Objective To explore the influence of risk situations of doctor-patient dispute and professional identity on the willingness for grassroots service of rural-oriented tuition-waived medical students in a medical college in Guangzhou, so as to inform the cultivation of rural-oriented tuition-waived medical students. Methods This study was conducted experimental control method and questionnaire survey method. A total of 200 rural-oriented tuition-waived medical students majoring in five-year clinical medicine enrolled in 2020 were selected as research participants from a medical college in Guangzhou in May 2021 through cluster sampling, and 2×2 between-subject design was conducted, in which the situation (risk situations of doctor-patient dispute vs. neutral situations) and the level of professional identity (high vs. low) were the independent variables, and willingness for grassroots service was the dependent variable. Analysis of variance, t test and simple effect analysis were used for statistical analysis. Results A total of 193 rural-oriented tuition-waived medical students participated in this study. (1) The main effect of the situation was significant (η2=0.074,P=0.029). In the doctor-patient dispute risk situation, the willingness of rural-oriented tuition-waived medical students to serve at the primary level (6.37±1.63) was significantly lower than that in the neutral situation (7.62±2.14); (2) The main effect of professional identity was significant (η2=0.396,P<0.001). The intention of primary service of rural-oriented tuition-waived medical students with high professional identity (8.19±1.63) was significantly higher than that of rural-oriented tuition-waived medical students with low professional identity (5.67±1.54); (3) Doctor-patient dispute risk situation and occupational identity have a significant interactive effect on the willingness for grassroots service of rural-oriented tuition-waived medical students (η2=0.133,P<0.001). Among those with high professional identity significantly, the willingness for grassroots service decreased when the doctor-patient dispute risk situation was presented [(8.91±1.24) vs. (7.00±1.49), P<0.001], while no significant change was observed for those with low professional identity [(5.50±1.51) vs. (5.81±1.60), P=0.588]. Conclusions Rural-oriented tuition-waived medical students with high-level professional identity show a higher willingness for grassroots service, but it is easily affected by the risk of doctor-patient disputes. It is suggested that medical universities and colleges improve the willingness to serve at the grassroots by improving professional identity and guide rural-oriented tuition-waived medical students to analyze and look upon occupational risks rationally.
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