Ten years' GP training in China: progress and challenges.

Abstract

In 2009, China launched a programme of major primary healthcare reform, with the aim of achieving universal health coverage across urban and rural areas by 2020.1 This required a strong GP workforce. Facing a critical shortage of qualified GPs [32 400 nationwide], the Chinese government set a national target of providing 2–3 GPs per 10 000 population, a total of 300 000 GPs by 2020. Efforts to achieve this goal have progressed, as illustrated by data suggesting there were 309 800 in total (2.2 GPs per 10 000 population) in 2018 (Figure 1). We explore the progress and challenges in GP training in China over the past 10 years and its prospects for the future. Figure 1. Growth of GP numbers in China from 2009 to 2018. Source: China Health Statistics from 2010 to 2019. The education of GPs has attracted significant attention from the Chinese government since 2009, with the introduction of a series of new policies and GP training programmes. Huge investment was made (20 billion RMB, £2.2 billion, $2.8 billion) during 2010–2015 to promote development of the GP workforce.2 In 2011, the State Council initiated a unique GP training system with multiple pathways, tailored for China’s huge population and uneven distribution of resources, and accounting for existing community medical personnel. China now has five GP training programmes, each with specific aims, duration, curriculum, and targeted trainees. A new ‘5 + 3’ model of residency training (5-year medical school plus 3-year GP residency) is expected to become a gold standard. The government has established 559 hospital and 1660 community training bases nationally.3 Residency training becomes mandatory …