Why they leave: Small town rural realities of northern physician turnover

Orrantia, Eliseo; Jolicoeur, Jilayne; DeMiglio, Lily; Kin, LindsayNutbrown R.

doi:10.4103/cjrm.cjrm_2_21

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…While it may seem somewhat obvious, respondents highlighted the significance of their spouse/partner and/or family member’s fulfillment when contemplating rural practice. This aligns with findings that have shown physicians are more likely to leave rural practice when their partners express dissatisfaction with their own careers [ 17 ]. As a result, communities should recognize the significance of recruitment visits and invest time and effort to ensure that potential recruits' partners and/or families have positive experiences that showcase the unique advantages of rural life from their perspective.…”

Section: Discussionsupporting

confidence: 89%

“…Between 2019 and 2020, a single researcher (J.J.) conducted 12 one-on-one semi-structured telephone interviews. Interview questions were part of a larger study exploring factors related to the recruitment and retention of physicians in rural Northern Ontario [ 17 ]. For this segment of the study, questions were open-ended and designed to elicit participants' perspectives and opinions regarding their motivation to pursue rural practice as well as their experience practicing in rural Northern Ontario.…”

Section: Methodsmentioning

confidence: 99%

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Draw to Practice: A Qualitative Study Examining Factors Attracting Physicians to Rural Northern Ontario

DeMiglio,

Jolicoeur,

Lamb

et al. 2024

Cureus

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Introduction Physician shortages are a persisting issue in rural regions around the world, and rural Northern Ontario, Canada, is no exception. Even with significant government interventions, financial incentives, and rural-specific contracts, physician recruitment to the region remains an ongoing challenge. Refining recruitment strategies based on specific factors that attract physicians to rural practice could help address staffing shortages and, ultimately, enhance healthcare access and outcomes in rural communities. However, the draw to rural practice among physicians is poorly defined. Therefore, this study aims to bridge this knowledge gap and, in doing so, offers insight to better inform recruitment strategies for rural communities. Methodology As part of a larger qualitative study on physician retention and recruitment, semi-structured interviews were conducted with 12 physicians who had previously practiced in rural Northern Ontario communities. Interviews captured information about their individual experiences, including perspectives on factors that attracted them to establish a practice in rural Northern Ontario. Transcribed interviews were analyzed to identify recurring themes associated with the factors that affect the decision to practice in rural Northern Ontario. Results Participants described the draw to rural practice as being multifactorial and based on overlapping motivations. Key motivations described by participants could be categorized into three broad themes, including rural community connection and exposure, lifestyle and personal preferences, and career considerations. Specifically, participants emphasized the importance of pro-rural mentors and gaining firsthand experience in rural communities as important facilitators that created a connection with these areas. Interest in exploring new parts of the country, alignment with life plans, support of family, and the challenge of rural practice also played pivotal roles in the decision to pursue rural practice. Finally, the opportunity to have a broad scope of practice and serve a need in the healthcare system while receiving fair compensation within the framework of a flexible and supportive contract was also cited as a draw to practice. Conclusion The draw to rural practice is multifactorial and based on a wide array of motivations. As a result, recruitment strategies should move beyond single-pronged approaches and recognize the need to design strategies that address the multifaceted motivations and considerations that drive physicians towards rural practice. Designing and implementing recruitment approaches that consider the diverse factors influencing physicians interest in rural career paths is likely to enhance recruitment initiatives and more effectively address shortage of physicians in the region.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Draw to Practice: A Qualitative Study Examining Factors Attracting Physicians to Rural Northern Ontario

DeMiglio,

Jolicoeur,

Lamb

et al. 2024

Cureus

Self Cite

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“…Many of the medical learners reflected that the service-learning elective encouraged them to consider returning to these northern First Nation communities to locum in their future medical practice, but current research suggests that the longitudinal retention levels in northern communities are low [ 27 ]. This may be due to the remoteness of the communities, or the increased demand on physicians when working in low resource communities [ 27 , 28 ]. One potential medical education solution is creating more longitudinal integrated clerkships in rural and remote communities for students who are from northern locations or of Indigenous descent.…”

Section: Discussionmentioning

confidence: 99%

Operation Remote Immunity: exploring the impact of a service-learning elective in remote Indigenous communities

et al. 2023

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Background The novel coronavirus, COVID-19, emerged in December 2019. Shortly after, vaccines against the virus were distributed in Canada for public use, but the remoteness of many northern Indigenous communities in Ontario posed a challenge for vaccine distribution and dissemination. The Ministry of Health partnered with the Northern Ontario School of Medicine University (NOSMU) and the air ambulance service, Ornge, to assist in delivering the vaccination doses to 31 fly-in communities in the Nishnawbe Aski Nation and Moosonee, all within Ontario. These deployments were considered “service-learning electives” for Undergraduate and Postgraduate medical learners from NOSMU who joined the operation in two-week deployments. NOSMU is renowned for its social accountability mandate and gives its medical learners opportunities to participate in service-learning to enhance their medical skills and cultural sensitivity. The purpose of this study is to examine the relationship between social accountability and medical learners’ experiences during a service-learning elective in northern Indigenous communities in Ontario during the COVID-19 pandemic. Methods Data were collected through a planned post-placement activity completed by eighteen Undergraduate and Postgraduate medical learners, who participated in the vaccine deployment. The activity consisted of a 500-word reflective response passage. Thematic analysis was used to identify, analyze, and report the themes within the collected data. Results Two themes were identified by the authors, which formed a concise overview of the collected data: (1) confronting the realities of working in Indigenous communities; and (2) service-learning as a path to social accountability. Conclusions These vaccine deployments were an opportunity for medical learners to engage in service-learning and engage with Indigenous communities in Northern Ontario. Service-learning is an exceptional method which provides an opportunity to expand knowledge on the social determinants of health, social justice, and social accountability. The medical learners in this study reiterated the idea that learning medicine through a service-learning model leads to a greater depth of knowledge on Indigenous health and culture, and enhances medical knowledge compared to classroom learning.

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“…Historically, rural communities have been observed to have a higher burden of preventable morbidity and mortality, which has been largely attributed to reduced access to healthcare, social service, education and employment opportunities, and transport resources that are typically concentrated in more urbanized areas 31 . A 2021 report from Ontario identified equitable access to mental health services as a significant contributor to the mental health disparities between rural and urban areas 32 . Individuals living in rural areas face barriers to accessing healthcare services, imposed by transportation, inadequate resources, and low physician retainment 32,33 .…”

Section: How Is Rurality Linked With Srb?mentioning

confidence: 99%

“…A 2021 report from Ontario identified equitable access to mental health services as a significant contributor to the mental health disparities between rural and urban areas 32 . Individuals living in rural areas face barriers to accessing healthcare services, imposed by transportation, inadequate resources, and low physician retainment 32,33 . The Ontario Mental Health Association reported that an increasing number of rural family physicians were screening out high-needs patients with mental illness or addictions due to the lack of expertise and/or capacity.…”

Section: How Is Rurality Linked With Srb?mentioning

confidence: 99%

Is the association between sexual minority status and suicide-related behaviours modified by rurality? A discrete-time survival analysis using longitudinal health administrative data

Nielsen

Azra

Kim

et al. 2023

Social Science & Medicine

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Why they leave: Small town rural realities of northern physician turnover

Cited by 10 publications

References 16 publications

Draw to Practice: A Qualitative Study Examining Factors Attracting Physicians to Rural Northern Ontario

Draw to Practice: A Qualitative Study Examining Factors Attracting Physicians to Rural Northern Ontario

Operation Remote Immunity: exploring the impact of a service-learning elective in remote Indigenous communities

Is the association between sexual minority status and suicide-related behaviours modified by rurality? A discrete-time survival analysis using longitudinal health administrative data

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