宿迁市农村订单定向医学本科生履约现状分析

目的:分析宿迁市农村订单定向医学本科生毕业后履约情况和参加住院医师规范化培训情况,评价宿迁市农村订单定向医学本科生培养工作并提出相关政策建议。方法:采用自制问卷,对宿迁市2011年、2012年培养的85名农村订单定向临床医学专业本科生进行普查,采用描述性统计分析方法对数据进行分析。结果:86.08%农村订单定向医学本科生毕业后履约,就业后第一年参加住培的比例为92.65%,住培期间月平均总收入为3606.9元,82.54%的农村订单定向医学本科生认为住培基地成立独立的全科医学科“非常必要”,对住培满意度为95.24%,住培结束后愿意继续履约的比例为55.56%,合约期满后愿意继续留在基层工作的比例为10.29%。结论:宿迁市农村订单定向医学本科生履约情况及参加住培情况良好,对住培满意度高,但住培结束后与合约期满后愿意留在基层工作的比例低,相关部门应采取措施提高基层吸引力。     

农村订单定向医学生就业与规培:两年跟踪分析

目的:跟踪分析两届订单定向医学生毕业后两年的就业与规培情况,探讨首届定向生规培结束后能否"回乡"履约,并提出政策建议。方法:选取中西部四所医学院校,分别对2015届305名和2016届435名订单定向生在毕业当年建立队列,随后连续两年开展随访调查和深入访谈。结果:当前订单定向毕业生履约率高于99%,工作落实率高于98%,2015届和2016届定向生编制落实的比例分别为86.7%和93. 8%,参加规培的比例分别为97. 4%和68. 3%,规培期间月总收入分别为3 879元和3 783元。结论:与首届定向生相比,2016届毕业生的工作及编制待遇落实更为顺畅,但是出现与家乡所在地签约率下降、定向工作地点限制过严、部分定向生参加规培未得到有效落实等问题。相关部门应尽早明确规培与"回乡"的转接办法,充分调动地方政府的积极性,促进定向生履约。     

订单定向医学生的工作意愿：基于四所医学院校的三年跟踪分析

目的：跟踪分析三届订单定向医学生与普通临床毕业生在毕业三年后的就业与规培情况，探讨首届定向生的实际履约情况、基层服务意愿与职业发展路径特点，并提出政策建议。方法：选取中西部四所医学院校，分别对2015—2017届订单定向生和普通五年制医学生在毕业当年建立队列，随后连续三年开展随访调查。结果：首届（2015届）订单定向毕业生到乡镇卫生院服务的履约率高于98%，2016届定向生表示“一定会履行合约”的学生占80.6%。2015、2016两届学生中有51.6%愿意在基层服务满3年以上，在完成服务期后，定向生平均愿意在基层继续服务4.8年。乡镇卫生院发放的月工资每提高1 000元，学生平均愿意在基层多服务1.3年。结论：已毕业定向生在规培结束后回乡镇卫生院履约的比例很高，多数已毕业定向生愿意履约完成服务期，收入是唯一可以提高其基层服务意愿的激励因素。     

我国农村订单定向免费医学生培养成效及存在问题

目的:评价农村订单定向免费医学生培养政策实施效果,分析影响其效果的主要因素,探索培养的规律和模式,为农村基层卫生人才建设提供政策建议。方法:通过队列研究方法、采用问卷调查、定量和定性研究相结合的方法,在江西、青海和广西三个省份选取四所承担国家订单定向医学生培养项目的院校,对2015(首届)届和2016届医学毕业生开展现场调研,建立了订单定向医学生队列和非订单定向生队列,对737名医学毕业生进行了基线调查,跟踪随访了580人,开展了63次深入访谈和专题小组讨论。结果:订单定向生中农村生源占比由2015年73. 8%降至2016年63. 5%,低于非定向生。订单定向生家庭年收入低于非定向生家庭约1万元;选择订单定向政策的主要原因是毕业后有工作、高考分数限制和免学费;各地区政策实施过程中的合同签署和工作安排方面存在很大差异;收入和工作环境是影响毕业生就业意向的主要因素;仅1. 6%的定向毕业生有意愿到乡镇卫生院,但实际上履约率达到90%以上,到乡镇卫生院报到率达到80%。结论:订单定向政策可有效解决农村基层人才缺乏问题;需要尽快完善保障订单定向政策顺利实施的相关政策;提高基层岗位收入和改善工作环境能够留住人才。     

引导免费医学生当好基层医疗“守门人”

<正>近日，教育部发布通知指出，今年将继续实施农村订单定向医学生免费培养，要求各地做好2023年中央财政支持中西部农村订单定向免费本科医学生招生培养工作。2023年中央财政支持高等医学院校为中西部乡镇卫生院培养订单定向免费五年制本科医学生共计6150人，报考免费医学定向招生计划的考生均须参加当年全国统一高考，实行单列志愿、单设批次、单独划线，只招收农村生源，在本科提前批次录取。     

留下还是离开，规范化培训纠结

住院医师规范化培训是毕业后医学教育的一个重要组成部分,也是医学毕业生成长为合格临床医师的必由之路。然而．过去我国在相当长的一段时间内缺乏以提高临床实践能力为主的系统性、规范化培训．医学生从医学院校毕业后,直接被分配到医院从事临床工作,     

农村订单定向医学生免费培养政策实施现状调查

调查订单定向医学生的招生情况、培养模式和职业生涯规划,分析农村订单定向医学生免费培养政策的实施过程,为农村基层卫生人才建设提供可行性策略和路径。方法:采用问卷调查和定性研究方法,在江西、青海和广西三个省份抽取四所承担国家订单定向医学生培养项目的院校,对2015年应届医学毕业生308人进行问卷调查、深入访谈和专题小组讨论。结果:调查对象中,1~15岁主要生活地在农村的有223人(72.9%),家庭年收入平均为2.82万元;选择订单定向政策的主要原因是毕业后有工作、高考分数限制和免学费;各地区政策实施过程中的合同签署和工作安排方面存在很大差异;收入和工作环境是影响毕业生就业意向的主要因素。结论:订单定向政策能够有效解决农村基层卫生人才缺乏问题;尽快完善保障订单定向政策顺利实施的相关政策;提高基层岗位收入和改善工作环境能够留住人才。     

小荷才露尖尖角

<正>从2010年起,我国在高等医学院校开始了农村订单定向医学生免费培养工作,由政府财政出资,为乡镇卫生院及以下医疗卫生机构培养全科医疗卫生人才。5年医学本科毕业后,第一批学生随即接受为期3年的住院医师规范化培训,去年八九月间,4800余名经过"5+3"医学教育的学生走上了农村基层医疗卫生工作岗位。转眼间快一年了,这些年轻人在新的岗位上工作、生活得如何,给农村卫生事业带来了哪些变化?     

广西三地首届服务期满农村订单定向医学生工作及影响因素研究

目的：分析广西首届服务期满农村订单定向医学生工作情况、工作满意度、续约情况及影响因素,并提出政策建议。方法：选取广西河池、南宁、北海三市,对47名订单定向医学生及乡镇卫生院院长、卫生行政部门管理人员进行问卷调查和深度访谈。结果：广西三地首届服务期满农村订单定向医学生续约率为42.6%;年收入差距8万元,周工作时长54小时,年培训机会1～4次;非续约者服务期满再就业后对工作条件、职业发展评价高于服务期满前和续约者;工作满意度也高于续约者;影响续约因素中,收入水平位居第1。结论：广西首届服务期满农村订单定向医学生乡镇卫生院续约率不高;收入差距大、工作时间长、培训机会少、工作条件差、职业发展受限,并且续约者工作满意度低、离职倾向高,短期内流失率可能进一步增加;收入水平是影响订单定向医学生续约的首要因素,居民认可尊重产生的工作成就感归属感有助于提高续约率。     

宁夏医学本科生对住院医师规范化培训制度的认知调查研究

为了解宁夏医学生对住院医师规范化培训制度的认知情况,并有针对性地提出改进建议,为今后住院医师规范化培训工作提供改进信息,使宁夏地区住院医师规范化培训制度更加完善。以宁夏医科大学2011—2015级共计3 546名医学生为样本总体,采用分层随机抽样方法抽取400名医学生为调查对象,定量分析和定性分析相结合的方法分析所得数据。结果显示,不同年级医学生对于住院医师规范化培训制度的认知存在差异,分析发现,年级越高,对住院医师规范化培训制度的认知情况越高,反之越低。同时,医学生普遍关注规范化培训待遇、规范化培训时间及规范化培训后就业等方面的问题。因此,相关部门在加强住院医师规培制度宣传的同时,应更加注重规范化培训待遇、规范化培训时间及规范化培训后就业等方面的问题,切实维护医学生的利益,使医学生可以全身心地投入到规范化培训中。     

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

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。     

Entry of US medical school graduates into family medicine residencies: 2010-2011 and 3-year summary

This is the 30th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. This retrospective analysis based on data reported to the AAFP from medical schools and family medicine residency programs shows approximately 8.0% of the 17,081 graduates of US medical schools between July 2009 and June 2010 were first-year family medicine residents in 2010, compared to 7.5% in 2009 and 8.2% in 2008. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2010 than were residents from privately funded schools (9.6% versus 5.4%). The Mountain and West North Central regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2010 (14.3% and 11.3%, respectively); the New England and Middle Atlantic regions reported the lowest percentages (5.6% and 5.3%, respectively). Approximately four in 10 of the medical school graduates (40.3%) entering a family medicine residency program as first-year residents entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the 3-year average percentage from each medical school of graduates entering family medicine residencies and the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs in 2010.     

Entry of US medical school graduates into family medicine residencies: 2004-2005 and 3-year summary

This is the 24th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. Approximately 9.2% of the 15,895 graduates of US medical schools between July 2003 and June 2004 were first-year family medicine residents in 2004, compared with 9.3% in 2003 and 10.3% in 2002. Medical school graduates from publicly funded medical schools were more likely to be first year family medicine residents in October 2004 than were residents from privately funded schools, 10.8% compared with 6.5%. The West North Central and the Mountain regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2004 at 14.9% and 12.8%, respectively; the New England and Middle Atlantic regions reported the lowest percentages at 6.6% and 5.2%, respectively. Nearly half of the medical school graduates (46.8%) entering a family medicine residency program as first-year residents in October 2004 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.     

Entry of US medical school graduates into family medicine residencies: 2005-2006 and 3-year summary

This is the 25th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family medicine residency programs. Approximately 8.4% of the 16,066 graduates of US medical schools between July 2004 and June 2005 were first-year family medicine residents in 2005, compared with 9.2% in 2004 and 9.3% in 2003. Medical school graduates from publicly funded medical schools were more likely to be first-year family medicine residents in October 2005 than were residents from privately funded schools, 9.9% compared with 5.8%. The Mountain and the West North Central regions reported the highest percentage of medical school graduates who were first-year residents in family medicine programs in October 2005 at 13.3% and 12.7%, respectively; the New England and Middle Atlantic regions reported the lowest percentages at 5.2% and 5.6%, respectively. Nearly half of the medical school graduates (47.3%) entering a family medicine residency program as first-year residents in October 2005 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. This article reports the average percentage for each medical school for the last 3 years. Also reported are the number and percentage of graduates from colleges of osteopathic medicine who entered Accreditation Council for Graduate Medical Education-accredited family medicine residency programs, based on estimates provided by the American Association of Colleges of Osteopathic Medicine.