Abstract
BackgroundThe shortage of primary care physicians in rural China is an enduring problem with serious implications for access to care. In response to the shortage in health workforce in rural areas, China government has launched the rural-oriented tuition-waived medical education (RTME) programme since 2010, aiming to train more general practitioners to address the rural health workforce requirements in middle and west areas. This study aims to investigate the prevalence of mental illness and the level of professional identity in the rural-oriented tuition-waived medical students (RTMSs), and to explore the impact of the RTMSs’ professional identity and related cognition and satisfaction with the RTME programme on mental health.MethodsWe conducted a descriptive, cross-sectional study. A total of 1103 RTMSs and 1095 non-oriented medical students from seven medical universities (colleges) in Anhui province completed a demographic questionnaire, the Depression, Anxiety, Stress Scales and the Professional Identity Questionnaire for Undergraduate Students. Cognition and satisfaction with the RTME programme of the RTMSs were collected. Multiple linear regression analysis was used to analyze the data.ResultsThe prevalence of depression, anxiety, and stress in RTMSs were 11.8, 22.9 and 3.4%, respectively. The mean total scores of the Professional Identity Questionnaire for Undergraduate Students were 3.58 (SD = 0.61). Results of multiple linear regression model indicated that students who are dissatisfied with targeted primary healthcare institution are likely to suffer from depression and anxiety; moreover, students who enrolled in the rural-oriented tuition-waived medical education programme due to economic reason are more likely to suffer from anxiety. Furthermore, a significant positive correlation was found between professional identity and mental health.ConclusionsProviding better information about the RTME programme prior to enrollment and improving the students’ cognition of the policy’s effectiveness and the social value of rural healthcare work may contribute to improving the professional identity of the RTMSs. Meanwhile, a significant positive association was found between professional identity and mental health. This is a new perspective that shows that developing and improving professional identity may help medical students reduce the risk of psychological illness.
Highlights
The shortage of primary care physicians in rural China is an enduring problem with serious implications for access to care
In terms of the view on the rural-oriented tuition-waived medical education (RTME) programme, 45.4% believed that this programme limits personal career development, and only 8.4% believed this programme will help achieve personal value
In terms of satisfaction with the RTME programme, 47.6% of the Rural-oriented Tuition-waived Medical Student (RTMS) were satisfied with targeted primary health organization, whereas 50.9% were satisfied with the living allowance; the percentage of satisfaction with 6 years’ service period was the lowest at only 34.0%
Summary
The shortage of primary care physicians in rural China is an enduring problem with serious implications for access to care. In response to the shortage in health workforce in rural areas, China government has launched the rural-oriented tuition-waived medical education (RTME) programme since 2010, aiming to train more general practitioners to address the rural health workforce requirements in middle and west areas. In response to the shortage in health workforce in rural areas, China has proposed numerous health workforce development plans or policies, including the rural-oriented tuition-waived medical education (RTME) programme initiated and promoted since 2010. This programme aims to train additional general practitioners to address the rural health workforce requirements in the middle and west areas. Obstacles that discourage them from practicing as a rural general practitioner include limited professional development prospect, unsound medical equipment and facilities, and inadequate financial remuneration, thereby simultaneously influencing the professional identity of RTMSs
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