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中国中医临床专业毕业生的职业偏好:一项离散选择实验

Job preferences among traditional Chinese medicine clinical graduates in China: a discrete choice experiment.

作者信息

Gu Yichun, Tian Botao, Wu Shang, Liu Shimeng, Sun Lihang, Wang Yaqun, Yu Huaxin, Zhang Yulin, Su Jinying, He Da

机构信息

Shanghai Health Development Research Center, Shanghai, China.

School of Economics and Management, Jiangxi University of Chinese Medicine, Nanchang, China.

出版信息

BMC Med Educ. 2025 Feb 20;25(1):272. doi: 10.1186/s12909-025-06841-4.

DOI:10.1186/s12909-025-06841-4
PMID:39979980
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11841246/
Abstract

BACKGROUND

Primary-level Traditional Chinese Medicine (TCM) healthcare institutions are currently facing a severe shortage of TCM professionals, highlighting the urgent need to explore the job preferences of TCM clinical graduates. This study aimed to investigate the stated job preferences of TCM clinical graduates when seeking employment.

METHODS

A discrete choice experiment (DCE) was conducted to assess the employment preferences of TCM clinical graduates from 16 TCM universities across China. The job attributes examined included the monthly income, work location, hospital tier, job stability (position tenure), work intensity, opportunities for mentorship under renowned practitioners, and career advancement prospects. A mixed logit model was employed to obtain the main effects model. Based on the results of the main effects model, analyses of relative importance and willingness to pay (WTP) were conducted. Additionally, heterogeneity analysis and scenario simulation analysis were performed.

RESULTS

A total of 2,402 valid questionnaires were included in the primary DCE analysis. Monthly income was the most important factor (RIS = 52.58%). Among non-economic factors, participants expressed the strongest willingness to reduce workload, being willing to forgo 2,367.5 yuan in monthly income to transition from high to low work intensity. Other significant factors included formal establishment (RIS = 11.32%), mentorship opportunities (RIS = 7.44%), and hospital level (RIS = 4.63%), with job location being the least important (RIS = 3.44%). Subgroup analysis showed that male graduates were more willing than female graduates to forgo formal establishment for mentorship opportunities. Graduates from the eastern region valued lower work intensity and formal establishment more than those from the central and western regions. Postgraduates were more likely than undergraduates to give up monthly income for jobs in higher-tier cities. Scenario analysis revealed that graduates had a 43.0% probability of choosing third-tier cities under baseline conditions. Comprehensive improvements (e.g., higher income and formal establishment) increased this probability to 84.8%, rising to 87.3% with better promotion opportunities.

CONCLUSION

This study demonstrates that the monthly income has the most significant impact on employment preferences. The work intensity and mentorship opportunities also play crucial roles, with the influence of the work intensity surpassing those of other non-economic factors. In contrast, the hospital tier and work location have a relatively smaller impact on graduates' preferences. In addition, a combination of certain non-economic measures can enhance students' willingness to choose hospitals in third-tier cities. Based on these findings, it is recommended that recruitment and career development strategies focus on the salary, work intensity, and mentorship opportunities, while providing stable job positions and favorable work environments, so as to meet the primary needs of TCM clinical graduates. A novel contribution of this study is its identification of the significant influence of mentorship opportunities, which are one of the distinctive features of TCM, on the employment choices of TCM graduates, filling a gap in the existing research. Future studies should integrate online questionnaires with offline interviews to gain deeper insights into the decision-making processes of graduates in real-world work environments.

摘要

背景

基层中医医疗机构目前面临着中医专业人才的严重短缺,这凸显了探索中医临床毕业生就业偏好的迫切需求。本研究旨在调查中医临床毕业生在求职时所表明的就业偏好。

方法

进行了一项离散选择实验(DCE),以评估来自中国16所中医药大学的中医临床毕业生的就业偏好。所考察的工作属性包括月收入、工作地点、医院级别、工作稳定性(职位任期)、工作强度、师从知名从业者的机会以及职业发展前景。采用混合逻辑模型来获得主效应模型。基于主效应模型的结果,进行了相对重要性分析和支付意愿(WTP)分析。此外,还进行了异质性分析和情景模拟分析。

结果

初步DCE分析共纳入2402份有效问卷。月收入是最重要的因素(相对重要性得分[RIS]=52.58%)。在非经济因素中,参与者表示最愿意减少工作量,愿意放弃2367.5元的月收入以从高工作强度转变为低工作强度。其他重要因素包括编制(RIS=11.32%)、导师指导机会(RIS=7.44%)和医院级别(RIS=4.63%),而工作地点是最不重要的因素(RIS=3.44%)。亚组分析表明,男性毕业生比女性毕业生更愿意为了导师指导机会而放弃编制。东部地区的毕业生比中西部地区的毕业生更看重较低的工作强度和编制。研究生比本科生更有可能为了在更高层级城市的工作而放弃月收入。情景分析显示,在基线条件下,毕业生选择三线城市的概率为43.0%。综合改善(如更高的收入和编制)将这一概率提高到84.8%,在有更好晋升机会的情况下则升至87.3%。

结论

本研究表明,月收入对就业偏好的影响最为显著。工作强度和导师指导机会也起着关键作用,工作强度的影响超过了其他非经济因素。相比之下,医院级别和工作地点对毕业生偏好的影响相对较小。此外,结合某些非经济措施可以提高学生选择三线城市医院的意愿。基于这些发现,建议招聘和职业发展策略应侧重于薪资、工作强度和导师指导机会,同时提供稳定的工作岗位和良好的工作环境,以满足中医临床毕业生的首要需求。本研究的一个新贡献是确定了导师指导机会(中医的独特特征之一)对中医毕业生就业选择的显著影响,填补了现有研究的空白。未来的研究应将在线问卷与线下访谈相结合,以更深入地了解毕业生在实际工作环境中的决策过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/11841246/3d185a997b99/12909_2025_6841_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/11841246/c45df8854430/12909_2025_6841_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/11841246/a8f6c7be3271/12909_2025_6841_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/11841246/3d185a997b99/12909_2025_6841_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/11841246/c45df8854430/12909_2025_6841_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/11841246/a8f6c7be3271/12909_2025_6841_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79bc/11841246/3d185a997b99/12909_2025_6841_Fig3_HTML.jpg

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