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

Abstract

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.

Determinants of research productivity during postgraduate medical education: a structured review

“…In recent decades many jurisdictions have re-distributed provision of medical education with less emphasis on large tertiary care urban settings with a shift to smaller communities. However, failure to concomitantly increase research mentors in these distributed centres presents a significant risk to trainee research productivity and merits further attention [ 98 ].…”

Psychiatrists’ Engagement in Research as a Pathway towards the Expansion of Distributed Medical Education (DME): A Regional Analysis across Two Provinces in Atlantic Canada

“…In 2020, there were 242 physicians per 100,000 population in Canada, and out of these physicians, only 8% were in rural areas, while 92% were in urban areas [2]. Although it is natural to have more physicians in urban areas due to the larger population, urban-centered medical education may contribute to this difference and has not addressed the needs of the underserved rural and small communities and has failed to attract physicians to these areas [3][4][5].…”

“…Institutional Review Board Statement: This research has been formulated and conducted in adherence to the Declaration of Helsinki guidelines for studies involving human participants. It has obtained an exemption from the Dalhousie University Research Ethics Board in line with the Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans (article 2 5)…”

Exploring Current Practices, Needs, and Barriers for Expanding Distributed Medical Education and Scholarship in Psychiatry: Protocol for an Environmental Scan Using a Formal Information Search Approach and Explanatory Design

“…In addition to the potential benefit of recruiting physicians, rural training offers trainees unique clinical experiences and provides first-hand knowledge of the health care systems that exist in rural, small, and underserved communities located outside of the academic centers in regional or “satellite” sites [ 13 , 15 ]. There is also the possibility that exposure to smaller communities and community-based practice may encourage generalism [ 16 ].…”