Study On The Status And Training Needs Of Rural Doctors In Hunan Province

Objective:Through investigating the status of country doctors, the status of their education or training and training needs, et al in three county of Human Province, analyze the problems in country doctors training and their influencing factors, come up with related proposals, provide scientific evidence for health administrative department to formulate policies of country doctors training and strengthen the construction of country medical staff.Methods:using multistage stratified cluster sampling method, questionnaire survey was conducted among country doctors in Hunan. The survey includes the basic status of country doctors, the status of their training and training needs. The data were statistically analyzed by using SPSS13.0. Statistical methods included Statistical description and statistical inference. Chi-square test was used on rate comparison of measurement data and univariate analyses.Result:(1) Among the respondents, male accounted for67%, female accounted for33%; mean aged47.4±11.2years old, the age distribution had the greatest number in the31-40years old group, which accounting for32.6%, more than60years old group accounted for17%; doctors who had technical secondary education degree accounted for56.7%, who had junior college degree accounted for8.9%, who had bachelor degree or above accounted for only0.7%, others accounted for33.7%; doctors who had practicing (assistant) physicians qualification accounted for19.3%.(2) Among the respondents, doctors who participated in training once per year accounted for54.1%. Their main purposes of training were to improve the level of medical treatment and the ability of preventive care, to achieve the requirement of the health department, accounted for64.1%,16.7%,14.8%respectively. Couldn’t leave work, superior department didn’t arrange and expense was too high were the three main reasons why country doctors couldn’t participate in the training, accounted for59.3%,13.3%and11.1%respectively.Univariate analysis showed that the frequency, duration and purpose of country doctors training were significantly different by different educational degree.(3) Investigated country doctors thought disease diagnosis and treatment (68.1%), vaccination (55.9%) and health management (47.4%) were the three most important work tasks; ability of comprehensively analyze and judge problems (27%), basic theory(38.9%) and ability of analyze and discriminate patients’condition (38%) were the three main aspects of contents which hadn’t taught well in the past trainings.Univariate analysis showed that educational degree, area, duration of occupation had influence on country doctors’consideration about which kinds of work they often can’t do well, which kinds of problems they often worry about and which aspects of contents they thought they hadn’t trained well.(4) Among the respondents, doctors who thought network learning or video learning (28.1%) is the best form of on-the-job learning. The three aspects of content that most urgently needed in trainings are diagnosis and emergency of common disease, planned immunization and prevention of infectious diseases, rational drug use; the most urgent demand at present is obtained licensed (assistant) physicians qualification, The87%of the country doctors believed that it is necessary to improve educational degree, and they believed that the most suitable ways are part-time academic education (32.6%) and correspondence course(27%). Univariate analysis showed that the country doctors’preference of training form, content, location and other aspects were significantly different by different educational degree, area, duration of occupation.Conclusion:(1) Among the country doctors, the number of female was relatively small, age structure was relatively old, income was relatively low, educational degree was relatively low, the proportion of country doctors who had a practicing qualification was relatively small.(2) The training frequency and duration had reached the national requirements, and country doctors’purposes to participate in the training were consistent with the national tasks and requirements to them. The majority of country doctors hadn’t accepted higher level of academic education after occupied in medicine. Can’t leave work and the financial difficulty were the main reasons why country doctors could’t participate in the training.(3) The training needs and Countermeasures of country doctors①According to the actual situation of country doctors’work and its training needs, at this stage the target of training should be to promote country doctors’abilities of medical treatment and public health service, and to improve the overall quality of country doctors.②The main contents should be basic medical treatment and public health knowledge training, and the main form should be on-the-job training, while the academic education should be a supplementary.③According to the actual situation, choose the form and the method which are suitable for the training of country doctors. The main forms should be online learning, full-time further education and seminar, the main trining teachers should be medical staff of city or county hospitals; and the main training sites should be the medical or health institutions of county or township level. (4) Carry out the treatment issue and form a complete set of security policies, to ensure the realization of the objectives of country doctor training. Firstly, solve their treatments and pension issues; secondly, carry out the allowance issue of country doctor training.