Township has a general practitioner (Health Focus)
In 2010, the state launched a free training program for rural order-oriented medical students, aiming to train a group of high-quality general practitioners for rural grassroots.
The plan is aimed at candidates who have participated in the unified admission of the college entrance examination, and implements separate voluntary, separate cross-line, and early admission.
After graduating from these medical students for 5 years, they will have to go to the grassroots level to perform 6 years of service. Among them, the first 3 years will participate in the standardized training of resident doctors. The cost of the study and training period is guaranteed by the central and provincial finances according to the standard.
As of the end of 2020, Guizhou Province has trained 5,070 undergraduate order-oriented general practitioners, with an average of 3.7 in each township health center, which is one of the provinces with the largest number of training in the country.
At present, 2938 people have graduated, all of whom have reported to the grassroots to perform their contracts.
Since 2018, more than 1,000 general practitioners who have completed the standardized training of resident physicians have returned to township health centers to serve.
How to train medical students who are trained by orders in Guizhou Province and how is their work?
A few days ago, the reporter conducted an interview.
Excellent quality, "get it down"
The most critical part of implementing the policy of order-oriented general practitioners is the school.
This group of students has hard professional quality and harder spiritual quality
Is going?
Stay?
When the city and county hospitals threw an olive branch, Li Tianshu hesitated again and again, and finally decided to stay, because "the doctor is more needed here."
In 2010, after taking the college entrance examination, the class teacher announced the good policy of free training for rural medical students with orders. Li Tianshu, who had difficulties in family and wanted to study medicine, saw hope and was admitted to the Department of General Medicine of Zunyi Medical University as he wished.
Five years of undergraduate, three years of standardized training for residents, and counting, the state has invested more than 200,000 yuan for Li Tianshu.
In 2018, he fulfilled his contract and served the grassroots for 3 years and returned to his hometown of Yachuan Township Health Center in Fenggang County.
Soon, the villagers discovered that since high-level general practitioners came to the town, many diseases that could not be cured in the past can be cured. They no longer have to travel far to the county and city hospitals, saving money and reducing pain. Healed the disease.
Li Tianshu said: "There are many doctors in the city, and there is no shortage of me. The health of the villagers needs me to guard."
Since 2018, more than 1,000 general practitioners like Li Tianshu who have completed the three-year standardized training of general practitioners have been directed to return to township health centers to serve.
"To implement the order-oriented general practitioner policy, the most critical link is the school." said Xiao Xue, deputy director of the Department of General Medicine of Zunyi Medical University and director of the general practice base of the affiliated hospital.
Guizhou’s order-oriented free medical students’ admission standards are not low, and rural candidates are selected based on the county as a unit and no less than the score of the second school.
The training standards are relatively high, requiring "one specialization and multiple abilities". The training bases are all set up in general medicine, "doing a little bit of everything" and "seeing a little bit of any disease", focusing on the training of general practice quality, and requiring graduates to have preliminary solutions Capacity for common, frequently-occurring, infectious and endemic diseases in rural areas and related public health services.
Xiao Xue said that these medical students must not only be qualified in professional quality, possess a variety of and sophisticated general abilities, but also be qualified in ideology and possess the spiritual quality of gratitude and integrity.
The teaching practice follows the training path of "three comprehensives": complete curriculum, practical training, and ideological and political education.
In 2014, Li Jun was admitted to the Department of General Medicine of Zunyi Medical University.
In 2019, after graduation, he returned to his hometown of Huaqiao Town Health Center, Shiqian County, Tongren City, and was assigned to the General Practice Specialty Base of the Affiliated Hospital of Zunyi Medical University that year.
Compared with other medical majors, Li Jun found that the department offers many courses, involving internal medicine, surgery, obstetrics and gynecology, pediatrics, ophthalmology, otolaryngology, Chinese medicine, etc. It is a set of "general education courses and physical and mental quality courses + basic and The modular curriculum system of clinical + general practice and public health + practical skills and innovation and entrepreneurship".
36 months of training period, of which 27 months will be rotated to 23 hospital departments, which is twice the average of other professional training students, 6 months to the community health service center to receive treatment, 3 months to return to the hospital to choose independently Department.
"Let him go and let him diagnose and treat, but he has to watch the whole process, and finally summarize and improve." As Li Jun's teaching teacher, Zou Qu, the teaching director of the General Practice Base of the Affiliated Hospital of Zunyi Medical University, said this is called "letting go and not looking at it". Effectively, all general practitioners in the base have obtained the qualification certificates of practicing physicians during the training period.
Order orientation, fulfillment is fundamental.
Zou Qu said frankly that these students have strong professional qualities and even harder spiritual qualities.
Schools and bases put the emphasis on ideological and political education on gratitude and integrity, and use red resources in the old revolutionary base to organize orders for general practitioners to read red books, re-take the Long March, go to free consultations in difficult areas, and carry out voluntary services, from learning, training, All-round care in life and family, so that they know how to be grateful for the country's cultivation, abide by the contract, contribute to the grassroots, and forge excellent quality.
Zunyi Medical University has currently trained 2,069 undergraduate order-oriented general practitioners, accounting for 41% of the province, of which 519 have all fulfilled their contracts after completing 8 years of study and training.
Take a stand alone, "have a dry head"
General practitioners have improved the overall level of diagnosis and treatment and standardized management in health centers, allowing more rural patients to stay at the grassroots level
In the early morning of August 16, 2018, Li Tianshu happily set off from his home in Chaoyang Village and drove 5 kilometers to the Yachuan Town Health Center.
Unexpectedly, I reported on the first day and was in a mess from morning to night.
No one took him to get acquainted, and there was no time to transition, so he went straight to the doctor.
At the end of the day, he has entered a state and feels like he has been working here for a long time.
On the first day, he suddenly understood why he studied the "general specialty" and why the country implemented the policy of free medical students with orders.
In recent years, as the state has increased its investment, the conditions of township health centers have improved.
Fenggang County invested more than 10 million yuan to build the Yachuan Town Health Center in 2017 and build it into a medical center in the southern part of the county. Such conditions are considered medium and high in the county.
However, until Li Tianshu reported to the clinic, there were only general clinics, Chinese medicine departments, only 3 doctors, no medical record rooms, no standardized medical procedures, and unclear division of medical care.
Li Tianshu received more than 50 patients on the first day of his arrival, including internal and external women and children, otolaryngology, and patients from various departments.
What impressed me the most was a diabetic villager. From admission to examinations, intravenous injections, and night care, Li Tianshu was all-inclusive. Eight years of general practice study came in handy.
The arrival of Li Tianshu gradually changed the health center.
Zhang Jie, the dean who has worked in three township health centers, found that the most significant change is that the number of visits in the whole hospital is steadily increasing, and the number of doctors designated to see Li Tianshu is gradually increasing. Look, the patients who used to go to county and city hospitals have stayed in the health center.
In May 2019, Zhang Jie recommended to the organization to exceptionally promote Li Tianshu as the deputy dean in charge of the business.
Li Tianshu lived up to expectations and began to establish a medical record room, standardize medical procedures, and carry out business training... In 2020, the number of visits in the whole hospital increased to 42,000, with a total income of 10.55 million yuan. In the first half of this year, revenue increased by 1 million yuan year-on-year.
Li Tianshu's classmate Zheng Qianyi went to work in Wangzhai Town Health Center.
Wangzhai Town is the second remote town in Fenggang County. It is more than 70 kilometers away from the county seat. It takes an hour by car.
Yang Zhengzhi, a 70-year-old villager in Guantang Village, suffers from chronic pulmonary heart disease. He spends an average of 1,000 yuan each time at the county hospital for a few days almost every month.
Zheng Qianyi went to the town health center, Yang Zhengzhi never went to the county hospital again, and spent an average of more than 100 yuan each time at the town health center.
Yang Zhengzhi sighed: "Xiao Zheng is a good medical man. Seeing him to see a doctor, he suffers less crimes, and his family can save 10,000 yuan every year."
Li Zhuo, director of Wangzhai Town Health Center, believes that general practitioners have improved the overall diagnosis and treatment level and standardized management of the health center, allowing more rural patients to stay at the grassroots level, and promoting the implementation of the hierarchical diagnosis and treatment system.
"Keep it" without any distractions
Treat general practitioners as "treasures" and provide adequate protection in terms of living and housing, appointment and promotion, and relatives' work
Most of the order-oriented general medicine students come from remote and impoverished mountain villages.
Compared with classes in other departments of the school, the proportion of poor students is higher.
Therefore, the training and use of order-oriented general practitioners has received more national policy guarantees and humanistic care.
"The policy of order-directed general practitioners has fulfilled my university dream. If it is not free, our family can't afford it." During the school period, Ningyue Lanneng Province would save money, keeping the monthly living expenses at an average of more than 600 yuan. , This is almost the lowest level of students in the school, and the money saved will be sent to the family.
Ning Yuelan's family was in Longli Village, Xiajiang Town, Congjiang County. Her elder sister was in college and her younger brother was in middle school.
The high cost of studying medicine once made her desperate when she wanted to study medicine.
After the 2016 college entrance examination, Ning Yuelan learned from the teacher the policy of order-oriented general practitioners, and did not hesitate to apply for the exam, and was admitted to the First Clinical Medical College of Guizhou University of Traditional Chinese Medicine.
Among the 98 students in the orientation class, there are more than 30 poor students.
Yang Xiaotong, deputy secretary of the Party Committee of the First Clinical Medical College, introduced that in addition to subsidies from the state, the hospital favors poor students in terms of grants, awards, and other aspects, providing public welfare positions and recommending work-study programs.
Ning Yuelan got a work-study opportunity as a civilized facilitator in the school's first affiliated hospital, with a daily allowance of 50 yuan and a lunch subsidy of 15 yuan.
"Funding guarantee is the cornerstone of the implementation of the order-oriented general practitioner plan." Li Mengrong, director of the Science and Education Department of the Guizhou Provincial Health Commission, introduced that the central and provincial finances will invest 8,800 yuan per person per year for the five-year tuition fee for order-oriented students. , Accommodation, living expenses, and textbook subsidies.
During the three-year training period, in addition to enjoying targeted unit wages and benefits, the state will also invest 32,000 yuan in training funds per person per year.
Up to now, the central and provincial governments in Guizhou have invested nearly 200 million yuan in total.
Recently, Ning Yuelan got the registration card.
She is a girl from the Dong ethnic group. She was assigned to the most remote Miao ethnic town in Congjiang County. She traveled to the county town for 5 hours by car. There were only 7 doctors and nurses in the town health center.
She said: "I will not only go, but also do well. Farm children are not afraid of hardship. Miao medicine is a national treasure, and the local medicinal materials are rich. I must make good use of Miao medicine and Miao medicine."
Wang Qin, director of the Fenggang County Health Bureau, said frankly that the county treats general practitioners as "treasures" and provides adequate protection in terms of living and housing, appointment and promotion, and relatives' work.
At present, the county has signed 50 orders for general practitioners, the number is among the highest in the province, and 3 of them have been promoted to deputy deans.
Guizhou Province insists on controlling every pass, so that the medical students trained in order-oriented training return to the grassroots.
The first is to properly control the "use clearance" and enjoy the "unit person" treatment during the training period, with a per capita monthly income of more than 4,000 yuan; after the training is qualified, they will go to the grassroots service and enjoy the preferential policies for living allowances and guaranteed housing for general positions to ensure " Can be retained".
The second is to take good care of the "growth barrier". After passing the training, you can directly participate in the intermediate professional title examination and be hired as a general practitioner. If you meet the degree-granting standard, you can be awarded a master's degree in clinical medicine; in poor areas Grassroots employees who have worked continuously for more than 10 years after obtaining the intermediate professional title can directly obtain the deputy senior professional title through the assessment and confirmation to ensure "development".
Sun Fa, director of the Guizhou Provincial Health Commission, believes that the implementation of a series of policy guarantee measures for order-oriented training of medical students and the implementation of all general practitioners to the grassroots service will help improve the medical and health service system, promote the realization of hierarchical diagnosis and treatment, and help the construction of a healthy China.
Our reporter Wang Zhiqiu