Scope of practice of family medicine graduates who completed a rural versus urban program (original) (raw)
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Canadian family physician Médecin de famille canadien, 2012
To describe the relationships between rural practice and the personal and medical education characteristics of medical students and residents. Cross-sectional, mailed survey. Manitoba. Of 2578 physician graduates of the University of Manitoba from 1965 to 2000 who were surveyed, 1269 (49%) responded. Whether physicians had ever practised in rural settings, and their demographic characteristics and adolescent, medical school, and residency training experiences. Multivariate logistic regression models were used to determine variables jointly and independently associated with rural practice. Of 1269 respondents, 39% had practised in rural settings, including 58% of the 362 respondents who identified family practice as their primary career activity, and 32% of the 907 respondents whose primary activities were other than family practice. For all graduates, being male (P = .0289), having lived in a rural community (P < .0001), having attended a rural high school (P < .0001), and hav...
CMAJ Open, 2019
I n Canada, as in many other countries, access to a family physician remains problematic for many patients, espe cially those in northern, rural and remote commun ities. 1-4 In 2016, there were 234 physicians per 100 000 pop ulation in Canada; 92% were located in urban areas and only 8% were located in rural areas, 5 yet 18% of Canadians live in rural areas. 6 Regional medical campuses represent an educa tional strategy for addressing health care workforce needs. 7 Traditionally, regional medical campuses provide training in basic science, clinical training or both. Physician maldistribution is evident in British Columbia, where physicians cluster mainly in urban areas. 8 In 2004, the University of British Columbia (UBC) established a com bined regional medical campus model 9 where, in addition to the main campus, 2 regional medical campuses provided both basic science and clinical training. Since then, many other medical schools in Canada and the United States have devel oped regional campuses. 10 Students from rural backgrounds are more likely to practise in rural areas, 11 and previous stud ies suggest that undergraduate rural training (especially longi tudinal rural training) increases the likelihood of rural practice. Research regarding undergraduate rural education models is sparse 12 beyond descriptive studies, and evidence is lacking that these educational interventions increase the rural workforce. 13 The primary objective of this study was to deter mine the association between a combined regional medical campus model and rural family medicine practice. Methods Setting Community action in BC led to a collaboration between the UBC Faculty of Medicine (the only medical school in the province), the BC government,
Canadian family physician Médecin de famille canadien, 2005
To examine where rural physicians grew up, when during their training they became interested in rural medicine, factors influencing their decision to practise rural medicine, and differences in these measures according to rural or urban upbringing. Mailed survey. Rural Canada. Rural family physicians who graduated between 1991 and 2000 from a Canadian medical school. Backgrounds of recently graduated rural physicians, when physicians first became interested in rural practice during training, and most influential factors in decisions to practise rural medicine. Response rate was 59% (382/651). About 33% of rural physicians grew up in communities of less than 10 000 people, 44% in cities of 10 000 to 499 999 people, and 23% in cities of more than 500 000 people. Physicians raised in rural areas were more likely than those raised in urban areas to have some interest in rural family practice at the start and end of medical school (90% vs 67% at the start, 98% vs 91% at the end, respecti...
Rural and remote health, 2018
Rural recruitment and retention of physicians is a global issue. The Faculty of Medicine at Memorial University of Newfoundland, Canada, was established as a rural-focused medical school with a social accountability mandate that aimed to meet the healthcare needs of a sparse population distributed over a large landmass as well as the needs of other rural and remote areas of Canada. This study aimed to assess whether Memorial medical degree (MD) and postgraduate (PG) programs were effective at producing physicians for their province and rural physicians for Canada compared with other Canadian medical schools. This retrospective cohort study included medical school graduates who completed their PG training between 2004 and 2013 in Canada. Practice locations of study subjects were georeferenced and assigned to three geographic classes: Large Urban; Small City/Town; and Rural. Analyses were performed at two levels. (1) Provincial level analysis compared Memorial PG graduates practicing ...
Canadian rural family medicine training programs: growth and variation in recruitment
Canadian family physician Médecin de famille canadien, 2005
To document the proliferation of rural family medicine residency programs and to note differences in design as they affect rural recruitment. Descriptive study using semistructured telephone interviews. All family medicine residency programs in Canada in 2002. Directors of Canadian family medicine residency programs. Number of rural training programs and positions; months of rural exposure, degree of remoteness, and specialist support of rural communities within rural training programs. The number of rural training programs rose from one in 1973 to 12 in 2002. Most medical schools now offer dedicated rural training streams. From 1989 to 2002, the number of rural residency positions quadrupled from 36 to 144; large jumps in capacity occurred from 1989 to 1991 and then from 1999 to 2001. Rural positions now represent 20% of all family medicine residency positions. Among rural programs, minimum rural exposure ranged from 4 to 12 months, and the median distance between rural training co...
Human Resources for Health, 2017
Background: The "rural pipeline" suggests that students educated in rural, or other underserviced areas, are more likely to establish practices in such locations. It is upon this concept that the Northern Ontario School of Medicine (NOSM) was founded. Our analysis answers the following question: Are physicians who were educated at NOSM more likely to practice in rural and northern Ontario compared with physicians who were educated at other Canadian medical schools? Methods: We used data from the College of Physicians and Surgeons of Ontario. We compared practice locations of certified Ontario family physicians who had graduated from NOSM vs. other Canadian medical schools in 2009 or later. We categorized the physicians according to where they completed their undergraduate (UG) and postgraduate (PG) training, either at NOSM or elsewhere. We used logistic regression models to determine if the location of UG and PG training was associated with rural or northern Ontario practice location. Results: Of the 535 physicians examined, 67 had completed UG and/or PG medical education at NOSM. Over two thirds of physicians with any NOSM education were practicing in northern areas and 25.4% were practicing in rural areas of Ontario compared with those having no NOSM education, with 4.3 and 10.3% in northern and rural areas, respectively. Physicians who graduated from NOSM-UG were more likely to have practices located in rural Ontario (OR = 2.57; p = 0.014) whereas NOSM-PG physicians were more likely to have practices in northern Ontario (OR = 57.88; p < 0.001). Conclusions: NOSM education was associated with an increased likelihood of practicing in rural (NOSM-UG) and northern (NOSM-PG) Ontario.
Canadian family physician Medecin de famille canadien, 2017
To develop a pan-Canadian rural education road map to advance the recruitment and retention of family physicians in rural, remote, and isolated regions of Canada in order to improve access and health care outcomes for these populations. Members of the task force were chosen from key stakeholder groups including educators, practitioners, the College of Family Physicians of Canada education committee chairs, deans, chairs of family medicine, experts in rural education, and key decision makers. The task force members were purposefully selected to represent a mix of key perspectives needed to ensure the work produced was rigorous and of high quality. Observers from the Canadian Medical Association and Health Canada's Council on Health Workforce, and representatives from the Royal College of Physicians and Surgeons of Canada, were also invited to provide their perspectives and to encourage and coordinate multiorganization action. The task force commissioned a focused literature revie...
Canadian Medical Education Journal
Background: Urban background physicians are the main source of physician supply for rural areas across Canada. The purpose of this study was to describe factors that influence rural career choice and practice location of urban background family medicine graduates. Methods: We conducted a qualitative, descriptive study employing telephone interviews with 9 urban background family medicine graduates. Those who completed residency training between 2006 and 2011 and were in rural practice, but who had an urban upbringing were asked about: when the decision for rural practice was made; factors that influenced rural career choice; and factors that influenced choice of a particular rural location. Emerging themes were identified through content analysis of interview data. Results: We identified four themes as factors influencing rural career choice - variety/broad scope of rural practice, rural lifestyle, personal relationships, and positive rural experience/physician role models. We ...
Preparing for rural practice. Enhanced experience for medical students and residents
Canadian family physician Médecin de famille canadien, 1998
Recruitment and retention of physicians appropriately trained for rural practice in Canada continues to be a serious challenge. We describe three integrated educational programs at the University of Alberta that aim to increase students' and residents' participation in rural health care and encourage them to take up practice in rural areas. OBJECTIVES OF PROGRAM: To expand and enrich rural educational experiences at undergraduate and postgraduate levels and to supplement family medicine postgraduate education with a third-year special-skills program for rural practice. Main components are sustained, reliable funding from the Government of Alberta for the Rural Physician Action Plan; adequate infrastructure to support the program; and commitment by university faculty, rural physicians, and communities. The rural-based educational programs have allowed more than 95% of medical students to gain experience in rural areas. The number of family medicine residents doing rural rotat...