Training Pathways to Working as a General Practitioner in China

Abstract

Background and Objectives: To achieve the goal of 300,000 general practitioners by 2020—an increase of 215,200 in a decade—China is utilizing multiple training pathways. To comprehensively illustrate general practitioner training strategies in China, this article introduces and describes these pathways. Methods: We used descriptive policy analysis. This involved taking an inventory of existing literature and source documents and developing a model to illustrate pathways for training general practice physicians. Results: The rural doctor pathway represents rural clinicians who had only basic training and practiced multiple years prior to training reforms. The 3+2 pathway to assistant general practitioners requires 3 years of junior college and 2 years of clinical training. The transfer pathway for current physicians requires 1-2 years of training. The 5+3 pathway comprises 5 years of bachelor of science degree training in clinical medicine and 3 years of standardized residency training. Despite the development of advanced degree programs, their use remains limited. Conclusions: These pathways illustrate significant heterogeneity in training of general practitioners. Training ranges from a 2-year technical degree to a doctorate with research. Emphasis on the 5+3 track shows promise for China’s goals of improved quality and new goal of 500,000 additional general practitioners by 2030.

Do Physicians’ Attitudes towards Patient-Centered Communication Promote Physicians’ Intention and Behavior of Involving Patients in Medical Decisions?

“…It was likely that physicians in THCs would be more likely to face patients of low literacy, and would serve as the delegates of patients as “decision-makers” [ 36 ]. Moreover, the physicians in THCs would have fewer opportunities and resources of patient-centered communication skills [ 37 ], which would lead to failure of expressing a friendly attitude towards patients or involving them in decision-making.…”

Comparison of general practice residents’ attitudes and perceptions about training in two programmes in China: a mixed methods survey

“…In large Chinese hospitals, doctors receive higher salaries, have higher reputations and have better career opportunities than general practitioners 26. The educational level in hospitals is higher than community health organisations 6. These factors likely contribute to lower social status, but do not justify pejorative attitudes.…”

“…For example, in 2012, the highest level of government financial support per programme amounted to ¥560 000 (about US$88 900) in Chongqing, and ¥150 000 (about US$23 800) in Beijing,5 while there was no financial support in Sichuan 5. Lian et al 6 have documented eight pathways used to train general practitioners in China, but the government has encouraged mostly the ‘5+3’ pathway 6. The 5+3 pathway comprises 5 years of undergraduate training in medical sciences conferring a Bachelor of Science degree and then 3 years of postgraduate and clinical training.…”

Is training policy for general practitioners in China charting the right path forward? a mixed methods analysis

“…27 Improving teaching has been identified as one of the key factors for improving the quality of GPs. 28 According to the World Organization of National Colleges, Academies and Academic Association of General Practitioners (WONCA), half of the training time should be spent in a general practice environment, with GPs acting as the principal teachers and mentors. 29 Finally, current GP training in China does not adequately prepare trainees in the areas of differential diagnosis and criteria for referring patients with frequently-occurring diseases.…”