Turnover Intention and Associated Factors in Guizhou's Targeted Admission Medical Graduates Trained with the "5+3" Standardized General Residency Program: an Online Questionnaire Survey

Abstract

Background The turnover intention level of general practitioners (GPs) in primary care in China is relatively high, and identification of its associated factors will offer insights into the curbing of outflow of health talents in primary care. The targeted admission medical graduates (TAMG) who completed the "5+3" standardized general residency program (5-year undergraduate medical education plus 3-year standardized residency training) have gradually entered primary care to fulfill their preadmission commitments, but research on their turnover intention after the tenure is few. Objective To explore the turnover intention and associated factors in Guizhou's TAMG trained with the "5+3" standardized general residency program after fulfilling their preadmission commitments in primary care, providing a basis for improving the policies about retaining the in-service health talents and developing the general practice workforce. Methods Participants were TAMG who were working in primary hospitals of Guizhou for fulfilling their preadmission commitments after finishing the "5+3" standardized general residency program at the end of 2020 (with a starting time for the 3-year standardized residency training of 2015—2017) . An online questionnaire survey was conducted with them from January 20 to February 10, 2021 for understanding their general information, self-assessed job satisfaction, turnover intention and planned career development after the expiration of services. Three hundred and eleven (89.6%) of the 347 cases who returned responsive questionnaires were selected as the final participants. Univariate and stepwise multiple linear regression analyses were used to explore the factors related to turnover intention. Results The average turnover intention score for the respondents was (3.98±0.98) points. The prevalence of having turnover intention was 73.6% (229/311) . The level of turnover intention differed obviously by sex, hospital location, and daily workload (P<0.05) . Stepwise multiple linear regression analysis found that the way leaders treating their subordinates, sense of work-related, the level of satisfaction with current income, family's support for their job, the implementation of local incentive policies accomplishment were associated with turnover intention (P<0.05) . In terms of the post-expiration development, 12 (3.9%) planned to continue working at the current hospital, 21 (6.7%) planned to work at another primary care setting, 196 (63.0%) planned to work at a higher level hospital, and 60 (19.3%) planned to study full-time to get a master's degree. Conclusion The level of turnover intention was high in TAMG working as a GP in primary care in Guizhou, and it is estimated that many of them would outflow after the expiration of services. To improve this, it is suggested to value their needs, take actions to increase income and optimize trainings and employment forms for them, and to further develop primary care hospitals, as well as to strengthen the publicity of general practice.

Keywords

• general practitioners|target admission medical graduates|education, medicine|turnover intention|job satisfaction|burnout, professional|root cause analysis