河南省全科专业住院医师规范化培训现况及就业选择影响因素分析

Status of general practice residency training and career choice of trainees in Henan Province

目的了解河南省全科专业住院医师规范化培训(简称"全科规培")实施情况及结业学员的就业情况。方法2017年12月至2018年2月以河南省首届(2014—2017年)参加全科规培的332名学员为调查对象,采用自填式调查问卷,了解学员基本信息及就业情况;用logistic回归模型分析学员选择全科专业工作的影响因素。结果332名规培学员中,委培学员167名,社会学员165名,各占50%。其中,委培学员来自全省56家医疗机构,三级医院委培学员的参与比例(75.5%,126/167)远高于二级医院(24.5%,41/167)。随访全部规培学员后发现,24名学员培训后待业,308名学员已就业,其中,仅111名(36.0%,111/308)结业后从事全科医学工作,197名(64.0%,197/308)未从事全科医学工作。委培学员及研究生学历的学员更倾向于不选择全科医学工作,主要原因是委培单位无全科医学专业或被安排从事其他专业(57.9%,114/197)。结论在今后的全科规培中,应以本科医学毕业生为主,以保证培训的实效性,总体规划省内全科医生资源的配置。

Objective To survey the status general practice residency training and career choice of trainees in Henan Province.Methods From December 2017 to February 2018,332 trainees from the first general practice residency training program(2014-2017)were enrolled in the study.The self-administered questionnaire included the demographic information and the current career status.The logistic regression model was used to analyze the influencing factors of the career choice when their completed the training.Results Of 332 participants,there were 167 participants designated by the institutions and the others were directly enrolled by the program.The designated participants were from the 56 medical institutions in Henan.The percentage of participants from the tertiary hospitals was 75.5%(126/167),which was much higher than that from the secondary hospitals(24.5%,41/167).There were 24 participants who did not have a work six months after graduation.Of the 308 employed participants,there were only 111(36.0%,111/308)working in the department of general practice,and 197(64.0%,197/308)working in other departments.The participants designated by the institutions and with the post-graduate degrees preferred to choose other specialties,instead of the general practice.The reasons were that there was no department of general practice in their institutions or the participants had been designated to the other departments(57.9%,114/197).Conclusion The survey suggests that the general practice residency training program should enroll trainees mainly from the medical graduates in order to improve the effectiveness of general practitioner residency training and the allocation of health resources in Henan Province.