医学生基层就业意向及影响因素分析

The medical undergraduates' employment intentions and determinants on primary healthcare institutions

目的:了解医学生基层就业意向,分析其影响因素,为解决当前医学生就业难与基层人才短缺的结构性矛盾提供参考与建议。方法:采用自行设计的问卷调查表,对杭州师范大学、浙江医学高等专科学校的482名医学生进行调查,通过卡方检验与二分类Logistic多元回归分析医学生基层就业意向的主要影响因素。结果:44.4%的医学生不愿意去基层就业,仅有8.5%表示非常愿意去基层就业。多因素分析结果显示:女医学生的基层就业意向是男生2.5倍(P<0.001);农村户口医学生的基层就业意向是城市户口医学生的2.1倍(P=0.007);医学生的基层就业意向与政府政策和学校的基层就业指导的效果呈正相关。结论:制定积极的政策、做好宣传与引导工作、探索合理的用人机制、加强学校就业指导和深化教育教学改革是引导医学毕业生面向基层就业的重要措施。

Objective：The paper analyzes the medical undergraduates＇ employment intentions and determinants to provide reference for solving the structural contradictions between the current difficulties of medical undergraduates＇ employment and a shortage of medical talent in grassroots areas.Methods：482 medical undergraduates were surveyed by a self-designed questionnaire from Hangzhou Normal University and Zhejiang Medical College.The determinants of medical undergraduates＇ employment intentions were analyzed by a chi-square test and binary logistic regression method.Results：44.4％ of medical undergraduates were unwilling to work in grassroots areas,while only 8.5％ medical undergraduates said that they were very willing to work in primary healthcare institutions.A multivariate analysis indicated that the employment intentions of female medical undergraduates are 2.5 times higher than male undergraduates （P ＜ 0.001）.The grassroots employment intentions of medical undergraduates in rural areas are 2.1 times higher than those of urban undergraduates （P =0.007）.The effects of government policies and school grassroots employment guidance practices were positively correlated to medical undergraduate grassroots employment intentions.Conclusion：The Development of positive policies,sound advocacy and guidance,exploration of reasonable employment mechanisms,strengthening of school employment guidance practices and the deepening of educational reforms are important measures to improve the grassroots employment of medical graduates.