Recruitment of general practitioners in China: a scoping review of strategies and challenges

Abstract Background China is rapidly expanding its general practitioner (GP) workforce as part of recent healthcare reform, with an extra 400,000 GPs by 2030. This scoping review identifies the published strategies for GP recruitment that are being implemented and the challenges encountered. Methods...

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Main Authors: Shiwei Chen, Xin Hui Sam, Aijia Soong, Lorainne Tudor Car, Siqing Lian, Helen E. Smith
Format: Article
Language:English
Published: BMC 2022-09-01
Series:BMC Primary Care
Subjects:
Online Access:https://doi.org/10.1186/s12875-022-01854-0
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author Shiwei Chen
Xin Hui Sam
Aijia Soong
Lorainne Tudor Car
Siqing Lian
Helen E. Smith
author_facet Shiwei Chen
Xin Hui Sam
Aijia Soong
Lorainne Tudor Car
Siqing Lian
Helen E. Smith
author_sort Shiwei Chen
collection DOAJ
description Abstract Background China is rapidly expanding its general practitioner (GP) workforce as part of recent healthcare reform, with an extra 400,000 GPs by 2030. This scoping review identifies the published strategies for GP recruitment that are being implemented and the challenges encountered. Methods We searched six English and three Chinese databases from 2015 to April 2022, following Arksey and O’Malley’s framework and the PRISMA ScR reporting guidelines. Results A total of 40 Chinese-language and 5 English-language records were included. We identified multiple policies, pathways and programmes focused on expanding GP recruitment. Twenty-two evaluations of these initiatives show varying degrees of effectiveness. Selecting general practice as a career is affected by many factors, including individual’s background, remuneration and benefits, career prospects, working environment, self-fulfilment, and current national developments and reorganisations of primary care. The challenge most frequently reported was the adequate provision of qualified GP in rural regions. The targeting of students from rural areas and provision of free education in return for an obligatory six-years’ working in their hometown upon graduation appears to be effective. Extracted records mostly studied views of trainees in a defined locality, and we identified a paucity of studies which explored the perspectives of organisations and institutions, similarly there were areas of China not contributing to the literature and there were no records taking a national perspective. Conclusions Long-term monitoring is required to assess policy changes and to systematically evaluate the effectiveness of the interventions nationally. The monitoring of the challenges influencing GP recruitment can be used to inform the design of future initiatives. Development of a minimum agreed standardised set of outcomes used to measure and report evaluations will help assess the relative contributions and cost effectiveness of different approaches being used to boost GP numbers. We provide suggestions for improving the benefits and rewards for GPs and how to promote recruitment to the more rural or less attractive areas.
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spelling doaj.art-3715b8b81b444d00b89804c5d11542fb2022-12-22T04:29:01ZengBMCBMC Primary Care2731-45532022-09-0123111410.1186/s12875-022-01854-0Recruitment of general practitioners in China: a scoping review of strategies and challengesShiwei Chen0Xin Hui Sam1Aijia Soong2Lorainne Tudor Car3Siqing Lian4Helen E. Smith5Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological UniversityFamily Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological UniversityFamily Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological UniversityFamily Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological UniversityPeking University First HospitalFamily Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological UniversityAbstract Background China is rapidly expanding its general practitioner (GP) workforce as part of recent healthcare reform, with an extra 400,000 GPs by 2030. This scoping review identifies the published strategies for GP recruitment that are being implemented and the challenges encountered. Methods We searched six English and three Chinese databases from 2015 to April 2022, following Arksey and O’Malley’s framework and the PRISMA ScR reporting guidelines. Results A total of 40 Chinese-language and 5 English-language records were included. We identified multiple policies, pathways and programmes focused on expanding GP recruitment. Twenty-two evaluations of these initiatives show varying degrees of effectiveness. Selecting general practice as a career is affected by many factors, including individual’s background, remuneration and benefits, career prospects, working environment, self-fulfilment, and current national developments and reorganisations of primary care. The challenge most frequently reported was the adequate provision of qualified GP in rural regions. The targeting of students from rural areas and provision of free education in return for an obligatory six-years’ working in their hometown upon graduation appears to be effective. Extracted records mostly studied views of trainees in a defined locality, and we identified a paucity of studies which explored the perspectives of organisations and institutions, similarly there were areas of China not contributing to the literature and there were no records taking a national perspective. Conclusions Long-term monitoring is required to assess policy changes and to systematically evaluate the effectiveness of the interventions nationally. The monitoring of the challenges influencing GP recruitment can be used to inform the design of future initiatives. Development of a minimum agreed standardised set of outcomes used to measure and report evaluations will help assess the relative contributions and cost effectiveness of different approaches being used to boost GP numbers. We provide suggestions for improving the benefits and rewards for GPs and how to promote recruitment to the more rural or less attractive areas.https://doi.org/10.1186/s12875-022-01854-0Primary careChinaGeneral practitionersRecruitmentFamily doctorsHealthy China 2030
spellingShingle Shiwei Chen
Xin Hui Sam
Aijia Soong
Lorainne Tudor Car
Siqing Lian
Helen E. Smith
Recruitment of general practitioners in China: a scoping review of strategies and challenges
BMC Primary Care
Primary care
China
General practitioners
Recruitment
Family doctors
Healthy China 2030
title Recruitment of general practitioners in China: a scoping review of strategies and challenges
title_full Recruitment of general practitioners in China: a scoping review of strategies and challenges
title_fullStr Recruitment of general practitioners in China: a scoping review of strategies and challenges
title_full_unstemmed Recruitment of general practitioners in China: a scoping review of strategies and challenges
title_short Recruitment of general practitioners in China: a scoping review of strategies and challenges
title_sort recruitment of general practitioners in china a scoping review of strategies and challenges
topic Primary care
China
General practitioners
Recruitment
Family doctors
Healthy China 2030
url https://doi.org/10.1186/s12875-022-01854-0
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