Supporting policies for assistant general practitioner training program (3+ 2 mode) in Shanghai: A qualitative study
Authors: Jie Gu, Zhigang Pan, Yao Shen, Yuting Jiang, Jian Gong, Wei Dai
Journal: BMJ (2015)

Objective
To investigate the supporting policies of assistant general practioner training program (3+ 2 mode) in Shanghai.


Methods
Total 53 subjects were involved in 15 in-depth interviews and 5 focus group discussions held from October 2012 to October 2013, including 8 graduates from the specialty of country doctor of Shanghai Institute of Health Sciences, 12 country doctors, 2 leaders of 3+ 2 mode training hospital, 5 leaders of rural community health centers, 3 leaders of Shanghai Institute of Health Sciences, 9 leaders of Commission of Health and Family Planning in Shanghai suburbs, 3 leaders of Shanghai Municipal Commission of Health and Family Planning, 1 leader of National Health and Family Planning Commission.


Results
Three leaders of Shanghai Municipal Commission of Health and Family Planning admitted the training program involved multiple departments and there were no unified supporting policies, 2 leaders of Commission of Health and Family Planning in Shanghai suburbs thought the enrollment amount should be appropriately controlled.The exploration ofsocial person (non-formal employees) mode was encouraged by the leaders of Shanghai Municipal Commission of Health and Family Planning.Leaders of rural community health centers strongly recommended to increase the selection and withdrawal mechanism to ensure the quality of students and training.Three leaders of rural Commission of Health and Family suggested to enroll student from other provinces.Leaders of rural community health centers and Shanghai Municipal Commission of Health and Family Planning agreed that qualifying as assistant general practioner was an important target of training which should be obtained before graduation.All 3+ 2 mood trainees had a strong expectation to get a bachelor degree at the same time of completing the training.Leaders of Shanghai Municipal Commission of Health and Family Planning and 3+ 2 mode training hospitals proposed to pay attention to the construction of training base and teacher training.About one third of the 3+ 2 mood trainees, graduates from the specialty of country doctor of Shanghai Institute of Health Sciences and country doctors hoped to get more space for development.Leaders of rural community health centers and Shanghai Municipal Commission of Health and Family Planning considered that the qualification of assistant general practioner should be the minimal recruitment for recruitment of new medical personel.Leaders of Shanghai Institute of Health Sciences and 3+ 2 mode training hospital suggested the relevant departments to support the new country doctors in terms of income, promotion policies and so on.


Conclusions
The supporting policies of the pilot 3+ 2 training in Shanghai are imperfect.It can be improved from organization, management, training implementation and career development.Effective support policies can help to generalize the 3+ 2 training.


Key words: 
Inservice training; Qualitative research; General practitioners