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Career orientation and its impact factors of general practitioners in Shanghai, China: a cross-sectional study

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      To understand the career orientation and impact factors of general practitioners (GPs) in Shanghai.


      A cross-sectional study was carried out from August 2014 to December 2015 using the Career Orientations Inventory (short form).

      Setting and participants

      We conducted a cross-sectional study of 1159 GPs, of which 1067 (92.06%) completed the assessment tools, from 223 community healthcare centres in Shanghai


      The top career orientation was organisational job security (71.60%), followed by technical competence (12.18%). Compared with female GPs, male GPs scored higher in managerial competence (p <0.001), creativity and entrepreneurship (p <0.001), and lower in organisational job security (p=0.034). Compared with GPs younger than 40, those aged 40 years and older scored higher in sense of service (p=0.003) and lower in autonomy (p=0.022) and lifestyle integration (p=0.039). Compared with GPs with lower education levels, those with at least a bachelor’s degree scored higher in managerial competence (p=0.001 and autonomy (p=0.025). In addition, those with fewer than 10 years of work experience scored higher in managerial competence (p=0.008) and scored lower in geographical security (p=0.032) compared with GPs with longer durations of work experience. GPs with senior professional positions scored higher in technical competence (p=0.012) compared with those with lower professional positions.


      The search for job stability and the lack of career prospect planning are two factors that impact community GP growth. Individualised skills training and career development planning should be provided to GPs of specific genders, educational background and vocational competence, in order to enhance their job satisfaction and service quality, thereby achieving retention of this staff group.

      Related collections

      Most cited references 29

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      Age and work-related motives: Results of a meta-analysis

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        Work stress of primary care physicians in the US, UK and German health care systems.

        Work-related stress among physicians has been an issue of growing concern in recent years. How and why this may vary between different health care systems remains poorly understood. Using an established theoretical model (effort-reward imbalance), this study analyses levels of work stress among primary care physicians (PCPs) in three different health care systems, the United States, the United Kingdom and Germany. Whether professional autonomy and specific features of the work environment are associated with work stress and account for possible country differences are examined. Data are derived from self-administered questionnaires obtained from 640 randomly sampled physicians recruited for an international comparative study of medical decision making conducted from 2005 to 2007. Results demonstrate country-specific differences in work stress with the highest level in Germany, intermediate level in the US and lowest level among UK physicians. A negative correlation between professional autonomy and work stress is observed in all three countries, but neither this association nor features of the work environment account for the observed country differences. Whether there will be adequate numbers of PCPs, or even a field of primary care in the future, is of increasing concern in several countries. To the extent that work-related stress contributes to this, identification of its organizational correlates in different health care systems may offer opportunities for remedial interventions. Copyright 2010 Elsevier Ltd. All rights reserved.
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          Career anchors: A comparison between organization-assigned and self-initiated expatriates


            Author and article information

            [1 ] departmentGeneral Practice , Zhongshan Hospital, Fudan University , Shanghai, China
            [2 ] departmentEpidemiology , School of Public Health, Fudan University , Shanghai, China
            [3 ] departmentGeneral Practice , Tangqiao Community Healthcare Centre in Pudong New District , Shanghai, China
            [4 ] Close Concerns , San Francisco, California, USA
            Author notes
            [Correspondence to ] Dr Jian Wang; wangjian072@
            BMJ Open
            BMJ Open
            BMJ Open
            BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
            3 March 2019
            : 9
            : 3
            30833308 6443062 bmjopen-2018-021980 10.1136/bmjopen-2018-021980
            © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

            This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

            General practice / Family practice
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            care orientation, primary care, general practice


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