2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Background: To address the widespread attrition and instability among primary care healthcare workers, China launched the rural-oriented tuition-waived medical education (RTME) programme in 2010 to train more general practitioners for service in grassroots rural facilities.By comparing job preferences among rural-oriented tuition-waived medical students (RTMSs) at different stages, this study aims to inform the design of effective incentive policies that can enhance the retention of rural primary-care personnel.

Methods: A discrete-choice-experiment questionnaire was developed and administered to 1,475 RTMSs recruited through Stratified Cluster sampling from Guangxi Medical University, Guilin Medical University, and Youjiang Medical University for Nationalities. Mixed logit models were used to estimate students’ job preferences and willingness to pay for selected job attributes.

Results: Monthly income, workplace atmosphere, workload, career-development opportunities, working conditions, and living environment all exert significant motivational effects on the job preferences of RTMSs across different stages, with workplace atmosphere ranking first in preference weight. Job location significantly motivates the job preferences of RTMSs in the service-fulfilment stage, but not those in school or in standardized residency training. The influence of non-economic factors on job preferences shows differentiated characteristics as the career development stage progresses.

Conclusion: The influence of economic and non-economic factors on the job preferences of RTMSs varies across different career stages. Therefore, a phased and differentiated incentive mechanism should be established to enhance the stability of primary healthcare personnel.