Analysis of Problems and Optimization Strategies of the Free Training Program for Rural Order-oriented Medical Students in Guangxi Based on Social Network Analysis

Background In 2010, China began to implement a free training program for rural order-oriented medical students (the "program") , which has played an important role in improving the construction of grass-roots health personnel and upgrading the level of grass-roots medical and health services. As the program has progressed, despite certain successes, there are many problems that remain to be solved, and it is not yet known which are the urgent and important core issues. Objective Sorting out the problems with the program to provide lessons learned for moving the program forward. Methods In May 2023, Chinese databases were searched using the literature analysis method to sort out the problems of the project documented in the literature; the problems resulting from the sorting out were analyzed using the social network analysis method, and the results calculated based on the social network analysis method were comprehensively evaluated using the TOPSIS method. Results The relevant problems in the literature were organized and counted. The top-ranked problems in order of frequency were low salary and treatment at the grassroots level for oriented medical students (14 times) , limited space for career development at the grassroots level for oriented medical students (10 times) , imperfect relevant supporting policies (10 times) , poor working conditions at the grassroots level (7 times) , and lack of motivation and initiative in learning for oriented medical students (7 times) ; and the results of the social network analysis were synthesized and evaluated by the TOPSIS method. The results of the social network analysis method were comprehensively evaluated by the TOPSIS method, and the top four rankings were imperfect relevant supporting policies (Ci=0.867) , limited space for grassroots career development of oriented medical students (Ci=0.800) , low grassroots salary and treatment of oriented medical students (Ci=0.786) , and poor grassroots working conditions (Ci=0.621) in the order of ranking. Conclusion Guangxi's free training program for rural order-oriented medical students still has major problems in the process of promoting the program. It is recommended that the program be optimized in the following ways to ensure its high-quality development: improve relevant supporting policies and strengthen supervision and evaluation; smooth career promotion channels and establish a long-term incentive mechanism; improve the remuneration system and raise the level of treatment; and improve the grass-roots working environment to enhance the quality of grass-roots work and increase efficiency.