Delayed Completion in General Practice Residency Training：a Cross-National Comparative Study on Causes and Reform Strategies postprint

Abstract: This review focuses on the delayed graduation issue in standardized residency training for general practitioners（GPSRT），conducting a cross-national comparative analysis of training systems，current status of delays，contributing factors，and reform strategies across 11 representative developed and developing countries. Findings reveal that delayed graduation in global GPRT programs is widespread，with postponement rates influenced by multiple factors including clinical resource shortages，elevated assessment standards，public health emergencies，and residents' mental health challenges. Developing countries face more pronounced challenges due to regional resource disparities. Nations demonstrate differentiated countermeasures： the United States optimizes training pathways through dynamic assessment mechanisms，Japan enhances grassroots physician retention via policy incentives，while China strengthens training process management through digital technologies. The study proposes that resolving this issue requires coordinated efforts across three dimensions：restructuring adaptive training models，building supportive ecosystem networks，and iterating crisis response mechanisms. This approach seeks to balance efficiency with humanistic care，standardization with personalization，ultimately enhancing the resilience of general practice education and healthcare service quality.