Dan Hu1, Baisong Zhang1, Mingyu Huang2, Min Liu3, Xiulong Xia4,Yanli Zuo5 and Xiaoyun Liu1
1. China Center for Health Development Studies, Peking University, Beijing, China
2. Qinghai Center for Health Development Studies, Medical College of Qinghai University, Xining, Qinghai, China
3. Center for RuralMedical Education Research, Gannan Medical College, Ganzhou, Jiangxi, China
4. International ResearchCenter for Rural Medical Education, Jiujiang University, Jiujiang, Jiangxi, China,
5. Department of General Medicine, Guangxi Medical University, Nanning, China
Abstract
Background Since 2010, China has implemented a national programme to train general practitioners for rural areas. The programme enrolled medical students with a rural background who signed a contract for 6 years’compulsory rural service after raduation. China is transitioning its national COVID-19 strategies in view of the features of coronavirus Omicron variant, the vaccination coverage, and the need for socioeconomic development. Strengthening primary health care, especially the health workforce in rural areas, should be an important consideration during the policy transition. This study aims to evaluate the implementation process of enrolling medical students in the programme, their willingness to work in the rural settings and their actual job choice after graduation.
Methods The study chose four medical universities in central and western China.
A total of 2,041 medical graduates who have signed a contract for compulsory
rural service and 1,576 medical graduates enrolled “as usual” (no compulsory rural
service) were recruited in five campaigns–every June from 2015 to 2019. A survey
was conducted 1 week before their graduation ceremony.
Results
The top three reasons for choosing this programme were: a
recommendation of a family member or teacher, a guaranteed job after graduation
and the waiver of the tuition fee. 23.0–29.7% of the study participants were not
familiar with the policy details. 39.1% of the medical students signed a contract with
a county other than that of their hometown. Medical graduates on the compulsory
rural service programme had very low willingness (1.9%) to work in rural areas but
86.1% of them actually worked at township health centers. In contrast, the willingness
to work at township health centers was 0.2% for the comparison group (medical
graduates without the contract), and their actual job choice at township health
centers was 0%.
Conclusions Although the well-trained medical graduates on the compulsory rural
service programme have low willingness to work in the township health centers, 86.1%
of them choose to do so following their contract. This programme will strengthen
the primary health workforce to deal with the increasing disease burden as China is
transitioning its national COVID-19 strategies.
KEYWORDS
evaluation, China, policy, compulsory rural service, medical education
For additional information , please refer to the original source DOI 10.3389/fpubh.2023.1042898