公共卫生人才是医药卫生人力资源的重要组成部分，公卫医师是公卫人才的主要力量。公共卫生执业医师考试作为一项准入性考试，对于保证公卫人才队伍的数量和质量具有“关卡”作用。因此研究考生特征变化趋势、影响考生考试结果的因素以及考试实施现状和优化策略对于加强医药卫生人才队伍建设以及完善公卫执业医师考试制度具有重要意义。研究描述了2015-2019年参加海南省公共卫生执业医师考试考生个人特征的变化趋势并对其异动情况进行了总结。进一步采用生存分析的方法探究了影响考生通过执业医师考试早晚的相关因素。在定量研究的基础上，研究通过半结构化访谈的方法探究了考试实施现状和优化策略。研究主要结论为：海南省公卫医师增量不足且性别不均衡；基层医疗卫生机构考生占比增高；考生毕业后延迟参考的趋势增强以及高学历考生占比较少。Kaplan-Meier分析发现单位所属类型、从事本专业年限、参加考试时的年龄、学校省份和学位情况是影响考生通过考试时间早晚的因素。生存分析发现考生参加考试时的毕业年限是影响考生考试结果的因素。半结构化访谈发现考试实施现状包含以下四个方面：有关考试管理的规定完备，但细节有待优化和完善；考务组织科学规范，但考官主观性影响评定标准；考试内容难度适宜，但临床知识所占比例有待减少；培养单位给予的实践指导不足，给考生备考实践考试造成挑战。政策建议优化包括以下五个方面：国家加大资金和政策支持，赋予公卫执业医师资格证书更多的职能；优化制度建设，不断完善考试的组织管理水平；完善内容和题目设计，调整试卷内容比例；培养单位切实履行主体责任，加强人才培养建设；考生树立正确的人生观和职业观，认真备考，尽早参考。本文提出以下政策建议：加快推进资格考试改革任务中“一年两试”工作试点；加强重点环节管理和信息化以提高实践考试科学性；参考其他从业考试规定，缩短报考和考试时间跨度；完善考试内容和题目设计，加强医师队伍素质建设；各主体切实履行责任，以公卫执医考试要求为参考；强化公卫领域的毕业后教育，提高考生的实践能力；考生应树立正确的价值观念，认真备考，尽早参考。

Public health personnel is an important part of China's medical and health human resources, public health physicians are the main force of public health personnel. As an entrance examination for public health physicians, the public health physician examination is a "gateway" to ensure the quantity and quality of public health personnel. Therefore, it is important to study the trends of candidates' personal characteristics, factors affecting their passing the examination, as well as the current situation of the examination implementation and optimization strategies to strengthen the construction of China's medical and health personnel and improve the public health physician examination system.The study described the changing trends of personal characteristics of candidates taking the public health physician examination in Hainan Province from 2015 to 2019 and summarized their variances. Survival Analysis was further used to explore the factors associated with candidates' early and late passage of the licensure examination. Based on the quantitative study, the study explored the current status of exam implementation and optimization strategies through semi-structured interviews.The main findings of the study were: trend analysis found that the increment of public health physicians in Hainan Province was insufficient and gender imbalanced; the proportion of candidates in primary health care institutions increased; the trend of candidates delaying taking the examination after graduation increased; and the proportion of public health candidates with high education was relatively low. The Kaplan-Meier analysis found that type of unit affiliation, years of experience in the profession, age at the time of taking the exam, school province, and degree were factors associated with how early candidates passed the exam. Survival Analysis found that the number of years of graduation at the time of taking the exam was a relevant factor in the outcome of the exam. Semi-structured interviews revealed the following four aspects of examination implementation: the regulations on examination administration are complete, but the details need to be optimized and improved; the examination organization is scientific and standardized, but the subjectivity of examiners affects the evaluation criteria; the examination content is appropriately difficult, but the proportion of clinical knowledge needs to be reduced; and the practical guidance given by training units is insufficient, which poses a challenge for candidates to prepare for the practical examination. Policy suggestions for optimization include the following five aspects: the state should increase financial and policy support and give more functions to the certificate of public health physician; optimize the system construction and continuously improve the organization and management level of the examination; improve the content and topic design and adjust the content ratio of the examination paper; training units should effectively fulfill their main responsibility and strengthen the construction of talent training; candidates should establish a correct outlook on life and career and prepare for the examination seriously and as early as possible Reference.This paper puts forward the following policy recommendations: accelerate the pilot of "two exams in one year" in the task of qualification examination reform; strengthen the management of key aspects and information technology to improve the scientific nature of the practical examination; refer to the regulations of other practice examinations to shorten the time span of application and examination; improve the content and topic design of the examination and strengthen the quality of the physician team; the mains should effectively fulfill their responsibilities and take the requirements of the public health examination as reference; strengthen post-graduation education in the field of public health and improve the practical ability of candidates; candidates should establish the correct values, prepare for the examination and take part in it as early as possible.