Challenges
"Even though the government is putting much more effort into cultivating GPs, 40 percent of current GPs still transfer to other specialities," said Du, who believes a lack of training and low income are the main reasons professionals leave general practice.
Most of the seven GPs who work at Zhang's healthcare center are retired doctors from general hospitals.
"Before retired doctors join us, they receive special training on being a GP, as general practice is different from the work of a specialist," Zhang said. "The training normally lasts for months but the training content has barely changed from the time I was trained 10 years ago."
In Shanxi, there are currently about 4,000 GPs altogether. Only a few of them, however, have passed the national GP exam.
Wang Junying has been working at the Balingqiao Community Healthcare Center in Taiyuan City, north China's Shanxi Province, since 2007. As one of the first 50 GPs in the province, Wang went through a one-year training to convert from a specialist in internal medicine to a GP.
"We spent the first two months on intense theoretical study in a medical college. We compressed lessons that should be finished in one year into two months. Then we spent another eight months in big hospitals on practice, switching from one department to another to become familiar with the work of different departments," Wang said.
Wang believes, however, that the training he received wasn't sufficient to meet the demands of general practice.
Yang Ruihong, who has worked at the Kairuiyuan Community Healthcare Center in Zibo, Shandong Province, as a GP for five years, also received similar training when she switched from internal medicine to general practice.
"We practiced in different departments of a general hospital but I don't think I was really qualified to be a GP after that training," Yang said. "What we learnt from the training was just some medical knowledge that we could learn in regular medical schools. The other aspects of being a GP, such as how to communicate with residents and spread medical knowledge among them were not included in the training. But I think they are very important for a qualified GP."
At present, medical universities in China still focus on training specialists. Only a few universities offer students the chance to major in general practice. This means that many doctors working in community healthcare centers don't have access to comprehensive GP training.
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