Analysis On The Willingness Of Working At Grassroots And Influencing Factors Of General Practice Order Graduates In Wuhan

Objective: By investigating the performance of general medicine graduates in Wuhan,their willingness to serve at the grassroots level and their influencing factors,we understand the implementation effect of the Wuhan general medicine order medical student training program,and provide some reference data,reasonable suggestions and countermeasures for the later training of general practitioners to promote the development of primary health care in Wuhan.Method: A whole-group sampling method was used to select 175 graduates from the 2019 to2021 classes of general medicine order classes at the School of Medicine of Jianghan University as survey subjects,and data were collected by means of questionnaires,which included general information,compliance,employment,income,perception of career identity,willingness to serve at the grassroots level,factors influencing willingness to serve at the grassroots level,and satisfaction with standardized residency training.A total of 9 interviewees were selected from each of the 2019,2020,and 2021 classes of general medicine graduates of Jianghan University School of Medicine by stratified sampling method for compliance,contract renewal,and contract violation,respectively,and were interviewed and summarized by semi-structured interviews to understand the opinions of Wuhan general medicine graduates on general medicine,general medicine order training model,residency standardized training model,future career planning,and The interviewees were interviewed by semistructured interviews and summarized to understand the views of Wuhan general medicine graduates on general medicine,general practice order training mode,residency training mode,future career planning and development prospects of general medicine.Result: A total of 175 questionnaires were distributed,and 160 were valid,with a valid return rate of 91.4%.1.Among the 160 cases of general practice order graduates surveyed in this study,104(65%)performed,35(21.88%)defaulted,and 21(13.13%)renewed;the performance rate of the 2019 class was 61.22%,62.26% of the 2020 class,and 70.69%of the 2021 class.2.The current willingness of graduates of general practice orders to serve at the grassroots level is as follows: 95(59.38%)expressed willingness to serve at the grassroots level,12(7.5%)expressed unwillingness to serve at the grassroots level,and53(33.12%)had unclear willingness to serve at the grassroots level;the willingness of graduates of general practice orders to serve at the grassroots level after the contract period is over is as follows: 90(56.25%)expressed willingness to continue to serve at the grassroots level,18(11.25%)said they were not willing to continue to serve the grassroots,and 52(32.5%)were not clear about their willingness to continue to serve the grassroots.3.The univariate analysis found that factors such as the consistency between the place of birth and the place of employment,performance,working environment,recognition of orientation policy,pre-school contract bondage,interest in general medicine,contribution to the grassroots in hometown,no pressure of employment,and long service period had an influence on the willingness of graduates with general practice orders to serve at the grassroots level,which was statistically significant(P<0.05).an alysis showed whether the place of birth was the same as the place of employment(OR=3.76,95% CI 1.13～12.53,P<0.05),compliance(OR=5.52,95% CI 2.86～10.63,P<0.001),interest in general medicine(OR=3.57,95% CI 1.16～11.00,P<0.05),being pre-school contract bind(OR=0.30,95% CI 0.11～0.81,P<0.05),and long service duration(OR=0.23,95% CI 0.09～0.62,P<0.05)were factors influencing the willingness of Wuhan general practice order graduates to serve at the grassroots level.4.The satisfaction scores of standardized residency training were ranked as follows: necessity score of 4.09±0.903,workload score of 3.89±0.669,teaching process score of 3.69±0.728,assessment system score of 3.58±0.732,rotation length score of 3.29±0.850,and salary and treatment score of 3.13±0.877.5.Suggestions of general practice order graduates on general practice order training mode,with 125 items,ranked in the top 3 in terms of salary and treatment(28 items),training program(21 items),and policy(20 items).Conclusions:1.The compliance rate of graduates with general practice orders is on the rise year by year.2.Willingness to serve at the grassroots level is high among graduates with general practice orders.3.Factors such as consistent place of birth and place of employment,compliance and interest in general medicine will increase graduates’ willingness to serve at the grassroots level,while factors such as being bound by pre-school contract and long service period will decrease graduates’ willingness to serve at the grassroots level.4.The overall satisfaction of general practice graduates with the standardized residency training is between average and satisfactory.5.It is suggested that the health department,training colleges and primary medical institutions should take multiple measures to improve the incentive mechanism,perfect the training model and implement relevant policies,so as to increase the willingness of primary care graduates to serve at the grassroots level and promote the sustainable development of primary health care.