Early outcomes of a rural-oriented physician education programme against rural physician shortages in Guangxi province: a prospective cohort study

Ying Shen; Xing Huang; Hong Li; Enran Chen; Yan Kong; Jia Yu; Xiaoyun Liu; Siam Ai Mobarak; Yanli Zuo

doi:10.1136/bmjopen-2021-049274

Early outcomes of a rural-oriented physician education programme against rural physician shortages in Guangxi province: a prospective cohort study

BMJ Open. 2021 Sep 7;11(9):e049274. doi: 10.1136/bmjopen-2021-049274.

Authors

Ying Shen¹, Xing Huang², Hong Li¹, Enran Chen¹, Yan Kong¹, Jia Yu¹, Xiaoyun Liu³, Siam Ai Mobarak⁴, Yanli Zuo⁵

Affiliations

¹ School of General Practice, Guangxi Medical University, Nanning, Guangxi, China.
² Division of Teaching Affairs, Guangxi Medical University, Nanning, Guangxi, China.
³ China Center for Health Development Studies, Peking University, Beijing, China.
⁴ The Department of Cardiology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China.
⁵ School of General Practice, Guangxi Medical University, Nanning, Guangxi, China zuoyanli@gxmu.edu.cn.

Abstract

Objectives: This study aimed to investigate early outcomes of one of the first medical undergraduate education programmes with a goal of mitigating severe rural physician shortages in China, which was developed by Guangxi Medical University (GXMU) and was called the Rural-oriented Free Tuition Medical Education (RTME)-GXMU programme.

Design: A prospective cohort study comprising a baseline investigation and follow-up research was conducted to dynamically observe the evolution of the RTME-GXMU programme that began since 2010.

Participants: 380 RTME-GXMU graduates and 383 non-RTME-GXMU graduates from GXMU who completed trainings between 2015 and 2018 were recruited in the baseline investigation. Among them, 285 RTME-GXMU and 283 non-RTME-GXMU graduates responded to the follow-up research.

Main outcome measures: Graduate practice location, registered specialty, passing rate of the National Medical Licensing Examination (NMLE), specialty of residency programme and contract compliance for the RTME-GXMU graduates.

Results: By the end of 2018, 100% of the 2015 RTME-GXMU graduates enrolled in this study practised in rural township health centres and registered themselves as general practitioners (GPs). All the RTME-GXMU graduates had completed or were attending residency programmes of general practice (GP). The above data stood in stark contrast to that of the non-RTME-GXMU graduates among whom as few as 1.06% worked in rural areas, 2.13% registered as GPs and less than 3% chose GP residency programmes. No significant differences were detected on passing rates of the NMLE between the two groups. Only one RTME-GXMU graduate broke the contract and dropped off the programme.

Conclusions: The RTME-GXMU programme has achieved encouraging early outcomes. Reduced entry score and proper usage of urban primary care institutions are two key approaches contributing to these positive early results.

Keywords: education & training (see medical education & training); health informatics; medical education & training.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Career Choice
China
Humans
Physicians*
Professional Practice Location
Prospective Studies
Rural Health Services*
Rural Population