北京市乡村医生队伍现状及培养与发展的思考

The current situation and policy recommendation to coping with challenges in the development of rural doctors in Beijing

目的调查北京市乡村医生培养、职业保障、执业准入和执业发展的现状,分析可能存在的问题,并提出相应的政策建议。方法采用问卷调查和深度访谈方法,自编问卷对北京市9个远郊区乡镇的324名乡村医生进行问卷调查,并对其卫生行政部门负责乡村医生管理的6名人员进行访谈。结果北京市乡村医生平均年龄65.99岁。78.4%(254/324)的乡村医生具有中专或相当于中专学历,59.6%(193/324)的乡村医生无医学院校学医经历;98.8%(320/324)的乡村医生参加过乡村医生岗位培训。乡村医生近3年年均收入在30001~45000元的最多,占比38.6%(125/324)。78.4%(254/324)的乡村医生所在乡镇卫生院未为其购买保险或公积金。6.8%(22/324)的乡村医生为执业(助理)医师,12.0%(39/324)的乡村医生为乡村全科执业助理医师,79.9%(259/324)为注册乡村医生。结论北京市乡村医生队伍存在培养力度不够、职业保障制度建设滞后、执业能力偏低、执业发展空间有限等问题,政府应当加大人才培养力度、完善职业保障制度、提高乡村医生执业能力、拓宽执业发展空间。

Objective To investigate the current situation of training,employment,practice authorization and professional development of rural doctors in Beijing and to find the potential challenges as well as policy recommendations to cope with.Methods Questionnaire survey and depth-interview were used among 324 rural doctors enrolled from 9 rural villages and towns located in suburb of Metropolitan Beijing.Six staff members from local government sectors in charge of rural doctor management were interviewed.Results The average age of rural doctors in Beijing is 65.99.There are 78.4%(254/324)rural doctors have experience of the secondary technical school education or equivalent education experience.The results also show that 59.6%(193/324)of them have no experience of medical college or universities education but 98.8%(320/324)of them have experienced rural doctor training.The average annual income of 38.6%(125/324)rural doctors in recent three years is 30001~45000 Yuan(RMB).There are 78.4%(254/324)rural doctors not covered by insurance nor provident fund in township health centers.Among the population of rural doctors,79.9%(259/324)of them are registered rural doctors,6.8%(22/324)are practicing(assistant)physicians and 12.0%(39/324)are rural assistant general practitoners.Conclusions There are some problems of rural doctors in Beijing,such as insufficient training,backward construction of career security system,low practicing capacity and limited space for occupational development and so on.The government should put more effort to the talent training,the optimization of career security system,to strengthen the capacity building of rural doctors and to broaden their practicing development space.