How to Solve the Embarrassment of Employment for Public Health Talents with High Education and Not Going to Counties: Low Education and Inability to Enroll in Undergraduate Education | Public Health | No

"About 60% of undergraduate students further their education, while the rest of graduates' employment focuses on disease prevention and control centers, maternal and child health clinics, and related testing companies."

When discussing the employment and further education intentions of undergraduate graduates from the School of Public Health this year, Professor Chen Renru from the Department of Health Management at Anhui Medical University mentioned it.

Chen Ren told reporters that compared to the previous two years, the number of graduates who choose to continue their studies during this year's college recruitment season is basically the same as in previous years, with a slight increase. On the one hand, this is because the employment pressure on graduates cannot be underestimated, and on the other hand, it is also because high-level and versatile talents in public health are receiving more policy support, and the enrollment indicators for graduate students have significantly expanded compared to before the epidemic.

Since the outbreak of the COVID-19 epidemic, the public health profession represented by preventive medicine has become one of the most "popular" professional fields in the medical community. Over the past three years, a group of public health colleges established by vocational and undergraduate institutions have sprung up like mushrooms after rain, and the enrollment scale of undergraduate and graduate students has also been continuously expanding.

This year, the first batch of graduate students to enter the field of public health after the expansion of enrollment due to the epidemic will enter the workforce, with 634000 undergraduate and specialized medical graduates competing alongside them.

Can this large influx of public health talents into the job market be digested by the market? According to statistical data, in 2021, there were 6.79 professional public health personnel per 10000 people in China, which has not yet reached the established goal of "0.83 public health personnel per 1000 permanent residents in China by 2020" proposed in the National Medical and Health Service System Planning Outline. Therefore, theoretically speaking, the scale of public health talents trained by universities is still overshadowed by the large population base.

However, according to research conducted by First Financial, the structural contradiction between supply and demand has led to severe employment pressure on public health college graduates who graduated this year.

On the one hand, the shortage of public health talents is usually more prominent in grassroots public health institutions, but these units are often not the first choice for undergraduate and above public health graduates. On the other hand, due to job requirements, staffing scale, and other reasons, some employers have stated that although they lack public health professionals, they will not conduct large-scale recruitment in the next year.

Why Community Hospitals "Don't Need" and "Can't Keep" Public Health Talents

"There is currently no recruitment plan for public health personnel this year," Zhu Wen, the head of a community health service center in a central provincial capital city, told reporters.

According to Zhu Wen, the community health service center covers the health services of 80000 residents in the surrounding area. The center has a total of 45 medical staff, of which 5 have obtained the qualification of a public health practitioner, while only 4 are professional public health personnel.

"It's not about prioritizing medical care over public health," Zhu Wen explained. The center's public health work implements a full staff public health system, which means that all personnel, including administrative personnel, have 14 public health tasks including health education, reporting and handling of infectious diseases and sudden public health incidents, vaccination, and health management for key populations. At present, all general practitioners in the center are involved in the family doctor team.

Zhu Wen said that according to the performance distribution principle of "more work, more pay", the income level of general practitioners who undertake clinical diagnosis, treatment, and disease prevention work at the same time will be significantly higher than that of public health personnel. In addition, the latter's work is easily replaced by general practitioners or nurses, so "there is no need to recruit again.".

Li Qing is a general practitioner at a community health center in a second tier city in the Yangtze River Delta. She told reporters that the unit released a recruitment announcement for public health positions after late May. The recruitment focuses on various public health graduate students starting from undergraduate preventive medicine and graduate studies.

"Although it coincides with the recruitment season for college students, in previous years, due to the miscellaneous work done in the community, tiring work, and low salaries, public health college students often complain repeatedly during internships, let alone keep their jobs, and some leave less than a year after joining. In Li Qing's view, it is precisely because the job gap has always existed that" recruitment occurs several times a year ".".

Compilation is another issue. Zhu Wen stated that currently, the center belongs to Class II public institutions and implements a full staff employment system without a career establishment, which has also dampened the enthusiasm of college students to work at the grassroots level. "Even general practitioners often cannot stay."

Chen Ren believes that the pilot program for granting prescription rights to public health physicians is still being explored, and primary medical institutions often require clinical physicians with prescription rights when recruiting.

The city lacks available staffing for disease control, while the county's staffing for disease control cannot be fully utilized

"In addition to community health service centers, disease control centers in various cities, districts, and counties are another major employment direction for public health graduates," Chen Ren said.

According to the first financial analysis, in the 2022 employment data of graduates majoring in preventive medicine released by medical colleges in Anhui, Zhejiang, and other regions, 50% of graduates from many colleges have entered the disease control department.

However, for this year's graduates, it is significantly more difficult to squeeze into the city's first level disease control department.

Liu Lin is a undergraduate graduate majoring in Preventive Medicine from a medical college in Anhui. During her job search this year, she found that "without a graduate degree, she may not even meet the registration threshold this year.".

In February of this year, the Health Commission of Bengbu City, Anhui Province, announced the "Campus Recruitment" for the shortage of professional talents in its affiliated institutions in 2023, intending to publicly recruit 248 staff members in the scarce professional positions. Among them, the Bengbu Center for Disease Control and Prevention only released three spots, and the recruitment degree requirements are all "master's degree or above". Specifically, one is a health inspector, and the remaining two are professionals in public health and preventive medicine.

Chen Ren said that the COVID-19 epidemic has exposed the shortage of public health talents. Since 2020, many universities in various regions have strengthened the construction of public health colleges, and the enrollment of graduate students in related majors has significantly expanded. In addition, most undergraduate students choose to take the postgraduate entrance examination first, which has significantly expanded the scale of talent cultivation in the field of public health.

Taking An Medical University as an example, the enrollment plan for public health related graduate students in 2019 was 140, and by 2020, it had increased to more than 260, a growth rate close to double.

This year is the first year for graduate students who have experienced enrollment expansion. According to Chen Ren's investigation, as of now, the implementation rate of graduation destinations for graduate students majoring in public health is about 60%, which is not much different from previous years. However, this year, the supply-demand contradiction will be highlighted due to the basic saturation of disease control centers in various regions.

"Last year, disease prevention and control centers in various cities recruited a large number of people. For example, the Hefei Disease Prevention and Control Center recruited more than 20 medical college students. However, this year, the recruitment targets in various cities have significantly decreased, and the demand for employment is clearly insufficient compared to previous years," said Chen Ren.

But Chen Ren also mentioned that further down at the city level, such as county-level disease control centers, there is often a lack of high-level talents in the field of public health. "It depends on the attractiveness of the position and the graduates' employment expectations."

Similar to Anhui, another province with a large population of graduates, Henan, also faces the phenomenon of differentiated demand for public health talents in disease control departments at different levels.

First Finance and Economics has noticed that the Zhengzhou Municipal Bureau of Human Resources and Social Security issued a notice in March 2022, stating that 17 public institutions in Zhengzhou will publicly recruit public health professionals in 2022. This public recruitment involves 36 positions in 17 units of the Zhengzhou Center for Disease Control and Prevention and the district and county centers for disease control and prevention, with a total recruitment of 281 people. Afterwards, the Zhengzhou Municipal Bureau of Human Resources and Social Security has not yet released recruitment information for the disease control department.

In a certain county in Luoyang, the head of the local disease control department revealed to reporters that for two consecutive years of college graduation season, the positions within the establishment have not been fully recruited. "Last year, 7 college students were recruited, and 5 were in place. This year, with the addition of positions that were not fully filled last year and those vacant due to personnel retirement, there are still more than a dozen positions waiting to be recruited."

The reason for the above situation, the relevant personnel of the county health committee told reporters that there were two reasons: first, the county disease control bureau had just been established this year, and there was a large demand for personnel; second, the county colleges did not set up preventive medicine before the COVID-19 epidemic. "Those with lower education cannot be recruited, while those with higher education will not be sent to the county."

Expert: Meeting the development needs of multi-level public health talents

In an interview with reporters, Professor Jiang Qingwu from the School of Public Health at Fudan University believes that the development needs of talents should be respected and guided correctly regarding the "postgraduate entrance examination rate" of undergraduate students majoring in preventive medicine.

"Firstly, the shortage of public health talents in China is not only reflected at the grassroots level, but also in the complex high-end talents," said Jiang Qingwu.

In order to cultivate high-level talents with innovative research capabilities and interdisciplinary qualities, at the beginning of last year, the General Office of the Ministry of Education and four other departments issued a notice on the construction of high-level public health colleges and related construction guidelines. The plan is to build a world-class public health college with Chinese characteristics over a period of about 10 years, forming a high-quality education development system that adapts to the construction of a modern public health system.

Starting from this year, the "Catalogue of Graduate Education Disciplines and Majors" has been officially implemented, and this revision of the discipline and major catalogue will adjust the public health master's degree to a specialized doctoral degree.

At the same time, since the beginning of this year, many parts of the country have explored ways to promote the sinking of public health talents to the grassroots level by improving the level of treatment and protection for public health talents, and increasing their career development space.

In mid April this year, the General Office of the Shanghai Municipal People's Government issued the Implementation Plan for Further Enhancing the Community Health Service Capacity in the City, which clearly stated that the recruitment of community public health personnel will be expanded, and new recruits from district disease control institutions will be sent to the community for 3-6 months. Improve the continuing education and further training system for community doctors, strengthen training in general practice, public health, and traditional Chinese medicine services. In principle, community doctors should go to higher-level hospitals for further training every five years or practice at multiple points for 3-6 months.

First Financial has noticed that since this year's college recruitment season, several medical colleges and universities in the Yangtze River Delta region have reprinted a "Shanghai 2023 Public Recruitment Announcement for Public Institutions" on their official websites. Among them, professionals in public management and public health and preventive medicine have an "exclusive" occupation - employees of the Health Promotion Department.

According to the job description, this profession aims to conduct research on the development of public health in the region, track and summarize various business data.

Jiang Qingwu stated that in addition to improving income and benefits, increasing the professional recognition of public health talents, and meeting their demands for professional ability improvement, it is also an indispensable part of truly "retaining people" at the grassroots level.