Clinical Adaptability and Protected Research Time as Key Determinants of Core Competency: A Cross-sectional Study of China's "Dual-Track Integration" Clinical Professional Master’s Students

Background In China, the integrated training model for clinical medicine professional master’s students merges postgraduate education with standardized residency training. Trainees face dual pressures from clinical rotations and academic research, which may compromise competency development. However, the role of adjustable factors, particularly clinical practice adaptability and protected research time, is not well defined. Objective This study evaluated the current state of core competencies among these students and investigated the influence of clinical practice adaptability and the sufficiency of protected research time. Methods A multicenter, cross-sectional survey was administered in Guangdong Province between December 2024 and January 2025. Participants included 921 students from 41 national standardized residency training bases. Data were collected using structured questionnaires comprising the Core Competency Scale and the Clinical Practice Adaptability Scale. Analyses involved nonparametric tests and multiple linear regression. Results Core competency dimensions were ranked by mean score (highest to lowest): Professionalism, Patient Care, Communication and Collaboration, Lifelong Learning, Knowledge and Skills, and Teaching Capability. This profile indicated relative deficits in Teaching Capability and Knowledge and Skills. Univariate analyses revealed that total competency scores were significantly associated with gender, place of origin, adequacy of protected research time, role identity, stress attitude, and clinical practice adaptability ( p  < 0.05). The regression model identified both clinical practice adaptability ( β  = 0.425, p  < 0.001) and adequacy of protected research time ( β  = 0.079, p  = 0.010) as independent, positive predictors of core competency, with adaptability being the strongest contributor. The model accounted for 21.7% of the score variance (Adjusted R ² =0.217). Conclusion Students in the integrated training model show an uneven development of core competencies. Interventions aimed at improving clinical practice adaptability and guaranteeing sufficient dedicated research time are essential for balanced competency growth. Training institutions should adopt focused measures, including establishing specialized clinical teaching teams and securing protected time for scholarly activities.