First School of Clinical Medicine, Gannan Medical University, Ganzhou, 341000, China.
School of Business, Macao University of Science and Technology, Macao S.A.R, 999078, China.
BMC Prim Care. 2024 Nov 4;25(1):389. doi: 10.1186/s12875-024-02637-5.
Turnover intention (TI) indicates an employee's intention to depart from their current role within a defined timeframe. In China, the Targeted Admission Medical Education (TAME) program, initiated in 2010, offers tuition-free education to cultivate rural doctors. Despite continuous professional development (CPD) being considered a viable retention strategy, TI of alumni doctors from the TAME program remains high in recent years. This study aims to describe the prevalence of "turnover intention" among alumni doctors of the TAME program doctors in rural placements, and associated factors that predict high turnover intention.
A snowball sampling method was adopted to collect survey responses from 1,369 alumni doctors of the TAME program in Jiangxi Province, China. Based on the survey data, a binary variable was constructed to measure the turnover intention, and multivariate binary logistic regression models were used to investigate the relationship between doctors' turnover intention and demographic characteristics, work environment characteristics, and CPD activities. Results were presented using adjusted odds ratios with 95% confidence intervals.
Among the 1,369 alumni doctors of the TAME program surveyed in this study, 392 (28.6%) expressed intentions to leave their current positions. Of the respondents, 620 (45.3%) were female, and 930 (67.9%) were married. Additionally, 1,232 respondents (90%) indicated that their fathers were engaged in farm work. Strong associations with turnover intention were notably found among individuals who had undergone training at a higher-level healthcare institution for more than three months (aOR = 6.810, 95% CI: 3.333 to 13.909, p-value < 0.001), particularly those who had participated in CPD through a graduate degree program (aOR = 1.818, 95% CI: 1.272 to 2.597, p-value < 0.001).
Rural doctors in China from the tuition-free medical education program exhibit high turnover intention, especially those in graduate degree programs as CPD. To retain these highly qualified rural doctors, it is vital to offer competitive efficiency wages aligned with their skills and provide ample long-term career growth opportunities within the rural healthcare system.
离职意愿（TI）表示员工在规定时间内离开当前岗位的意愿。在中国，2010 年启动的定向招生医学教育（TAME）计划为培养农村医生提供免费教育。尽管持续专业发展（CPD）被认为是一种可行的保留策略，但近年来 TAME 计划农村岗位校友医生的离职意愿仍然很高。本研究旨在描述 TAME 计划农村岗位校友医生的离职意愿的流行程度，并预测高离职意愿的相关因素。
采用雪球抽样法从中国江西省的 1369 名 TAME 计划校友医生中收集调查回复。根据调查数据，构建了一个二项变量来衡量离职意愿，并使用多变量二项逻辑回归模型调查医生离职意愿与人口统计学特征、工作环境特征和 CPD 活动之间的关系。结果以 95%置信区间的调整优势比呈现。
在这项研究中，调查了 1369 名 TAME 计划的校友医生，其中 392 名（28.6%）表示有离开当前职位的意向。在回答者中，620 名（45.3%）是女性，930 名（67.9%）已婚。此外，1232 名受访者（90%）表示他们的父亲从事农业工作。与离职意愿显著相关的是，在三级及以上医疗机构接受培训超过三个月的个体（调整优势比[aOR] = 6.810，95%置信区间[CI]：3.333 至 13.909，p 值<0.001），特别是通过研究生学位课程参加 CPD 的个体（aOR = 1.818，95%CI：1.272 至 2.597，p 值<0.001）。
中国免费医学教育计划的农村医生离职意愿较高，特别是那些参加 CPD 的研究生学位课程的医生。为了留住这些高素质的农村医生，必须提供与他们的技能相匹配的有竞争力的效率工资，并在农村医疗体系内提供充足的长期职业发展机会。
