Objective:To investigate the current composition, competency needs, and villagers’ health-service demands among rural doctors in Hong’an County of Hubei Province, so as to provide evidence for formulating a precise, practical program that upgrades village doctors’ capabilities and safeguards their practice. Methods:Questionnaire surveys were the principal tool, supplemented by interviewsand document reviews, targeting village doctors under the township health centers across Hong’an County. Results:Most village doctors hold junior-college degrees and have a wide span of service years. A structural contradiction—simultaneous aging and limited educational attainment—is common. Village doctors most urgently need training in “clinical knowledge and skills” and “traditional Chinese medicine (TCM) techniques”, whereas villagers focus on “disease prevention and management” and “guidance on healthy lifestyles” yet have low awareness of policies such as medical-insurance regulations. Existing training content is misaligned with the hands-on skills that village doctors require.Conclusion:A tripartite, precision-oriented training system—integrating “technical upgrading (highlighting standardized protocols for acute and chronic conditions and appropriate TCM techniques), policy communication, and health education”—must be built in parallel with reinforced career safeguards (pensions, professional liability insurance, promotion pathways) to stabilize the workforce. Only by coupling optimized training models with improved protection mechanisms can the comprehensive service capacity and professional value of village doctors be effectively elevated, enabling them to fulfill their role as rural health “gatekeepers” and advance rural revitalization.