School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
Xi'an Health and Family Planning Commission, Xi'an, China.
BMC Med Educ. 2018 May 2;18(1):91. doi: 10.1186/s12909-018-1209-z.
Attracting and recruiting health workers to work in rural areas is still a great challenge in China. The rural-oriented tuition-waived medical education (RTME) programme has been initiated and implemented in China since 2010. This study aimed to examine the attitudes of rural-oriented tuition-waived medical students (RTMSs) in Shaanxi towards working in rural areas and the related influencing factors.
A cross-sectional survey was conducted in 2015 among 232 RTMSs in two medical universities from the first group of students enrolled in the RTME programme in Shaanxi. Descriptive and analytical statistics were used for the data analyses.
Of the 230 valid responses, 92.6% expressed their intentions of breaking the contract for working in rural township hospitals for 6 years after their graduation under the RTME programme. After the contract expired, only 1.3% intended to remain in the rural areas, 66.5% had no intention of remaining, and 32.2% were unsure. The factors related to a positive attitude among the RTMSs towards working in rural areas (no intention of breaking the contract) included being female, having a mother educated at the level of primary school or below, having a good understanding of the policy, having a good cognition of the value of rural medical work, and being satisfied with the policy. The factors related to a positive attitude of the RTMSs towards remaining in rural areas included being female, having a rural origin, having no regular family monthly income, having a father whose occupation was farmer, having a mother educated at the level of postsecondary or above, having the RTMSs be the final arbiter of the policy choice, having a good understanding of the policy, having a good cognition of the value of rural medical work, and being satisfied with the educational scheme.
Related policy makers and health workforce managers may benefit from the findings of this study. Appropriate strategies should be implemented to stimulate the RTMSs' intrinsic motivation and improve their willingness to work in rural areas and to better achieve the objectives of RTME policy. Meanwhile, measures to increase the retention of RTMSs should also be advanced.
吸引和招聘卫生工作者到农村地区工作仍然是中国面临的巨大挑战。农村定向免费医学教育（RTME）计划自 2010 年在中国启动并实施。本研究旨在调查陕西农村定向免费医学生（RTMS）对到农村地区工作的态度及其相关影响因素。
2015 年，对陕西省首批参加 RTME 计划的两所医学院校的 232 名 RTMS 进行了横断面调查。采用描述性和分析性统计方法进行数据分析。
在 230 份有效答复中，92.6%的人表示愿意在 RTME 计划毕业后的 6 年内违反与乡镇卫生院的工作合同。合同期满后，只有 1.3%的人打算留在农村地区，66.5%的人没有意愿留在农村地区，32.2%的人不确定。与 RTMS 对农村地区工作持积极态度（不打算违反合同）相关的因素包括女性、母亲受小学及以下教育、对政策有很好的理解、对农村医疗工作的价值有很好的认知、对政策满意。与 RTMS 对留在农村地区持积极态度相关的因素包括女性、农村出身、没有稳定的家庭月收入、父亲职业是农民、母亲受过中等或以上教育、让 RTMS 成为政策选择的最终裁决者、对政策有很好的理解、对农村医疗工作的价值有很好的认知、对教育计划满意。
相关政策制定者和卫生人力管理者可以从本研究的结果中受益。应实施适当的策略，以激发 RTMS 的内在动机，提高他们到农村地区工作的意愿，更好地实现 RTME 政策的目标。同时，还应推进增加 RTMS 留用率的措施。
