农村订单定向医学生基层就业意愿现状及影响因素分析

目的调查农村订单定向医学生（定向医学生）基层工作的意愿，分析其选择全科医生作为职业的影响因素，为定向医学生的培养提供建议。方法采用整群分层抽样现况调查的方法，通过问卷对某医学院校定向医学生进行一般人口学特征、基层服务意愿和教育服务质量满意度调查，分析基层工作意愿，采用多因素logistic回归分析其基层工作意愿的影响因素。结果定向医学生愿意到基层工作比例为42.45%（118/278）。基层就业意向定向医学生的学校教育服务质量满意度量表得分为（3.81±0.57）分，非基层就业意向医学生得分为（3.26±0.59）分，二者差异有统计学意义（P < 0.01）。单因素分析显示，不同年级、父亲文化水平和对国家政策认同情况、对医学兴趣认知情况、为家乡做贡献意愿、学前合同束缚感的定向医学生基层就业意向差异均有统计学意义（P < 0.05~P < 0.01）。多因素分析结果显示，对国家政策是否了解、对医学兴趣、为家乡做贡献、受学前合同束缚均为定向医学生基层就业意向的独立影响因素（P < 0.05~P < 0.01）。结论定向医学生到基层工作意愿较低，有关部门要完善定向政策和长期激励机制，加强定向医学生职业道德和思想教育，增加其对专业的热情。

Analysis on the present situation and influencing factors of grassroots employment intention in rural order-oriented medical students

ObjectiveTo investigate the grassroots of employment intention rural order-oriented medical students, analyze the influencing factors related to choosing general practitioners as a career for providing advice in training targeted medical students.MethodsThe general information, intention of serving the grassroots employment intention and satisfaction degree of education service quality in directional medical students selected by stratified cluster sampling method from a medical college were investigated using questionnaire.The intention of serving the grassroots was analyzed, and the influencing factors of which was analyzed using the multi-factor logistic regression method.ResultsThe proportion of directional medical students willing to work at the grassroots was 42.45% (118/278).The scores of school education service quality satisfaction scale in medical students willing and not willing to work at the grassroots were(3.81±0.57) and(3.26±0.59), respectively, and the difference of which was statistically significant(P < 0.01).The results of univariate analysis showed that the differences of the employment intention of the grassroots among medical students with different grades, father's level of education, identification with national policies, cognition of medical interest, willingness to make contributions to hometown and sense of constraint of preschool contract were statistically significant(P < 0.05 to P < 0.01).The results of multi-factor analysis showed that the understanding of national policies, interest in medicine, contribution to hometown and being bound by preschool contract were the independent factors influencing the employment intention of the grassroots in order-oriented medical students(P < 0.05 to P < 0.01).ConclusionsThe employment intention of the grassroots in order-oriented medical students is low.The related departments should improve the directional policies and long-term incentive mechanism, strengthen the education of professional ethics and ideas, and increase their enthusiasm for the specialty.