Abstract
Background: The career advancement system for physical therapists in public health facilities is
currently constrained by the limited positions of senior professional levels and unequal distribution. Such
structural limitations have resulted in reduced motivation and restricted professional development.
Objectives: To analyze current situations and barriers in the career advancement system, to study
impacts on professional development, and to develop policy recommendations.
Methods: A mixed-methods study first collected quantitative data from 363 physical therapists
through stratified random sampling; and qualitative data from 40 in-depth interviews. Data were analyzed
using descriptive statistics, significant difference and Spearman’s rank correlation tests.
Results: Imbalance in position distribution was found, with community hospitals having only 1.8%
of senior specialist positions compared to 12.3% in tertiary hospitals (p < 0.001). Main problems included limited positions (94.7%) and concentration in large hospitals (91.1%). Personal factors were significantly associated with motivation for self-development toward career advancement. Routine workload
showed a negative correlation with motivation (rho = –0.1141, p < 0.05), and family responsibilities
demonstrated a negative correlation as well (rho = –0.1645, p < 0.01).
Conclusions: The current system creates inequity and impacts professional development. Recommendations include restructuring position distribution, developing context-appropriate evaluation
criteria, and creating alternative career pathways.
