Does rural generalist focused medical school and family medicine training make a difference? Memorial University of Newfoundland outcomes

Abstract

ABSTRACT:Introduction: 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. Methods: 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) Two-sample proportion tests demonstrated Memorial University provided a larger proportion of its provincial physician resource supply than the other four single provincial medical schools, by medical school MD for FM (72.4% vs 44.3%, p<0.000) and for overall (63.2% vs 43.5% p<0.000), and by medical school PG for FM (90.8 % vs 72.0%, p<0.000). Conclusion: This study found Memorial University graduates were more likely to establish practice in rural areas compared with the national average for most program types as well as more likely to establish practice in NL compared with other single medical schools' graduates in their provinces. This study highlights the impact a comprehensive ruralfocused social accountability approach can have at supplying the needs of a population both at the regional and rural national levels.

Time to revisit the skills and competencies required to work in rural general hospitals

“…The Scottish Executive, UK government, and the UK General Medical Council have all recognised the issue of staffing R&R areas and made recommendations about the training needs of generalists [45][46][47]. while other nations provide researched models of R&R training pathways and their impact on recruitment, with evidence of collaboration that Scotland could emulate [48][49][50][51][52][53][54][55].…”

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

“…Developing rural‐focused curricula has been successful at rural medical schools . However, most rural programmes globally have been developed within the framework of larger, more established urban sites.…”

Time to end the drought in the bush

“…Workforce data suggest rural internship and specialty training places would further increase the rural medical workforce, given that residents trained in a rural/remote area are more likely to remain there. 17,18 Existing postgraduate studies are largely focussed on the discipline of general practice: in Australia, 19,20 and in the USA, 21 Canada, 22 South Africa 23 and Finland. 24 With respect to specialist areas in medicine, although there are some 25 suggestive data that rural undergraduate exposure increases rural work in some medical specialties (Australia, 26 Canada 27 ), in general, there has been a dearth of studies looking specifically at the outcomes of postgraduate specialist training in rural locations.…”

“…Workforce data suggest rural internship and specialty training places would further increase the rural medical workforce, given that residents trained in a rural/remote area are more likely to remain there. 17 , 18…”