In order to change the shortage of general practitioners in primary care, China has been implementing a rural order-oriented medical student training program in 2010. Currently, the overall performance intention, performance situation and retention intention of order-oriented medical students in China still remains unclear and need to be supported by more reliable evidence.

To systematically evaluate the performance intention rate, actual performance rate and retention intention rate of order-oriented medical students in China and analyze its influencing factors.

From January to June 2022, CNKI, Wanfang Data, VIP, PubMed and Embase databases were searched to collect literature related to service intention, performance intention and retention intention for primary care of order-oriented medical students in China with a time period from 2010 to 2021, and the language of the literature was limited to Chinese and English. Two investigators independently screened literature and extracted data independently to evaluate the risk of bias of the included studies. Meta-analysis of single-group rates was performed using RevMan 5.4 software.

A total of 49 papers were included with a survey period of 2010-2020, involving 22 413 order-oriented medical students. The performance intention rate of order-oriented medical students was 62% [95%CI (55%-69%) ], the performance rate was 95% [95%CI (93%-96%) ], the retention intention rate was 16% [95%CI (13%-19%) ]. The results of subgroup analysis showed that the performance intention rate of the literature published in 2011 [90%, 95%CI (84%-96%) ] was higher than the other years (P<0.01), the performance intention rate was higher in North China [87%, 95%CI (84%-90%) ] than the other regions, the performance intention rate of college students [68%, 95%CI (67%-69%) ] was higher than the residents in standardization training (P<0.01) ; the performance rate of the published literature in 2020 [99%, 95%CI (99%-100%) ] was higher than the other years (P<0.01), and the performance rate [100%, 95%CI (99%-100%) ] in Central China was higher than the other regions (P<0.01) ; the retention intention rate of the literature published in 2015 [36%, 95%CI (2%-70%) ] was higher than the other years (P<0.01), the retention intention rate [23%, 95%CI (4%-41%) ] was higher in South China than the other regions (P<0.01), the retention intention rate of the college students [18%, 95%CI (13%-22%) ] was higher than the residents in standardization training and primary care providers performing contracts (P<0.01) .

The actual performance rate of order-oriented medical students in China is high, but the performance intention rate and retention intention rate are low. Region, time and medical education stage are the influencing factors.

为改变基层全科医生数量不足的问题，我国从2010年开始实施农村订单定向医学生（以下简称订单生）培养项目，当前我国五年制本科订单生的整体履约意愿、履约情况、留任意愿仍不清楚，需要有更可靠的证据支持。

系统评价我国本科订单生的履约意愿率、履约率、留任意愿率，并分析影响因素。

于2022年1—6月，系统检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Embase数据库，以获取与我国订单生基层服务意愿、履约情况、留任意愿相关的文献，检索时限设定为2010—2021年，文献语种限定为中、英文。由2名研究员独立筛选文献并提取数据，评价纳入研究的偏倚风险。采用RevMan 5.4软件进行单组率的Meta分析。

共纳入49篇文献，调查时间为2010—2020年，涉及22 413名订单生。订单生的履约意愿率为62%[95%CI（55%~69%）]，履约率为95%[95%CI（93%~96%）]，留任意愿率为16%[95%CI（12%~19%）]。亚组分析结果显示，2011年发表文献的履约意愿率[90%，95%CI（84%~96%）]高于其他年份发表的文献（P<0.01），华北地区的履约意愿率[87%，95%CI（84%~90%）]高于其他地区（P<0.01），在校学生的履约意愿率[68%，95%CI（67%~69%）]高于住院医师规范化培训（简称规培）生（P<0.01）；2020年发表文献的履约率[99%，95%CI（99%~100%）]高于其他年份发表文献（P<0.01），华中地区履约率[100%，95%CI（99%~100%）]高于其他地区（P<0.01）；2015年发表文献的留任意愿率[36%，95%CI（2%~70%）]高于其他年份发表文献（P<0.01），华南地区的留任意愿率[23%，95%CI（4%~41%）]高于其他地区（P<0.01），在校学生的留任意愿率[18%，95%CI（13%~22%）]高于规培生和基层服务生（P<0.01）。

我国订单生的实际履约率较高，但履约意愿和留任意愿不高，地区、时间、所处医学教育阶段是影响因素。