上海市助理全科医生培训（3＋2模式）和全科医生规范化培训（5＋3模式）学员职业认知的调查比较

目的调查和比较上海市助理全科医生培训（3＋2模式）和全科医生规范化培训（5＋3模式）学员的职业认知，为完善全科医生培养方式提供依据。方法2012年8月至10月问采用问卷调查的方法，对上海市嘉定区3＋2模式培训学员和6家全科培训基地的2012级5＋3模式培训学员的职业认知进行研究。结果30名3＋2模式培训学员平均年龄（22．6±0．7）岁，男性占16．7％]和76名5＋3模式学员平均年龄（24．6±1．8）岁，男性占35．5％]完成调查。3＋2模式学员在“全科医生的社会地位”（平均秩69．37比47．24，Z=-3．589，P〈0．001）、“全科医生的职业前景”（平均秩66．13比48．51，Z=-2．953，P=0．003）和“目前社会对全科医生的需求”（平均秩68．17比47．71，Z=-3．261，P=0．001）三方面的总体判断均好于5＋3模式学员。93．4％（28／30）的3＋2模式学员和47．4％（36／76）的5＋3模式学员均认为目前全科医生最急需改善的是工作收入。5＋3模式学员的期望工作收入高于3＋2模式学员（8436±2963）形月比（6600±2694）形月，t=-3．087，P=0，003]。仅35．5％（27／76）的5＋3模式学员毕业后首选进入社区卫生服务中心工作，而39．5％（30／76）首选进入二、三级医院工作。Logistic回归分析显示，性别、户籍、毕业院校、学历、专业、培训前工作经验和预期收人与其首选就业意向无相关性。结论5＋3模式学员职业认知有待提高，就业意向尚需调整，全科医生的收入亟待改善。

Comparison of professional cognition between trainees of GP assistant training program and GPtraining program in Shanghai

Objective To investigate and compare the professional cognition between trainees of general practitioner （GP） assistant training program （3 ＋ 2 mode） and GP training program（5 ＋ 3 mode）in Shanghai. Methods A questionnaire survey on professional cognition was conducted among 30 trainees （22. 6 ±0. 7） y, 16. 7% male] of 3 ＋2 program from Jiading District and 76 trainees （24. 6 ± 1.8） y, 35.5% male] of 5 ＋ 3 program from 6 GP training bases in Shanghai during August to October 2012. Results The overall assessment of 3 ＋ 2 trainees was higher than that of 5 ＋ 3 trainees in three aspects ： ＂the social status of GPs＂ （ mean rank 69. 37 vs. 47. 24, Z = - 3. 589, P 〈 0. 001 ）, ＂the career prospects of GPs＂ （mean rank 66. 13 vs. 48. 51, Z = - 2. 953, P = 0. 003 ） and ＂the social demand for GPs＂ （ mean rank 68.17 vs. 47.71, Z=-3.261, P=0.001）. 93.4% （28/30） of 3 ＋2 trainees and 47.4% （36/76） 5 ＋3 trainees considered that what was most needed for any improvement of GPs was raising income. The expected income of 5 ＋3 trainees was higher than that of 3 ＋2 trainees I （8436±2963） vs. （6600 ±2694） yuan/m,t= -3. 087, P = 0. 003]. About employment intention, only 35.5% （27/76） of 5 ＋ 3 trainees regarded community health service centers as first choice, while 39.5% （ 30/76 ） of them preferred secondary or tertiary hospitals. Logistic regression showed that the preferred employment intention of 5 ＋ 3 trainees was not related to their gender, household registry, school of graduation, educational background, study major, working experience and expected income. Conclusions The survey indicates that the professional cognition of 5 ＋ 3 trainees need to be improved, their employment intention need to be adjusted and their income need to be raised.