected from each prefecture-level city and autonomous prefecture in Hunan Province, with 128 coming from community health service centers and 209 from township health institutions. The differences in gender, age, professional title, years of service at the grassroots level, and staffing status between general practitioners in township health institutions and community health service centers are all statistically significant (P<0.05). The results show that 75.1% (253/337) of participants consider themselves competent in the diagnosis and treatment of common diseases; 16.6% (56/337) of participants reported a lack of competence in certain diseases, with the top six including depression[89.3% (50/56) ], stress incontinence[69.6% (39/56) ], dementia[66.1% (37/56) ], stroke[53.6% (30/56) ], co-morbidities[51.8% (29/56) ]and tuberculosis[46.4% (26/56) ]. These findings consistent between community and township respondents. Furthermore, 71.8% (242/337) of participants reported being unfamiliar with referral practices. 73.0% (246/337) of participants indicated limited knowledge of evidence-based practice, and 85.8% (247/288) of participants have limited use of evidence-based practice. Additionally, 77.2% (260/337) of participants lacked sufficient knowledge of clinical practice guidelines; 90.8% (306/337) of participants rarely consulted guidelines when facing decision-making difficulties, mainly because they felt guidelines could not address complex cases[50.0% (153/306) ], were unclear on how to search for guidelines[43.1% (132/306) ]and the resources available for retrieving guidelines[34.3% (105 /306) ]; participants mainly obtain the guidelines through the WeChat official account[72.5% (237/327) ] and databases such as the China National Knowledge Infrastructure [50.2% (164/327) ]. 97.0% (327/337) of participants expressed a demand for training to improve their capabilities, suggesting that training should be tailored to the specific needs of primary care institutions[60.8% (205/337) ]; the preferred approaches are advanced training in higher-level hospitals[71.3% (233/327) ]and primary care institutions with high diagnostic and treatment capabilities[56.3% (184/327) ]; the preferred training programs are on standardized treatment of common diseases[78.0% (263/337) ]and multiple coexisting diseases[69.4% (234/337) ].

The majority of primary care general practitioners in Hunan Province consider themselves competent in the treatment of common diseases, but some are relatively incompetent in diseases such as depression, stress urinary incontinence, dementia, stroke, co-morbidities and tuberculosis; the majority of participants need to improve their capabilities in standardized referral, evidence-based practice, retrieval and application of clinical practice guidelines, suggesting that these items could be focus of training. The primary care general practitioners have a high demand for training, they prefer to engage in advanced training in high level institutions, and training in standardized treatment of common diseases and multiple coexisting diseases is needed. The training programs should be individualized based on the demands of primary care institutions.

To support the advancement of the "Healthy China" policy, is paper delves into the significance of interprofessional collaboration between health social workers and general practitioners in the primary healthcare setting. With a focus on three vital areas, including the synergy of complementary professional knowledge, integration with hospitals and communities, and the expansion of social health research, particularly in strengthening the public health emergency response system and boosting medical alliances. Synergistic efforts between health social workers and general practitioners can serve as a vital component in promoting nationwide health initiatives and fostering healthier societies. Furthermore, this paper proposes countermeasures to address the key challenges surrounding health social work.

With the deep reform of China's medical system, especially the advancement of the tiered diagnosis and treatment system, the role of general practitioners in the primary healthcare system has become increasingly significant. General practitioners are not only the first line of defense for residents' health, but also key executors of disease prevention, diagnosis, treatment, and health education. This article analyzes the classification of "major, minor, acute, chronic" diseases and the "4 virtues" positioning of general practitioners (namely adept at treating minor illnesses, identifying major illnesses, referring acute illnesses, and managing chronic illnesses), exploring the crucial functions and challenges of general practitioners in the era of new medical reform. The article points out that although the tiered diagnosis and treatment system aims to optimize the allocation of medical resources, it still faces challenges such as the ambiguity of the classification of "major, minor, acute, chronic" diseases and the uneven distribution of primary healthcare resources. General practitioners play a vital role in this system, needing comprehensive clinical diagnostic and treatment capabilities, and to establish clinical judgment standards and treatment protocols in collaboration with specialists. To address these challenges and fully leverage the role of general practitioners in the modern medical system, urgent reforms and optimizations in general medical education and practice are needed, along with strengthening the role of general practitioners, to ensure the improvement of medical service quality and efficiency while achieving a fair and sustainable health security system.

Patients with multimorbidity often require the concomitant use of multiple medications, presenting general practitioners (GPs) with the dilemma of assessing the benefits and risks due to complex and potential interactions between diseases and medications. This article takes one case of a multimorbid patient at a community health service center to illustrate and elucidate the process by which GP employs a medication decision-making framework for multimorbidity (MDMF). Furthermore, by examining the multi-stage goals set by Ariadne principle in the process of multimorbidity management, this article analyzes the key points and considerations for GPs in the assessment, communication, and making treatment plans, thereby offering reference to improve the quality of medication decision-making for patients with multimorbidity in the community.

Primary care physicians in community settings face numerous challenges when making medication decisions for patients with multimorbidity. Enhancing their decision-making capabilities through training is an important way to address these challenges. However, there is a dearth of in-depth research on the training needs of primary care physicians in the context of medication decision-making for multimorbidity.

This study aims to explore the challenge physicians encountered in medication decision-making for patients with multimorbidity and their needs for training content and modalities, providing a reference for designing the training courses for the abilities enhancement.

From October 5th to December 21st in 2023, physicians from community health care centers in Hangzhou, Ningbo, Jiaxing, Shenzhen, and Shanghai were recruited for in-depth interviews following the principle of purposive sampling and maximum variation, which focus on the content and formats of training to enhance medication decision-making abilities. Two researchers transcribed and coded the interviews independently, and content analysis was performed on the interview data.

A total of 20 Physicians completed the interviews and 15 were females, mean age were (38.5±3.0) years. Based on the challenges faced by primary care physicians in the medication decision-making for multimorbidity, the training should cover four aspects: evaluation of medication therapy, rational selection of medication, doctor-patient communication and shared decision-making, medication education and follow-up. In terms of training form, primary care physicians are willing to accept flexible and multiple teaching approaches, and prefer case-based training that aligns with community health needs.

Primary care physicians have clear training needs of medication decision-making for patients with multimorbidity. The results of this study provide a theoretical reference for the development of training courses, which adapt to the working environment and actual requirements of primary care physicians.

The rapid development of new technologies such as artificial intelligence and large language models has brought new transformations to clinical medical practice. Both domestically and internationally, research and practical exploration of intelligent general practitioners have begun, but a consensus has yet to be formed. Against this backdrop, experts and scholars from Tsinghua University Vanke School of Public Health, Peking University School of Public Health, Chinese Association of General Practitioners of Chinese Medical Doctor Association and several other domestic institutions collaboratively developed a consensus. The background of these experts spans multiple disciplines, including general medicine, public health, artificial intelligence, and evidence-based medicine. Based on extensive literature review both domestically and internationally and through multiple rounds of expert discussions, the Chinese Expert Consensus on Artificial Intelligent General Practitioner (AIGP) was finally formulated. It includes 17 core consensus concerning the definition, characteristics, applications, challenges and recommendations of AIGP. This consensus aims to provide scientific references to promote the empowerment of general practitioners with intelligent technology and enhance the smart service level of primary healthcare.

Primary care general practitioners encounter significant challenges in diagnosing and managing skin diseases, highlighting the urgent need for artificial intelligence (AI) assisted systems. Although AI has the potential to improve diagnostic and treatment efficiency, research on its application in primary care settings remains limited.

To investigate the effectiveness and impact of an AI-assisted system in supporting primary care general practitioners with the diagnosis and management of skin diseases.

From December 2022 to March 2024, 19 general practitioners from community health centers in Hangzhou were voluntarily recruited for this study. They were randomly divided into two groups: an AI group with 10 physicians and a control group with 9 physicians. During this period, these physicians treated a total of 90 patients with skin diseases: 50 in the AI group and 40 in the control group. Physicians in the AI group utilized the Ruifu AI-assisted system for diagnosing and managing dermatological diseases, whereas those in the control group followed standard treatment protocols without AI assistance. Both groups compiled patients' medical records, auxiliary examination reports, and photographs of skin lesions during consultations. Two skin disease experts were invited to conduct remote consultations to evaluate the diagnostic accuracy of the two groups. On the first day (1 d) and the fourteenth day (14 d) of treatment, patients underwent assessments using the Dermatology Life Quality Index (DLQI), and satisfaction surveys were conducted separately for patients in the AI and control groups. A questionnaire survey was administered to doctors in the AI group to assess their experience with the Ruifu AI-assisted system.

No significant differences were observed in gender, age, or education level among patients in the AI and control groups (P>0.05), nor among physicians in terms of gender, age, education, and professional titles (P>0.05). The AI group's general practitioners achieved higher diagnostic accuracy for skin diseases than those in the control group (64.0% vs 37.5%, P=0.012). Fourteen days post-treatment, improvements in the DLQI scores were observed in both the AI and control groups, with significant differences (P<0.05), and the improvement in the AI group was more significant (P<0.05). The satisfaction level of the AI group was higher than that of the control group (P=0.024), and there was a positive correlation between the 14 d DLQI score and patient satisfaction in the AI group (r_s=0.471, 95%CI=0.186-0.683, P=0.002), the correlation between the improvement in DLQI score and patient satisfaction was even more significant (r_s=0.816, 95%CI=0.676-0.899, P<0.001). The results of the questionnaire survey revealed that a majority of physicians demonstrated a positive attitude towards their use of the AI-assisted system, acknowledging its practical value in several areas: diagnosis selection (70.0%), auxiliary diagnosis (80.0%), treatment recommendations (60.0%), and the provision of professional knowledge (90.0%). Remarkably, 90.0% of the physicians indicated their intention to continue utilizing the AI-assisted system.

In the primary care setting, the application of AI-assisted systems has enhanced the diagnostic accuracy of general practitioners in identifying skin diseases, improves the quality of life for patients, and increases patient satisfaction. The majority of general practitioners report positive experiences with the use of AI-assisted systems.

As an important part of the general practice team, assistant general practitioners undertake a lot of grassroots general practice work, but at present, there is no recognized national level assistant general practitioners post competency model to provide scientific basis for training qualified assistant general practitioners.

The competency of assistant general practitioners for China was constructed to provide support for the design of national assistant physician qualification examination, and provide theoretical basis for the training and evaluation of assistant general practitioners.

Based on the research group's previous literature research and behavioral event interviews, from September 2019 to January 2020, the entry pool was established, and 30 experts engaged in general practice were consulted by Delphi method for 2 rounds. The index and weight coefficient of the Chinese assistant general practitioner post competency model were determined by AHP.

Six first-level indicators [the basic medical and health services (0.244 8), medical knowledge and life-long learning (0.244 8), and professional quality (0.244 8), interpersonal communication and team work (0.138 9), the basic public health services (0.085 8), the information utilization ability and management capacity (0.041 0) ] and 63 second-level indicators were finalized, and the weight coefficients of each indicator were defined.

This study constructs the post competency of assistant general practitioners for China for the first time, which has a high degree of expert representativeness and authority, and a more comprehensive and reasonable index selection, laying a foundation for the empirical study of the index system.

Job demands and job resources are drivers of health and wellbeing of workfoce. This study aimed to explore the influence of personality traits on job stress in the Job Demands and Resources (JD-R) model.

May 2023, self-administered questionnaires for the Brief Job Stress Questionnaire (BJSQ) and the Ten Item Personality Inventory (TIPI) were distributed online to general practitioners (GPs) of 26 public community health centres of Luohu Hospital Group, Shenzhen China. 69.6% GPs completed the questionnaires. The BJSQ included job demands (8 items), job resources (8 task-level items, 11 workgroup-level items, 8 organisational-level items) and related outcomes (10 items). The personality traits including extraversion, agreeableness, conscientiousness, emotional stability, and openness. The median as well as the 25th and 75th percentiles were used to indicate the central tendency and the degree of dispersion of the items, and Pearson's correlation coefficient and ANOVA were used to test the correlational factors of the different personality traits and the JD-R model.

The personality traits of GPs, both male and female, were dominated by conscientiousness. agreeableness and conscientiousness were the dominant traits for those under 40 years of age and those in lower professional hierarchy, while emotional stability and conscientiousness were the dominant traits for those 40 years of age and over and those in higher professional hierarchy. The Big Five Personality Traits were related to interpersonal conflict, role conflict, job control, job adaptability, value of work, support from family and friends, job security, coping with organisational change, psychological stress, family satisfaction, job involvement, and job performance (P<0.01), but not to qualitative workload, or work predictability. Agreeableness (r=0.295, P<0.01) and emotional stability (r=0.196, P<0.01) were associated with workplace harassment. Correlation of emotional stability and JD-R model was evident statistically.

Personality traits are closely related to Chinese GPs work stress, psychosocial work environment and outcomes, and can be used as predictors with the JD-R model. Future research on professional burnout should consider personality traits as independent variable.

The authors suggest including personality, emotional intelligence, logical reasoning, and interpersonal relationship tests in the recruitment of students or trainees in medical schools and vocational training programs, in order to select and recruit suitable people for the delivery of medical services. Doctors with different personality traits could be supported with job demands and resources according to their individual characteristics to reduce professional burnout and improve work efficiency and patient care outcome. The authors called further studies on the relationship of Chinese doctor's personality traits and their study and working stress and performance.

With the changing disease spectrum of the population and the advancement of the national tiered diagnosis and treatment system, general practitioners play a vital role in disease diagnosis and treatment. At the same time, the continuous updating of medical knowledge and the ongoing changes in the health service demands of the residents necessitate the ongoing participation of general practitioners in continuing education and training. This ensures they can make the best diagnostic and treatment decisions and manage diseases effectively for their patients.

To analyze the current developments, training quality and research quality of continuing education research of general practice in China in the past ten years (2013-2022) .

In January 2023, eight Chinese and English databases including PubMed, Cochrane Library, Embase, CINAHL, ERIC, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and China Biology Medicine Literature Service System were used as data sources to obtain research on the training of continuing education for general practitioners in China. The literature was read, analyzed, organized, and summarized, with the search period ranging from January 2013 to December 2022. The Medical Education Research Study Quality Instrument (MERSQI) was utilized to comprehensively evaluate the quality of the literature.

This review included a total of 49 articles, of which 11 were in English and 38 in Chinese. The themes of continuing education training focused on cardiovascular and cerebrovascular diseases (22.4%), emergency-related content (6.1%), and mental health (6.1%). The training formats were relatively singular, mainly based on traditional expert lectures (69.3%), with only 6.1% adopting the form of skill training, and 4.0% of the studies using problem-based learning (PBL) or team-based learning (TBL) training formats. There was usually a lack of rigorous evaluation: 31 studies (63.2%) used questionnaires to assess the effectiveness of the training, of which 19 had not undergone validity and reliability testing. In the study design, the largest proportion was single-group pre-post comparison (53.1%), followed by randomized controlled trials with pre-post measurements (26.5%), and the smallest proportion was controlled pre-post comparison (4.1%). Only 9 studies (18.3%) explicitly mentioned ethical approval, while the majority of studies (81.7%) did not undergo ethical review. The evaluations focused on the enhancement of knowledge and skills of general practitioners before and after trainin (85.7%), with less coverage of actual behavioral changes (14.2%) and benefits to patients and healthcare facilities (22.4%) .

In the past decade, the attention to general practice continuing education research has been insufficient, but there is significant room for development. In the future, it is necessary to expand training themes and adopt diverse training methods based on actual needs. Utilizing assessment tools with good validity and reliability, and focusing on the actual behavioral changes brought about by training, will benefit patients and enhance the quality of continuing education for general practitioners in multiple dimensions.

Graded diagnosis and treatment is one of the main goals of medical reform. In 2015, the General Office of the State Council issued the"Guiding Opinions on Promoting the Construction of Graded Diagnosis and Treatment System" (Guo Ban Fa[2015]No. 70), which stated that in 2017, the proportion of diagnosis and treatment in grassroots medical institutions was over 65.0%, but that proportion was 54.2% that year, and in recent years, it has shown an overall downward trend. Previous literature has mostly focused on the demand side (patients) for research, while as one of the suppliers of graded diagnosis and treatment, there have been few surveys on the willingness of general practitioners to participate in graded diagnosis and treatment.

This article aims to take Suzhou City as an example to investigate and study the willingness of general practitioners to participate in graded diagnosis and treatment, analyze its influencing factors, and provide suggestions to improve the willingness of general practitioners to participate in graded diagnosis and treatment, providing reference for formulating policies related to graded diagnosis and treatment.

In June 2022, a multi-stage convenient sampling method was adopted to select 1 451 general practitioners from 175 grassroots medical and health institutions (hereinafter referred to as grassroots institutions) in 4 counties and 6 districts of Suzhou City. A self-developed survey questionnaire was used to conduct the survey. The questionnaire includes the survey of general practitioners' basic situation (demography characteristics), survey of general practitioners' willingness to participate in hierarchical diagnosis and treatment (this part of the questionnaire is based on the expanded model of influencing factors of general practitioners' willingness to participate in hierarchical diagnosis and treatment, which is a fusion model of theory of planned behavior (TPB) and technology acceptance model (TAM) combined with Document retrieval and interview collection content). According to the survey results, use structural equation model SEM analysis to test the influencing factors of general practitioners' willingness to participate in graded diagnosis and treatment, expand the model's fit, and determine the model's fit effect. Exploratory factor analysis was used to calculate the weight (influence) of each influencing factor of general practitioners' willingness to participate in graded diagnosis and treatment, and to build a Relational model of influencing factors of general practitioners' willingness to participate in graded diagnosis and treatment.

One thousand four hundred and fifty-one general practitioners participated in this questionnaire survey, and 1 302 valid questionnaires were collected, with an effective rate of 89.73%. The expanded model of influencing factors on the willingness of general practitioners to participate in graded diagnosis and treatment is well fitted. In the influencing factors of general practitioners' willingness to participate in graded diagnosis and treatment, participation attitude, subjective norms, and perceived behavioral control jointly affect the willingness of general practitioners to participate in graded diagnosis and treatment, with weights of 46.22%, 9.75%, and 44.02%, respectively. Perceived benefits and perceived usefulness jointly explain participation attitudes, with weights of 15.14% and 31.08% respectively. Disposable resources and expected resistance jointly explain perceptual behavioral control, with weights of 27.07% and 16.95%, respectively.

The degree of recognition of the medical service capabilities of higher-level hospitals by general practitioners, the complexity of referral procedures, and the degree of openness of medical resources from higher-level hospitals to general practitioners have a significant impact on the willingness of general practitioners to participate in graded diagnosis and treatment. It is recommended to strengthen communication and interaction among personnel within the medical association at the administrative, organizational, and personal levels, and use information technology to simplify referral processes and procedures Encourage higher-level hospitals to provide targeted and quantitative access to medical resources such as outpatient number sources and ward beds for general practitioners, and take various measures to increase their willingness to participate in graded diagnosis and treatment.

Since general practice was introduced to China in the late 1980s, significant phased achievements have been made in its development. The construction of the discipline and the talent training system has gradually improved, the quantity and quality of the talent pool have continuously increased, the structure of the team has been continuously optimized, service models have been continuously innovated, and service levels have steadily improved. A path of development with Chinese characteristics for general practice has emerged. The discipline of general practice in China has undergone profound changes in five aspects: from being neglected to being valued, from being lenient to being strict, from imitation to innovation, from a peripheral to a mainstream discipline, and from fragmentation to systematization. A mature general practice discipline requires four basic elements: unique theory, unique methodology, unique educational and training paradigms, and unique application scenarios. However, the development of the general practice discipline and the speed of talent cultivation in China still cannot meet the rapidly growing health needs of the people. In the face of these new challenges, the solution is to "develop academics, strengthen the discipline; build a brand, enhance quality; establish a platform, and strengthen culture. " By establishing the China Academic Community of General Practitioners/Family Physicians (CACGP), an academic community for general practitioners in China, conducting academic research that is oriented towards China and addresses grassroots health issues with the characteristics of general practice, and achieving shared academics, shared development, shared communication, and shared innovation, we can cultivate high-level talents in the general practice discipline, provide the people with high-quality and efficient general practice services, and promote the high-quality development of the general practice discipline.

General practitioners (GPs) are gatekeepers of residents' health, the rational allocation of resources is the basic guarantee for achieving fairness in health services. At present, research on the allocation of GPs in China mainly focuses on the whole country and individual provinces, lack of research on the allocation of human resources for general practitioners in the western region as the research object.

To comprehensively evaluate the current situation of GPs resource allocation in western China from 2015 to 2020, provide a reference for optimizing the resources distribution of GPs in the western region of China.

The data for this study were derived from the China Health and Family Planning Statistical Yearbook (2016-2017), the China Health Statistics Yearbook (2018-2022), and the China Statistical Yearbook (2016-2022). Using Atkinson index and location entropy to calculate and decompose the overall allocation of GPs resources in the western region. Using grey prediction model to predict the demand for GPs in the western region from 2022 to 2025.

From 2015 to 2020, the number of GPs in the western region increased from 39 290 to 94 652, with an average annual growth rate of 19.23%. The Atkinson Index by population, economy, and geography in 2015 and 2020 respectively were 0.1265 and 0.049 3, 0.124 4 and 0.038 2, 0.786 5 and 0.694 4. The location entropy of population, economy, and geographical indicators in the western provinces in 2020 respectively ranged from 0.794 3 to 1.219 0, 0.697 0 to 1.337 3, and 0.043 2 to 7.7270. The location entropy of geographical allocation in the southwest region is greater than 1, while the location entropy of population allocation in the northwest region is better than geographical allocation.The location entropy of economic indicators in Gansu, Qinghai and Guangxi is greater than 1 during the research period.The grey model predicts that the resources of GPs in the western region will show an increasing trend from 2022 to 2025.

The allocation level of GPs in the western region is gradually improving, and the structure is gradually optimizing. However, there are still problems such as insufficient total quantity, uneven distribution, low registration rate, and poor fairness. Suggestions should be based on geographical classification as the standard, with the principle of "Adjust increment and optimize inventory", the goal of occupational attractiveness, and the guidance of resource integration and regional collaboration to further optimize the resource allocation of GPs in the western region.

General practice research should be in the hands of general practitioners (GPs) . GPs' participation in research is an important condition of development of the discipline. Compared with other clinical medicines, the research activities of GPs need to be enhanced.

Based on the perspectives and actions of GPs worldwide towards research, this study aims to investigate the driving forces and obstacles underlying the development of family medicine.

Rapid literature review, using PubMed data to understand opinions of international general practice colleagues.

Over 90% GPs thought research was very important, 60% of GPs were interested in research, 30% expressed willingness to participate, 10% were actually involving research, and less than 1% of GPs published research results. In terms of attitude and ability, GPs believe that the lack of relevance between research and actual clinical practice weakens the usefulness of research; some GPs believe that research work is not part of their own duties and out of their abilities; less than half of doctors believe research training should provide to registrars. The barriers for research included heavy clinical workloads, too much paperwork, increasing clinical management requirements, doctors' goals of making more money, and lack of research practice, support and research funds. Facilitating factors for research included access to good research mentors, having the opportunity to join well-known and well-designed general practice research projects, or having access to more information resources through research activities. GPs' factors include experience, diligence and hard work, frequent participation in research training, frequent reading of academic literatures, and running or managing their own general practice.

Research activity in general practice is low and high-quality research results are few. Research methodology training is one of the strategies to promote general medical research. Same important, we should also pay more attention to the intrinsic motivation and intensity of doctors' participation in research, provide doctors with research time and funding resources, and encourage the establishment and maintenance of a core team and network for general practice research, as well to develop the research ideas and culture of critical thinking in general practice area.

Primary health care provided by general practitioners is an important safeguard for the achievement of universal health coverage. With the continues progress of new medical reform, the number of primary care settings, general practitioners and outpatient visits have increased significantly compared with one decade ago. General practitioners, as the main body of implementation of general practice, coincides with the concept of narrative medicine in terms of patient-centeredness and attention to both psychological and social factors of the patients. Narrative medicine is medicine practiced by clinical workers who have narrative ability, with strong theory and weak practice in our country at present. From the perspective of general practitioners, this paper presents the positive influence of narrative medicine practice in primary care on general practitioners in the form of parallel medical records.

General practice in China has developed rapidly in recent years with remarkable progress, but the gap with developed countries in Europe and the United States is still large, and the training system of general practitioners still remains impefect. In Germany, the construction of the primary health care system and the training system of general practitioners have been well developed. Under the system of universal health insurance coverage and hierarchical diagnosis and treatment, a high level of health and patient satisfaction with primary healthcare services among residents have been achieved in Germany. Therefore, this study compares post-graduate education and continuing education of general practice in China and Germany, analyzes the challenges of general practice education reform in China, drawing on the conceptual framework of general practice education in Germany, and proposes targeted ideas and recommendations for solutions as follows: for the standardized residency training of general practice, increase the rotation flexibility as appropriate to facilitate the optimization of trainees' individualized competencies, incorporate the standardized curriculum of psychosomatic medicine and Balint group training to improve trainees' competence in psychosomatic medicine, establish standardized selection criteria and promote standardized training program for faculty of community hospital, and revisit the duration of general practice (including community) rotation after improving the qualifications of general practice faculty of community hospital; for the continuing education, incorporate the special interest and small specialties into the general practice continuing education system to strengthen the functional medical characteristics of general practice and promote the professional diversification of general practitioners, and establish a national unified platform for continuing education in general practice. More practical research and resources are needed to improve the training system of general practitioners in China in the future.

Physical and medical integration is essential for promoting the health of community residents and is an important guarantee for the high-quality development of community medical services, and practitioners are the foothold and focus of physical medicine integration services. However, there is currently a lack of relevant research on the impact of community medical institutions in carrying out physical medicine integration services from the perspective of practitioners.

To study the understanding and views of practitioners on how to carry out the integrated service of physical medicine in the community to provide ideas and references for the community to better carry out the integrated service of physical medicine.

In March and April 2023, 11 practitioners from 5 community health service centers in Zhuzhou city, Hunan Province, were selected as survey subjects by means of an objective sampling method. The descriptive research method was adopted to conduct "one-on-one" semistructured in-depth interviews with community practitioners. With the help of the content analysis software Nvivo 12.0, text transcription recording, analysis unit formation, content coding and theme extraction were carried out for the interview content. Finally, the interview data were logically analyzed using descriptive phenomenological analysis to capture GPs' understanding and perceptions of the influences on the development of body-health integration services in the community, and to summarize the themes of the interviews.

The factors affecting the development of physical and medical integration services in communities can be summarized into 4 themes and 10 subthemes. There was an urgent need to optimize the service environment for the integration of physical medicine (insufficient site supply, lagging atmosphere, and insufficient publicity) , improve the ability of practitioners (insufficient cognitive ability for the integration of physical medicine and the ability to issue sports prescriptions) , lack of support in community hospitals (lack of training activities related to the integration of physical medicine, insufficient fund allocation and shortage of human resources) , and lack of patient cognition of the integration of physical and medicine (patients have poor cognition of the efficacy of body-medicine integration, and patients have poor cognition of the risk of body-medicine integration) .

There are still many shortcomings in the service ability of community practitioners. To promote better development of community integrated services, it is urgent to optimize the service environment of community integrated services, to improve practitioners' integrative cognition ability and exercise prescription ability, to strengthen the support and guarantee of community health service institutions, and to improve patients' awareness of the efficacy and risk of physical and medical integration services.

In standardized residency training for general practice trainees, the rotation time in various clinical specialties is short, and there is a wide range of learning content, requiring enhanced learning autonomy. General practice faculty would be dealing with trainees from a variety of backgrounds, including 5+3, transfer, professional masters, or 3+2 assistant general practitioners, interns, public health trainees. It was necessary to study how to enable different training targets to get what they need and achieve the desired training effect in training needed to be carefully studied.

The objective of this study was to explore a training method that addresses structural problems, enhances trainees' learning initiative, and cultivates their ability for deeper thinking.

At the end of each learning activity, immediate discussions were organized to address the following questions: "1. What have you learned through the study? 2. What other questions do you have? 3. What are the same or similar experiences that you can share with others? 4. What inspirations do you have for future work?" The paper conducted theoretical analyses of the four questions to elucidate the method's internal logic and trainees' thinking process. Corresponding questionnaires were designed for validation studies conducted in the General Practice Backbone Teachers' Training Class and the Grassroots Talent Class.

The training method received strong agreement from the trainees, with the composite score ranging between "strongly agreed" and "agreed". After conducting parameter tests, no statistical differences were found in the answers concerning gender, age, title, position, and working experience. However, statistical differences were observed in academic qualifications, work units, and participated training programs (P<0.05) .

The use of structural problems with progressive meanings and a flexible training format proved effective in stimulating deeper thinking among trainees. The higher level of acceptance observed in the Grassroots Talent Class suggested that the method was particularly applicable to primary general practitioners and can enhance their ability for deeper thinking.

Hierarchical diagnosis and treatment system is crucial for deepening the medical and health system reform and establishing the basic medical and health system with Chinese characteristics. Primary care institutions play an essential role in hierarchical diagnosis and treatment system by assuming the role of "gatekeepers" of residents health. The post competency of general practitioners, who are the core of primary care institutions, significantly influences the service capacity of these institutions.

To construct an indicator system for the evaluation of post competency of general practitioners in primary care institutions.

From September to December 2022, 13 medical professionals were consulted through two-round Delphi expert consultation method; the hierarchical analysis and entropy method was used to calculate the weights of the indicators.

The indicator system was optimized and sifted through two rounds of Delphi expert consultation, the evaluation system of primary general practitioners was finally constructed, consisting of 5 primary indicators and 27 secondary indicators. The weights of the indicators at all levels were clarified through the hierarchical analysis combined with the entropy method, in which the basic public health service capacity indicator had the highest weight and was the core indicator. The indicator system was tested for reliability and validity by small samples, and all of them were at an acceptable level.

An indicator system for evaluation the post competency of general practitioners in primary care institutions was constructed, contributing to the selection and appointment of general practitioners, which will provide an objective reference for the evaluation of post competence of general practitioners in primary care institutions.

The report of the 20th CPC National Congress pointed out that it is necessary to "develop and strengthen the medical and health care workforce, focusing efforts on rural areas and communities". General practitioners (GPs) are the "gatekeepers" of residents' health and medical expenses, and play an important role in basic medical and health services. Training applied and complex new-age GPs who can be deployed, retained and utilized is an important step in promoting the construction of a healthy China. On the basis of Training Development Report of GPs (2018), this report systematically reviews the team construction, training and education, reform of utilization and incentive mechanism of GPs in China from 2018 to the present, and puts forward the future outlook of GPs in China in the hope that it can provide information for further research on general practice in China.

General practitioners (GPs) play an important role in diabetes care in primary care as the "gatekeepers" of population health. The management of diabetes can slow its progression, reduce complications and improve patient outcomes, which requires effective communication and collaboration between patients and their doctors. GPs with good communication skills can help to build long-term care relationships with diabetes patients and help them develop effective self-management skills. This paper summarizes the design and development of diabetes communication skills training for GPs guided by research team with multiple theoretical frameworks, including evidence-based findings from systematic review, experiences and ideas of diabetes patients communicating with GPs based on qualitative studies, prioritization of training content for patient-doctor communication in GPs captured by mixed-methods research, in order to provide new ideas for high-quality diabetes management in primary care and inform the design of training programmes for GPs based on evidence and medical education frameworks.

General practitioners (GPs) are an indispensable part of primary health care system in China and the implementation of the "Healthy China" strategy. In the past decade, the number of GPs in China has developed rapidly.

To summarize the experience and achievements of GP team construction from 2012 to 2022 (nearly ten years) , analyze the existing difficulties and deficiencies, and provide reference for the subsequent construction of GP team in China.

With the help of Donabedian model, policy support, capital investment and base construction were selected as the evaluation indicators of structural design process based on the SMART principle, the process quality was focused from two perspectives of standardized training of residents (referred to as standardized training) and job transfer, the construction of GP team in central and western China. The team size, structure, job satisfaction, resignation intention and career development opportunity were considered as the main analysis dimensions. The data were mainly obtained from Chinese government website and CNKI from 2012-01-01 to 2022-12-31, as well as Health Statistical Yearbook 2012-2022.

In the past decade, the structural design of the construction of GP team in China has been continuously optimized and improved, and the supporting facilities such as capital investment and base construction have been closely implemented. The policy end of process has responded to the practical needs with dynamic adjustments, the standardization of relevant systems for standardized training and job transfer has steadily improved, and the construction of GP team in the central and western regions has been strengthened year by year. Regional differences in the effectiveness of team building still exist, and some problems need to be solved.

Existing human resource statistics on GP cannot accurately measure the human resource supply for GP team in China, and the construction of team stability needs to be further improved. It is recommended to continuously promote the stability construction of the GP team focusing on enhancing career attractiveness, improve the stability of the whole cycle of training, employment and career development, and jointly promote the stability of GP team.

Training general practitioners (GPs) and improving the practice competence of "GP-centered" primary health care personnel are important directions of the development of human resources for primary health care in China. At present, there is lack of an index system applicable to evaluate clinical competence of GPs in the circumstances of primary health care in China, which not only hampers accurate identification of gaps in clinical competence of GPs, but also impedes sustainable improvement of the education and training of GPs as well as primary health care personnel.

To develop an evaluation index system for consultation competency of GPs in the circumstances of primary health care in China based on the original version of Leicester Assessment Package (LAP), so as to provide an index model reference for the objective evaluation of consultation competency of GPs.

Between May to August in 2022, a total of 15 experts were invited by using the purposive sampling method to implement the Delphi method by correspondence, to evaluate the importance, feasibility, and textual representation of each index in the initial evaluation index system for consultation competency of GPs. Analytic hierarchy process was adopted to calculate weight and combined weight for the first-level and secondary-level indexes.

A total of two rounds of Delphi were conducted. The positivity coefficient, familiarity level, judgment coefficient, and authority coefficient were 100%, 0.77, 0.91, and 0.84 in both rounds of consultation; the mean score of the importance and feasibility of each indicator was 3.5, and the variation coefficient was 0.3. The Kendall coefficients for the importance and feasibility of the indexes in the two rounds of consultation were statistically different (P<0.001) and higher in the second round than in the first round. A total of 10 comments recommended to increase indexes, one comment to combine indexes, and 29 comments to modify indexes were collected during two rounds of Delphi consultation. The final version of evaluation system consisted of 7 first-level indexes and 42 second-level indexes, the weights of the 7 primary indicators ranged from 13.61% to 14.69%, and the combined weights of the secondary indicators ranged from 0.95% to 4.91%.

This study has constructed an evaluation index system for consultation competency of GPs in the circumstances of primary health care in China based on the original version of LAP. The evaluation index system includes 7 first-level indexes and 42 second-level indexes, which covers each essential section and important missions in GP consultations with high scientificity and practicality.

Currently, there is a lack of clinical competence evaluation tools applicable of general practitioners (GPs) practicing in rural settings in China, resulting in the lack of researches on the clinical competence evaluation of GPs in rural.

To explore reliability and validity of an evaluation index system for consultation competency of rural GPs developed previously, and provide an evaluation tool with high reliability and validity for scientific and objective assessment of consultation competence of GPs in rural settings.

Based on the evaluation system for consultation competency of rural GPs, a corresponding questionnaire was designed, and points were assigned to each option on a 5-point Likert scale. From September to December 2022, GPs or assistant general practitioners (AGPs) who were working in rural township health centers in Guangxi Province were recruited as the research subjects by using the purposive sampling and stratified sampling methods, the questionnaire was distributed through a national web-based survey platform-"WJX" to them. Cronbach's α coefficient, split-half coefficient, critical ratio (CR) and correlation coefficients were calculated based on questionnaire data. Confirmative factor analysis was employed to fit questionnaire data and assumed model, and calculate three categories of indicators, including preliminary fit criteria (PFC), overall model fit (OMF), and fit of internal structural model (FISM), to verify the degree of fit and structural validity of the measured data.

A total of 600 questionnaires were distributed and 366 were validly collected, with an effective recovery rate of 61.0%, 86.1% were registered as GPs and 13.9% as AGPs, who came from five cities, including Nanning, Guilin, Wuzhou, Baise, and Guigang, and 204 township health centers in Guangxi Province. Cronbach'α coefficient for the whole questionnaire or for every section was higher than 0.700, and Guttman Split-Half coefficient was 0.931. The initial first-order model met the PFC well; except for goodness of fit index (GFI), adjusted goodness of fit index (AGFI), and normed fit index (NFI), other indicators related to the OMF reached for the best levels in the modified first-order model. Apart from R² for 9 observable variables less than 0.5, the FISM for the modified first-order model showed good effects. The initial second-order model indicated as similar effects on the PFC as the initial first-order model; the modified second-order model shared similar OMF with the modified first-order model; the modified second-order model was inferior to the modified first-order model in terms of the FISM. Eventually, questionnaire data fitted the modified first-order model better.

The evaluation index system for consultation competency of rural GPs shows high reliability and validity, which can be used for research and practical work on the evaluation of consultation competence evaluation of GPs in rural settings.

General practitioners (GPs) are the"gatekeepers"of residents' health. In China, Up to 2021, 84.4% of GPs account for 22.7% of the total primary physicians. The quantity and quality of the GP workforce are related to the level of primary care services. In recent years, the central government and governments at all levels have attached great importance to the construction of the GP workforce and successively introduced many supportive policies. However, the number of GPs in China currently only accounts for 10.1% of practicing (assistant) physicians, and the lack of position attractiveness of GPs has become the main reason restricting the development and growth of the GP workforce. Based on the talent itself, this paper constructs a talent development mechanism-oriented model of "primary general practitioner-position attractiveness" to deeply analyze the dilemmas of GPs in seven aspects of education, recruitment, application, motivation, evaluation, development and support, explore countermeasures to solve the problems, in order to provide a scientific basis for enhancing the position attractiveness of GPs, stabilizing the talent team of GPs, and improving the quality and level of primary care services.

The prevalence rate of type 2 diabetes is increasing in China. General practitioners play an important role in the prevention and treatment of type 2 diabetes and its complications. Chronic kidney disease (CKD) is a common co-existing disease in patients with diabetes. However, at present, there is little research evidence on type 2 diabetes combined with CKD in primary care in China.

To investigate the obstructive factors in the monitoring and management of type 2 diabetes mellitus with CKD from the perspective of general practitioners.

From May to July 2022, a one-to-half structured interview was conducted with snowball sampling among general practitioners in an urban area of Beijing, and the interview outline was formulated based on the theoretical domains framework (TDF). NVivo 11 software was used to encode and classify the interview contents. Subject frame analysis method was used to sort out and analyze the data, and extract the theme.

13 general practitioners were interviewed in this study, and the years of working in general practice ranged from 8 to 22 years. The study identified barriers related to six domains in TDF, namely knowledge/skills, beliefs about outcomes, motivation and goals, medical background, resources and norms of conduct. After refining again, the themes were lack of systematic knowledge and skills related to CKD, imperfect incentive mechanism of primary medical staff, lack of smooth referral process between primary medical institutions and higher hospitals, poor self-management ability of patients and other obstacles.

There are many factors preventing general practitioners from monitoring and managing patients with type 2 diabetes complicated with CKD in the community. It is necessary to strengthen the knowledge and skills training of general practitioners with diabetes mellitus complicated with CKD, improve the ability of general practitioners to monitor and manage CKD, improve the incentive mechanism of primary medical institutions and establish an effective referral process with superior hospitals, strengthen the health education of patients, improve the self-management ability of patients, and enhance the prevention and treatment ability of primary medical institutions with type 2 diabetes complicated with CKD.

The current training content of continuing education in general practice cannot meet the needs of clinical practice, as well as the lacking of thinking and characteristics of general practice in teaching faculty and evaluation methods.

To explore the training of clinical thinking in general practice through continuing education, so as to solve practical problems and improve working competence of general practitioners (GPs) .

The design of the 8th GPs' practice ability training workshop course was optimized based on the literature reading and feedback from the continuing education course of GPs' practice ability workshop in November 2020, and a questionnaire survey was conducted through the "wenjuanxing" platform among 200 GPs who participated in the 8th workshop course to evaluate the overall and various levels of improvement in their clinical thinking ability and working competence.

A total of 200 questionnaires were distributed, and 172 valid questionnaires were collected, with a recovery rate of 86.0%. After the training, 52.3% (90/172) and 21.5% (37/172) of the GPs had improved and greatly improved their overall clinical thinking ability in general practice, respectively, and 56.4% (97/172) and 22.1% (38/172) showed improvement and great improvement in overall working competence. There was a statistically significant difference in the improvement of clinical thinking ability and working competence among GPs with different professional titles and job types after training (P<0.05). There were 134 (77.9%), 134 (77.9%), 133 (77.3%), 127 (73.8%), 114 (66.3%) GPs who believed that "reading images" "clinical thinking ability in general practice" "interpretation of test indicators" "diagnosis and treatment of common dermatological and pentacologic diseases" and "scientific research training" could significantly improve the working competence of GPs. There were significant differences in the improvement of working competence by the course on "reading images" "clinical thingking ability in general practice" "diagnosis and treatment of common dermatological and pentacologic diseases" among GPs with different professional titles and job types (P<0.05). There was significant difference in the improvement of working competence by "scientific research" training course section in GPs of different genders (P<0.05) .

Optimized continuing education of general practice has a significant effect on the clinical thinking and working competence of GPs. In the design of training to improve the clinical thinking and working competence of GPs, it is also necessary to pay attention to the integration of various types of knowledge and skills in the training, and the practice experience base and accumulation of the trainees.

Currently, there are many studies on family doctor contracting services from the perspective of residents, but few scholars have conducted studies on the current situation of family doctor team contracting based on the perspective of general practitioners (GPs) .

To understand the current situation of family doctor contracting services in primary health care institutions in Guangdong Province, and explore the factors affecting the contracted number from the perspective of the supplier.

From July 5—31, 2021, GPs in primary health care institutions in Guangdong Province were selected as the study subjects by using a multi-stage stratified cluster sampling method to conduct the survey with a self-designed questionnaire. The contracted number was compared by different GPs and their family doctor team characteristics. A two-level Logistic regression developed by R 4.2.2 software was used to identify influencing factors of contracted number above 2 000.

A valid sample of 3 252 cases in family doctor team with contracted number more than 100 was screened, and the median contracted number was 1 400 (2 499) in 2020. The differences were statistically significant when comparing the contracted number by gender, age, education level, position, employment form, working years, working unit, working area, training acceptance, and annual income, number of team members, population size under jurisdiction, willingness of specialists from medical community to join the team, inpatient bed resources and guidance from superior departments (P<0.05). Zero model fitting showed that contracted number was clustered at the regional level (P<0.05). Two-level Logistic regression model showed that, with master's degree or above as the reference, the contracted number of the team including GPs with college〔OR (95%CI) =2.79 (1.84, 3.74) 〕and secondary/high school〔OR (95%CI) =2.83 (1.80, 3.86) 〕degrees were more likely to be above 2 000; taking no position as reference, the contracted number of the team including unit leaders〔OR (95%CI) =0.66 (0.33, 0.99) 〕was more likely to be above 2 000; taking temporary staff as reference, the contracted number of the team including formal staff〔OR (95%CI) =2.02 (1.53, 2.51) 〕was more likely to be above 2 000; taking the team with size of 3 or less people as reference, the contracted numbers of the teams with size of 4 to 6 people〔OR (95%CI) =1.31 (1.05, 1.57) 〕, 7-10 people〔OR (95%CI) =2.06 (1.75, 2.37) 〕, 11-19 people〔OR (95%CI) =3.67 (3.31, 4.03) 〕and≥20 people〔OR (95%CI) =3.46 (2.74, 4.18) 〕were more likely to be above 2 000; taking population size under jurisdiction at 2 000 or less as reference, the contracted numbers of the team with population size under jurisdiction at 2 001 to 9 999〔OR (95%CI) =2.37 (2.12, 2.62) 〕, 10 000 to 29 999〔OR (95%CI) =2.92 (2.65, 3.19) 〕and more than 30 000〔OR (95%CI) =2.86 (2.55, 3.17) 〕were more likely to be above 2 000; taking condition of having inpatient bed resources as reference, the contracted number of the teams without such resources〔OR (95%CI) =1.38 (1.14, 1.62) 〕was more likely to be above 2 000 (P<0.05) .

The population under jurisdiction and the large number of team members create favorable conditions for contracting; family doctor teams with GPs with positions, inpatient bed resources and high education level have a good understanding of family doctor contracting service policies and control the number of contracted patients better; comparing with temporary staff, GPs team with formal staff may undertake more contracting tasks.

Domestic studies on post competency evaluation indexes of general practitioners mainly focus on economically developed areas in the east. While the applicability of existing evaluation indexes of post competency of general practitioners in rural areas or less-developed areas may be insufficient due to unbalanced allocation of medical resources and large disparities in medical levels among different regions in China.

To construct an evaluation index system for the post competency of general practitioners and to provide reference for the training, assessment and evaluation of general practitioners in less-developed areas.

An evaluation index system for the post competency of general practitioners in less-developed areas was constructed preliminarily through literature research. From January to June of 2021, 18 consultant experts were selected respectively from general practice clinical workers practicing in less-developed areas, general practice/health administration workers in provinces/counties/towns and general practitioners who had participated in the counterpart support in the east-west counterpart support and worked in less developed areas by purposive sampling method. The expert consultation and hierarchical analysis were used to complete the screening of evaluation indexes of post competency of general practitioners and determine the weight of each index in less-developed areas.

The effective recovery rate of two rounds of expert consultation questionnaires were 100.0%; the familiarity, judgment and authority coefficients were 0.76, 0.84 and 0.80; the Kendall coordination coefficients were 0.24 (χ²=297.543, P<0.001) and 0.26 (χ²=322.083, P<0.001). The evaluation index system for the post competency of general practitioners in less-developed areas was constructed consisting of 4 primary indexes, 20 secondary indexes and 44 tertiary indexes. The weights of primary indexes including "medical service capacity" "public health service capacity" "organizational management and coping ability" and "professionalism" were 0.350 9, 0.109 1, 0.189 1 and 0.350 9, respectively. The top 4 combination weighted indexes in secondary indexes were "professional quality" (0.177 1), "learning and thinking ability" (0.126 5), "communication and coordination in primary care" (0.118 6), "diagnosis and treatment of common diseases" (0.108 9). The top 4 combination weighted indexes in tertiary indexes were "civilized communication and friendship exchange with patients, colleagues and physicians at superior hospitals" (0.118 6), "humanistic care" (0.098 9), "mastering clinical appropriate technology such as cardiopulmonary resuscitation (CPR), defibrillation and catheterization" (0.088 3), "diagnosis and treatment of common and frequently-occurring diseases" (0.081 7) .

The evaluation index system for the post competency of general practitioners in less-developed areas constructed in the study have practicability and scientificity, which can provide scientific basis for the evaluation of post competency of general practitioners in less-developed areas.

General practitioners (GPs) mainly provide basic medical and health services. The construction of GPs human resources is closely related to the development of primary care system.

To investigate the current status of psychological capital (PsyCap) , professional identity, and intention to stay of GPs in China and explore the relationship among the above three.

A total of 4 632 GPs were selected for electronic questionnaire investigation in the eastern, central, and western China from March to May in 2021 by using a multi-stage stratified random sampling. The questionnaire mainly included basic information, PsyCap, professional identity, and intention to stay. Pearson correlation analysis, hierarchical multiple regression analysis and structural equation model were used to explore the relationship among professional identity, PsyCap, and intention to stay.

A total of 4 376 GPs were included with the effective response rate of 94.47%. The total scores of PsyCap, professional identity, and intention to stay were (102.89±16.94) , (33.93±8.95) , and (21.69±4.04) , respectively. Pearson correlation analysis showed that there were significant positive correlations between PsyCap and professional identity, professional identity and intention to stay, PsyCap and intention to stay (r=0.402, 0.459, 0.236, respectively, P<0.001) . The results of hierarchical multiple regression analysis showed positive predictive effects of PsyCap and professional identity on intention to stay (b=0.079 and 0.361, respectively, P<0.001) , and professional identity had a mediating effect between PsyCap and intention to stay. The structural equation model showed that PsyCap and professional identity had a positive predictive effect on intention to stay (b=0.032, P<0.05; b=0.446, P<0.001) , and professional identity had a part mediating effect between PsyCap and intention to stay.

The intention to stay among GPs in China is at a moderate level. There are positive correlations among PsyCap, professional identity, and intention to stay among GPs in China. PsyCap can affect intention to stay through professional identity. Improving the PsyCap and professional identity of GPs is conducive to improving their intention to stay.

The competency in primary performance positions of rural order-oriented medical graduates of standardized general residency training program (abbreviate for oriented general practitioners) has attracted wide attention. Strengthening continuing medical education is an important measure to enhance the competency of oriented general practitioners.

To understand the current situation, problems and needs of continuing medical education for oriented general practitioners in Guizhou Province, and to provide a basis for improving continuing medical education for oriented general practitioners.

From November to December 2021, 42 oriented general practitioners from 39 township hospitals in 9 cities in Guizhou Province were selected as the research subjects for semi-structured interviews by the purposive sampling and snowball sampling methods. The interview results were coded and analyzed by the research method of procedural grounded theory to extract and summarize the current situation, problems and needs of their continuing medical education.

After three-level coding, 145 concepts, 23 categories and 5 domains related to the continuing medical education of oriented general practitioners were finally sorted out, and a story line was consequenty formed: the continuing medical education of oriented general practitioners is influenced by several factors, among which actual situation is the obstacle, competency requirement is the extrinsic driver, policy system is important guarantee, self-demand is the intrinsic motivation, and the improvement of the training process management is the key process.

The training intention of oriented general practitioners remains to be strengthened in Guizhou Province. The quality of continuing medical education, integration degree of training content and demand, and attention of primary care institutions need to be improved. The support for continuing medical education and the construction of information platform should be strengthened, and the content and form of continuing medical education suitable for oriented general practitioners should be improved, in order to improve the quality and effect of training in continuing medical education.

In recent years, China has attached great importance to strengthening the development of general practitioner (GP) workforce and primary care service system. To innovate the incentive mechanism for GP training and employment and improve the training system for GPs, the government has also promulgated a series of policies and put forward major reform measures involving many aspects.

To analyze and evaluate the fairness of distribution of general practitioner (GP) resources in China, and to provide theoretical support for scientific and equitable allocation of GP resources.

Data were sourced from five volumes of China Health and Family Planning Statistical Yearbook (2017—2021), China Health Statistical Yearbook (2017—2021), and China Statistical Yearbook (2017—2021) in June 2022, including the number of GPs, the number of people registered as general medicine professionals, the number of people who obtained the General Practitioner Certificate after training, the number of GPs per 10 000 population, and the number of practicing (assistant) physicians in China, in each geographical division (eastern, central or western), and in each regionin, and the annual gross domestic product (GDP), gross regional product (GRP), and the year-end total population data of each region during 2016 and 2020. Additionally, the total land area of each region was extracted from the China ABC column on the website www.gov.cn. The Lorenz curve and the Gini coefficient were used to analyze the fairness in the distribution of GP resources. The Theil index was used to analyze differences in the distribution of GP resources in eastern, central and western China.

The number of GPs in China increased from 209 083 in 2016 to 408 820 in 2020, showing a growth rate 95.53%. In 2020, the proportion of GPs among all practicing (assistant) physicians reached 10.01% (408 820/4 085 689), and the number of GPs per 10 000 population was 2.90. The Gini coefficients measuring demographic, economic, and geographical distribution inequalities of GP resources were 0.235, 0.178, 0.722, respectively for 2016, 0.231, 0.170 and 0.726, respectively for 2017, 0.225, 0.161 and 0.729, respectively for 2018, 0.177, 0.147 and 0.714, respectively for 2019, and 0.157, 0.136, and 0.707, respectively, for 2020. Overall, the Lorenz curve measuring the inequality in the distribution of GP resources by demographics or economy had lower degree of curvature than that by geography. A reduction was found in Theil index measuring unequal demographic, economic or geographical distribution of GP resources in 2020 compared with that in 2016 (from 0.046 to 0.020; from 0.022 to 0.013; from 0.482 to 0.428) .

During the five years, the distribution of GP resources in China presented the following features: the number of GPs increased rapidly and became an important part of the workforce of practicing (assistant) physicians, the registration rate of GPs gradually increased, and the total GP resources showed a continuous growth, but the ratio of GPs per 10 000 population was still unsatisfactory, great inter-region differences existed in the distribution of GP resources, and the equity of the distribution of GP resources by geography was more unsatisfactory than by demographics or economy.

The design and implementation of county continuing professional development and training model for general practitioners is the core of the collaboration on continuing professional development of general practice between the Department of General Practice of Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine and Deqing County of Zhejiang Province. This article introduces the design and implementation of the "hierarchical progressive" continuing professional development training model in the collaboration framework in detail, shares a information platform by virtue of high-quality resources of general practice department of the general hospital, develops the county-level professional development training model for general practitioners, providing reference for colleagues.