Alignment between undergraduate public health training and workforce competency requirements under medical–public health integration: a dual-perspective cross-sectional study in Yunnan, China

Misalignments may exist between undergraduate public health training and frontline workforce competency requirements under medical–public health integration, particularly in border and multi-ethnic regions. This study assessed this alignment from the combined perspectives of students and employers. We conducted a dual-perspective cross-sectional survey supplemented by analysis of open-ended responses among undergraduate public health students enrolled in the 2020, 2021 and 2022 cohorts at Kunming Medical University and employer respondents from public health-related institutions. The student questionnaire included 13 satisfaction items across six training domains. The employer questionnaire assessed the perceived importance of 10 core competencies related to medical–public health integration and the perceived performance of recent graduates in these competencies. Descriptive statistics, one-way analysis of variance (ANOVA), importance–performance analysis, secondary exploratory k-means clustering and analysis of open-ended responses were used. We analysed responses from 160 students and 190 employer respondents. Given the scale direction, students reported generally low satisfaction across curriculum and classroom teaching, learning resources, faculty and teaching support, practical training, career guidance and overall programme satisfaction. The 2021 cohort reported relatively higher scores than the 2020 and 2022 cohorts, but absolute satisfaction levels remained low. Employer respondents rated most medical–public health integration competencies as important or very important, while reporting perceived performance gaps among recent graduates from the focal programme, particularly in field investigation of outbreaks, policy understanding and implementation, multisectoral collaboration, and data analysis and outbreak assessment. Open-ended responses further highlighted concerns about curriculum–employment alignment, authentic practice opportunities, data and information skills, and career preparation. The findings indicate perceived misalignments between undergraduate public health training and frontline competency requirements under medical–public health integration. Potential priority areas for curriculum improvement include practice-based training, policy understanding and implementation, field epidemiology, data analysis, intercultural communication and career preparation. Public health curricula may benefit from stronger authentic, practice-based learning and sustained collaboration among universities, Centers for Disease Control and Prevention (CDCs), hospitals and primary healthcare institutions, while further studies are needed to examine their transferability to broader settings.