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。

Study on the working status and influencing factors of the first group of targeted admission medical graduates in rural areas of three cities in Guangxi

objective: In order to analyze the working status, job satisfaction, contract renewal and influencing factors of the first group of targeted admission medical graduates in rural areas of Guangxi, and put forward policy suggestions. Methods: A questionnaire survey and in-depth interview were conducted among 47 targeted admission medical graduates,presidents of township health centers and managers of health administrative departments in Hechi, Nanning and Beihai, Guangxi. Results: The renewal rate of the first group of targeted admission medical graduates is 42.6% in rural areas of Guangxi. The gap of annual income is 80 000 RMB. The hour each week working is 54 hours. And the annual training opportunity is 1~4 times. The evaluation of working status and career development of non-renewed employees after the expiration of service is higher than that before the expiration of service, and higher than that of renewed employees. Job satisfaction is also higher than that of renewed employees. Among the influencing factors, the income level ranks first. Conclusions: The renewal rate of the first group of targeted admission medical graduates in rural areas of Guangxi after the expiration of the service period is not high, with large income gap, long working hours, few training opportunities, poor working status, limited career development. Renewals have low job satisfaction and high turnover intention, and the turnover rate may rise further in the short term.The income level is the primary factor affecting the renewal of targeted admission medical graduates. Residents recognize and respect the sense of job achievement and belonging, which helps to improve the renewal rate.