Zhongguo quanke yixue (Aug 2022)
Development of Compulsory Rural Service Directed Medical Student Free Training Project at Home and Abroad
Abstract
Background Our state policy of free training of compulsory rural service oriented medical students (abbreviated as rural service orientation project) starts with the construction of a team of primary medical health talents and makes an excellent contribution to improve the accessibility and quality of medical services in rural areas of China. A comprehensive understanding of the current state of the rural service directed medical student team is important to evaluate the implementation effect of the free training policy, as well as the long-term development of the primary care health talent team. Objective To review the research progress of related studies on rural service orientation project in China and similar projects abroad, summarize the execution process and execution results of the projects inductively, and compare the similarities and differences between domestic and foreign studies. Methods The study was conducted from July to September 2021. A literature search for Chinese language was conducted in CNKI, Wanfang Data Knowledge Service Platform and VIP, and the search time was set from 2010-07-01 to 2021-07-01. A literature search in English was conducted in PubMed, web of science, Scopus, and the search time was set from 2000-01-01 to 2021-07-01. Literature screening was performed according to the inclusion and exclusion criteria, relevant information was extracted, and the literature was classified and analyzed according to the subjects and contents of the studies. Results A total of 443 articles were finally included, with 427 of them on our rural service orientation project in China and the rest 16 on similar projects abroad. The research topics that were studied in the literature included four broad categories: cultivation mode, enrollment, training process, and employment development. In 427 related literatures of China's rural service orientation project: 102 (23.9%) discussed the training mode of rural service oriented project. Ten (2.3%) analyzed the admission status of rural service directed medical students and found that rural service directed medical students had higher awareness rate of the related policies (>75.0%-90.9%) and the proportion of rural students sources was higher (57.6%-84.2%). 270 (63.2%) literatures used the cultivation process of rural service directed medical students as a starting point and focused on their learning situation, professional identification and performance willingness, and found that rural service directed medical students had lower academic performance and professional recognition than general clinical medical students. The results of studies on the performance willingness of rural service directed medical students varied greatly (42.4%-98.4%), and the average performance willingness was 66.2% when weighted by sample size. Only 25 (5.9%) studied employment development in rural service orientated graduates and found an average performance rate of 93.6%. Rural service directed medical students had a faster rate of completing standardized residency training and passing practitioner examination than other five-year clinical graduates. Of the 16 foreign related literatures included, 11 (68.8%) examined the employment development of rural service directed medical graduates and obtained results similar to those of domestic studies. Conclusion A larger number of current studies focused on rural service oriented project and had rich topics. It was found that the rural service directed free medical student training policy was better implemented, leading to a large number of excellent primary health talents in the Midwest. However, most of the current research focuses on the cultivation stage of rural service oriented medical students, and there is insufficient understanding of medical students who have joined the primary care team at elementary level. Future research should focus on three aspects: performance status after rural service directed medical students having completed the contract period, career development process after employment and the actual role they play in primary health care institutions.
Keywords
