A comparison of teaching opportunities for rural and urban family medicine residents

2021

BMC Med Educ

Background The core business of medical schools includes clinical (education and service) and academic (research) activities. Our objective was to assess the degree to which these activities exist in a distributed medical education system in Canada. Methods A population-based design was utilized. Programs were contacted and public records were searched for medical trainees and faculty positions within a province in Canada during the 2017/2018 academic year. Data were expressed as positions per 100,000 residents within the Lower Mainland, Island, and Northern and Southern interior geographical regions. Results Substantial differences in the distribution of medical students by region was observed with the highest observed in the Northern region at 45.5 per 100,000 as compared to Lower Mainland, Island, and Southern regions of 25.4, 16.8, 16.0 per 100,000, respectively. The distribution of family medicine residents was less variable with 14.9, 10.7, 8.9, and 5.8 per 100,000 in the Northern, Island, Southern, and Lower Mainland regions, respectively. In contrast, there was a marked disparity in distribution of specialty residents with 40.8 per 100,000 in the Lower Mainland as compared to 7.5, 3.2, and 1.3 per 100,000 in the Island, Northern, and Southern regions, respectively. Clinical faculty were distributed with the highest observed in the Northern region at 180.4 per 100,000 as compared to Southern, Island, and Lower Mainland regions of 166.9, 138.5, and 128.4, respectively. In contrast, academic faculty were disproportionately represented in the Lower Mainland and Island regions (92.8 and 50.7 per 100,000) as compared to the Northern and Southern (1.4 and 1.2 per 100,000) regions, respectively. Conclusions While there has been successful redistribution of medical students, family medicine residents, and clinical faculty, this has not been the case for specialty residents and academic faculty.

Section: Discussionmentioning

confidence: 85%

Comprehensiveness of distributed medical education systems: a regional population-based perspective

2021

BMC Med Educ

“…Clinical faculty make up the majority of the workforce and volunteer to supervise and teach learners in the clinical setting. For these faculty, teaching is tied to clinical revenue and the distribution of medical students is labour intensive, can decrease productivity and limit the number of trainees in a community [33][34][35] . Juxtaposed, as observed in the ndings, academic faculty predominately reside in an urban center and supervise the majority of resident trainees.…”

Section: Discussionmentioning

confidence: 99%

“…Senior residents, for example, allocate a quarter of their time teaching interns and medical students; and they act as mentors, providing leadership, guidance and learning 13 . As follows, with few residency programs, there are fewer opportunities for residents to teach at distributed sites as compared to their urban colleagues 34 . It helps that medical students are distributed to increase opportunities for teaching, however, urban residents participate in broad community consistent with multiple learners, and more opportunities to supervise and teach while working as a team in the context of clinical practice 2,34 .…”

Section: Discussionmentioning

confidence: 99%

Comprehensiveness of Distributed Medical Education Systems: A Regional Population-Based Perspective

2020

Preprint

Background: The core business of medical schools includes clinical (education and service) and academic (research) activities. Our objective was to assess the degree to which these activities exist in a distributed medical education system in Canada. Methods: A population-based design was utilized. Programs were contacted and public records were searched for medical trainees and faculty positions within a province in Canada during the 2017/2018 academic year. Data were expressed as positions per 100,000 residents within the Lower Mainland, Island, and Northern and Southern interior regions. Results: Substantial differences in the distribution of medical students by region was observed with the highest observed in the Northern region at 45.5 per 100,000 as compared to Lower Mainland, Island, and Southern regions of 25.4, 16.8, 16.0 per 100,000, respectively. The distribution of family medicine residents was less variable with 14.9, 10.7, 8.9, and 5.8 per 100,000 in the Northern, Island, Southern, and Lower Mainland regions, respectively. In contrast, there was a marked disparity in distribution of specialty residents with 40.8 per 100,000 in the Lower Mainland as compared to 7.5, 3.2, and 1.3 per 100,000 in the Island, Northern, and Southern regions, respectively. Clinical faculty were distributed with the highest observed in the Northern region at 180.4 per 100,000 as compared to Southern, Island, and Lower Mainland regions of 166.9, 138.5, and 128.4, respectively. In contrast, academic faculty were disproportionately represented in the Lower Mainland and Island regions (92.8 and 50.7 per 100,000) as compared to the Northern and Southern (1.4 and 1.2 per 100,000) regions, respectively. Conclusion: While there has been successful redistribution of medical students, family medicine residents, and clinical faculty, this has not been the case for specialty residents and academic faculty.

“…Clinical faculty make up the majority of the workforce and volunteer to supervise and teach learners in the clinical setting. For these faculty, teaching is tied to clinical revenue and the distribution of medical students is labour intensive, can decrease productivity and limit the number of trainees in a community [38][39][40] . In contrast, as observed in the ndings, academic faculty predominately reside in a densely populated urbanized area and supervise the majority of resident trainees.…”

Section: Discussionmentioning

confidence: 99%

“…Senior residents, for example, allocate a quarter of their time teaching interns and medical students; and they act as mentors, providing leadership, guidance and learning 13 . With few residency programs, there may be fewer opportunities for residents to teach at distributed sites as compared to their urban colleagues 39 . It helps that medical students are distributed to increase opportunities for teaching, however, urban residents participate in a broad community consistent with multiple learners, and more opportunities to supervise and teach while working as a team in the context of clinical practice 2,39 .…”

Section: Discussionmentioning

confidence: 99%

Comprehensiveness of Distributed Medical Education Systems: A Regional Population-Based Perspective

2020

Preprint

Background: The core business of medical schools includes clinical (education and service) and academic (research) activities. Our objective was to assess the degree to which these activities exist in a distributed medical education system in Canada.Methods: A population-based design was utilized. Programs were contacted and public records were searched for medical trainees and faculty positions within a province in Canada during the 2017/2018 academic year. Data were expressed as positions per 100,000 residents within the Lower Mainland, Island, and Northern and Southern interior regions.Results: Substantial differences in the distribution of medical students by region was observed with the highest observed in the Northern region at 45.5 per 100,000 as compared to Lower Mainland, Island, and Southern regions of 25.4, 16.8, 16.0 per 100,000, respectively. The distribution of family medicine residents was less variable with 14.9, 10.7, 8.9, and 5.8 per 100,000 in the Northern, Island, Southern, and Lower Mainland regions, respectively. In contrast, there was a marked disparity in distribution of specialty residents with 40.8 per 100,000 in the Lower Mainland as compared to 7.5, 3.2, and 1.3 per 100,000 in the Island, Northern, and Southern regions, respectively. Clinical faculty were distributed with the highest observed in the Northern region at 180.4 per 100,000 as compared to Southern, Island, and Lower Mainland regions of 166.9, 138.5, and 128.4, respectively. In contrast, academic faculty were disproportionately represented in the Lower Mainland and Island regions (92.8 and 50.7 per 100,000) as compared to the Northern and Southern (1.4 and 1.2 per 100,000) regions, respectively. Conclusion: While there has been successful redistribution of medical students, family medicine residents, and clinical faculty, this has not been the case for specialty residents and academic faculty.