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.

The Chinese Government is promoting GP training program. By 2020 the number of GPs in the country is expected to reach 300,000, which means there should be two to three GPs for every 10,000 residents.

"Some local governments might lower the entrance requirements to reach the number," said Pan Zhigang, Deputy Director of the GP department of Shanghai-based Zhongshan Hospital. "But it should not be just about quantity, but also quality."

In 2001 Shanghai set up a GP training center offering four-year training programs. Over the past 10 years, Shanghai has educated more than 4,200 GPs.

Prior to 2006 the trainees were mostly fresh graduates from medical universities who were recruited by community healthcare centers. Since 2006 the trainees are mostly selected from voluntary applicants. After the training they can choose to work as GPs at community healthcare centers.

In May 2011 Shanghai set up another institution to train GPs. Following advanced evaluation and education methods from U.S. partners, the institution adopted a new five-plus-three training method. The trainees are medical college students who spend five years at university and another three years on GP training. After eight years, the trainees are expected to have the skills they need to function as GPs.

"It takes a long time to cultivate GPs, but unfortunately the pay is not always high enough to keep them in the job," Pan said.

"We are much busier than specialists but we get less money. I don't think it is fair," said Yang, who revealed her salary is about 2,000 yuan ($315) per month, not even half that of a specialist with her experience.

Du said that the GPs at the Yuetan center earned only slightly more than Yang. Worse still, community healthcare centers as a whole suffer from a deficiency of funds, as the standard for their government subsidies was set in the 1990s or even 1980s, which is far behind requirements.

"There is a real need for more GPs in China. But to realize the government's goal to popularize general practice in communities, there is still a long way to go," Du said.

General Practice in China

General practice was adopted in China in the 1990s. At present, there are roughly 130,000 GPs in the country, mainly in big and medium-sized cities.

In June 2010 an executive meeting of the State Council decided that China will establish a national system of general practitioners.

A statement of the meeting lists principles for establishing the new system to ensure the quality of GPs, with a focus on improving their capabilities in clinical practice, standardizing the criteria for training GPs and creating strict requirements for doctors who wish to apply for GP certification.

China will work to ensure that for every 10,000 urban or rural residents, there will be two to three qualified general practitioners ready to take care of their health problems. Based on this standard, by 2020, China will have 300,000 GPs.

In this case, "qualified" is defined as having completed a five-year bachelor's degree program in clinical medicine and three years of specialized medical education before becoming a general practitioner, the statement says.