[ 摘要 ]
政府自民國47年起陸續藉著公費醫師制度的方式培養原住民醫師至山地鄉服務，以解決偏遠山地鄉醫療資源貧乏的困境。然而，要經過服務過程「養成」的原住民公費醫師，才能對地方居民的健康有較大的幫助。因此，使原住民公費醫師在服務期滿後續留當地是非常重要的。由於關於公費醫師續留的研究並不多，針對原住民公費醫師的研究更是沒有，因此，我以深入訪談的方式來了解原住民公費醫師們在公費服務期間的情形，並且透過分析訪談內容以了解影響他們服務期滿時決定是否續留的因素。我根據擬定的訪談大綱訪談了7名服務期滿以及1名當時即將屆滿服務期限的原住民公費醫師。這8名受訪醫師中，有2名醫師服務期滿後續留在原單位服務、2名離開衛生所到醫院服務、3名離開衛生所在山地鄉開業，另外1名則是到市區開業。分析訪談的資料歸納出以下幾類影響他們續留決定的因素。第一類是個人的因素，其中包括收入、家庭、視為挑戰、轉換跑道等因素。第二類是對於服務對象的責任。這類因素影響了幾位決定開業醫師執業地點的選擇。第三類是其他因素，包括了是否受到上級的支持、個人在工作中所得到的回饋、原住民的使命感以及醫師科別不同的影響。目前原住民公費醫師制度已經跟過去不太相同，但大環境也在改變，在醫療資源越來越充裕的情形下、原住民公費醫師制度有必要因應現況再做調整。雖然這個研究所蒐集的資料是少數已經服務期滿的原住民公費醫師的經驗，但是從分析結果所得到的影響續留因素，基本上還是可能會影響未來的原住民醫師服務期滿後續留的決定。因此我也根據研究結果，針對提高續留率提出增加人力配置、提供彈性服務方式、提供相關配套的訓練以及上級的支持等建議。希望這些資訊可以提供政府制訂政策時的參考，也可以使對原住民公費醫師相關議題有興趣的研究者，對原住民公費醫師的服務經驗有初步的認識。

[ 英文摘要 ]
Since 1958, in order to increase the medical resources in remote areas, qualified Taiwanese aborigines have been trained to be medical doctors through the government sponsored medical education program in exchange for their 7-10 year of service in assigned health centers in remote areas after completing the medical training. However, it is the government-sponsored aboriginal medical doctors who have gathered experiences from service would become a greater help to the health of the local residents. Hence, it is important for these doctors to remain in assigned health centers after fulfilling the service requirement and be a continuous medical help to residents in those areas.
In order to explore factors influencing government-sponsored aboriginal medical doctors’ decisions on whether or not to stay in the assigned health centers after fulfilling the service requirement, I interviewed eight such doctors who had made their decisions and are currently practicing medicine in Hualien county. Among these eight doctors, two stayed and six left to continue practicing medicine in hospitals or clinics after fulfilling the service requirement.
According to the data gathered from interviews, the factors influencing these eight government-sponsored aboriginal medical doctors’ decisions included personal concerns for income and family, pursuing challenges and other factors such as relationship with authority personnel or with patients. One other finding that bore some importance was that even though six doctors chose to leave the assigned health centers after fulfilling the service requirement, the location that some of them had chosen to continue practicing medicine. indicated that they left the government-funded health centers but not the remote areas.
Based on the results of this study and the experiences of eight interviewed doctors, I discussed the possible strategies that the government can employ to increase the likelihood of government-sponsored aboriginal medical doctors’ continuous service in remote areas or assigned medical centers after fulfilling their service requirement. I also hope that the results of this study not only can be helpful to the government in policy amending, but also serves as a starting point for more research focusing on government-sponsored aboriginal medical doctors to come.