订单定向医学生的职业发展:基于四所医学院校的七年跟踪分析

Career development of targeted admission medical students:A seven-year follow-up analysis based on four medical colleges

目的:应用订单定向医学生队列的7年面板数据,探究其职业发展情况,为我国中西部农村地区留住基层卫生人才提供参考。方法:自2015年起,选取我国中西部四所医学院校的订单定向与普通临床毕业生建立队列并跟踪其职业发展情况。结果:在规培进程和执业医师考试通过率方面,订单定向毕业生与普通临床毕业生相似;在职称和职务晋升方面更快,毕业7年后,82.5%成为主治医师,16.2%获得职务。然而,其月收入显著低于普通临床毕业生,且差值绝对值逐年增大。截至2022年12月,完成合同的493名订单定向毕业生中,38.5%留在基层;离开基层的毕业生中,60%前往县级及以上公立医院工作,7.9%攻读研究生,27.7%待业。结论:订单定向毕业生培养质量好,职业晋升快,但较低的收入显著影响其留在基层的意愿。服务期满后,有1/3左右的订单定向毕业生选择留在基层。

Objective:Utilizing a seven-year panel data set of a targeted admission medical student cohort,this study aims to examine their career development and provide insights for retaining healthcare talent in township health centers and village clinics in the central and western rural areas of China.Method:Starting from 2015,cohorts of targeted and general clinical graduates from four medical colleges in central and western China were selected and tracked for their career progression.Results:The targeted graduates standardized residency training and medical licensing examination pass rates were similar to those of general clinical graduates.They advanced more quickly in professional titles and positions,with 82.5%becoming attending physicians and 16.2%obtaining positions in the seventh year after graduation.However,their monthly income was significantly lower than that of general clinical graduates,and this income discrepancy expanded annually.As of December 2022,among the 493 targeted graduates who completed their contracts,38.5%stayed in grassroots positions.Of those who left,60%moved to county-level or higher public hospitals,7.9%pursued further studies,and 27.7%were unemployed.Conclusion:Targeted graduates are well-trained and advance rapidly in their careers,but their lower income significantly impacts their willingness to remain at the grassroots level.After completing their service period,about one-third of the targeted graduates choose to stay in grassroots positions.