To understand the influencing factors of free education for rural order-oriented medical students and to explore the willingness of students to serve at the grass-roots, so as to provide reference for further optimizing the free education of medical students.

A self-designed questionnaire survey was performed among 196 medical undergraduates majoring in free clinical medicine in one medical university of Shandong Province in March 2018 and 198 undergraduates majoring in general clinical medicine enrolled in the same year. The results of the survey were analyzed by SAS 9.2, and chi-square test, rank sum test and logistic regression were used to make statistic analysis.

The factors such as score of the national university entrance exam (wald χ² = 52.309, P < 0.001), household registration location (wald χ² = 9.304, P = 0.002), whether the only child in the family (wald χ² = 12.608, P < 0.001), average monthly income of the family (wald χ² = 5.557, P = 0.018), decision makers (wald χ² = 15.206, P = 0.002) and willingness to serve at the grass-roots medical institutions (wald χ² = 67.832, P < 0.001) had influence on medical students' choice of free education for order directional medical students. There were 113 (57.65%) of the free medical students intended to work at the grass-roots, while only 16 (8.08%) of the general medical students who were willing to work at the grass-roots.

The implementation of free education for order-oriented medical students policy can satisfy the wishes of some people who have the willingness to serve at the grass-roots, but their family income and college entrance examination scores are not high. However, there are still some problems, which need the joint efforts of the government health departments and the training colleges and universities, and the corresponding follow-up support policies should be issued by the state at the same time.

Medical students; Rural order-oriented; Free educational medical students; Serve at the grass-roots