Objective To systematically define the critical issues in the practical teaching of oriented medical students in China and to provide a reference for the management of practical teaching. Methods Via CNKI, Wanfang Data, and VIP Journal Database, we searched for journal articles in the field of practical teaching of targeted medical students in China. The Smith model was used as the theoretical framework to systematically review and categorize the problem system, and the severity index, importance index and priority index were calculated according to the problem categories; the four-quadrant method and the coefficient of variation method were used to identify the key problems and propose countermeasures. Results Eighty-seven journal articles were finally included to form a list of 20 categories of problems; the problems in the practice teaching of oriented medical students in China were mainly concentrated in the part of the main body of policy implementation; the supervisory system (R = 0. 045), the teaching concept (R = 0. 042), the performance appraisal (R = 0. 027), and the coordination mechanism (R = 0. 026) were the existing key problems in the field of practice teaching of oriented medical students in China. While internship arrangement (R = 0. 108), and management system (R = 0. 087) were potential key issues that need to be kept in mind. Conclusion The development of practice teaching for oriented medical students in China is mainly limited by the insufficiency of supervision and coordination mechanisms for practice teaching, the diversity of assessment standards, and the fact that the concept of practice teaching has not yet reached the expected level of scientization. Therefore, in the future, under the guidance of macro policies, we should improve the supervision and coordination mechanism between schools and internship bases, construct scientific concepts of practical education, and adjust internship programs to enhance the effectiveness of internship. At the same time, following the concept of human-centered education and focusing on the cultivation of moral and emotional development of oriented medical students is also a necessary means to improve the quality of internship for oriented medical students. © 2025 Publishing House of Chinese Journal of General Practice. All rights reserved.
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