Abstract: Objective To analyze changes in enrollment and the home-province minimum admission rank percentage of three-year clinical medicine programs in Chinese higher vocational colleges from 2020 to 2024, as well as the association between these two measures, and to inform enrollment planning and monitoring of incoming student characteristics. Methods A questionnaire survey and document analysis were conducted among higher vocational colleges nationwide that offered three-year clinical medicine programs (program code 520101K) as of 2024. Enrollment data from 2020 to 2024 and the minimum admission ranks for the regular junior college admission batch in the colleges′ home provinces for students admitted between 2022 and 2024 were collected. The home-province minimum admission rank percentage was calculated. Descriptive statistics and Spearman rank correlation analysis were used. Results A total of 99 colleges participated in the survey, of which 87 had complete home-province minimum admission rank data. Total enrollment in the 99 colleges decreased from 41 557 to 35 371. Among the 87 colleges, the median home-province minimum admission rank percentage decreased from 75.1% in 2022 to 71.5% in 2024, with a decrease observed in 65 colleges (74.7%). The Spearman correlation coefficient between the enrollment change rate and the change in the home-province minimum admission rank percentage was 0.267 (P=0.012). Among the 23 provincial-level administrative regions, total enrollment decreased in 13, remained unchanged in 2, and increased in 8. Conclusions Enrollment in three-year clinical medicine programs decreased overall, while minimum admission ranks generally shifted forward. Enrollment changes were weakly associated with changes in the home-province minimum admission rank percentage, and a reduction in enrollment did not necessarily coincide with a forward shift in the minimum admission rank. Enrollment adjustments varied across provinces. Enrollment plans should be appropriately adjusted according to primary healthcare workforce needs, institutional educational capacity, and incoming student characteristics.

Key words: Clinical medicine, Vocational education, Enrollment, Minimum admission rank percentage