Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China.
OBJECTIVE
To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China.


METHODS
An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center.


RESULTS
Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary.


CONCLUSIONS
Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.
Administration Offices, Guangxi Medical University, Nanning, China.
Yunbo
0000-0002-9248-0018
Y
Qing
The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
Guijie
0000-0002-9404-5108
G
Hu
First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Qingyun
0000-0003-0781-3808
Q
Chen
Administration Offices, Guangxi Medical University, Nanning, China.
Hailun
0000-0002-8828-1569
H
Peng
Administration Offices, Guangxi Medical University, Nanning, China.
Kailan
0000-0001-7905-2273
K
Li
Administration Offices, Guangxi Medical University, Nanning, China.
Jinling
0000-0002-1264-6031
J
Wei
School for International Education, Guangxi Medical University, Nanning, Guangxi, China.
Yanhua
0000-0001-8690-952X
Y
Yi
Career choice; China; Motivation; Rural health services; Salaries and fringe benefits