1. Early-career work location of Memorial University medical graduates: why the decline in rural practice?
- Author
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Mathews, Marta, Ryan, Dana, and Samarasena, Asoka
- Subjects
Universities and colleges -- Analysis -- Newfoundland and Labrador ,Health ,Health care industry ,Social sciences - Abstract
Introduction: In a previous study, we found a decline in the proportion of Memorial University of Newfoundland (MUN) medical alumni practising in rural areas, particularly in Newfoundland and Labrador. The current study focused on the work location of recent graduates and examined the predictors of working in rural Canada and in rural Newfoundland and Labrador within the first 15 years following graduation. Methods: We linked data from graduating class lists and the alumni and postgraduate databases with Scott's Medical Database to create a record of all graduates from 1973 to 2008, including their work location. We identified differences and significant predictors for each outcome and then described and compared the characteristics of 4 cohorts of graduating classes. Results: In their early career, 127/1113 (11.4%) MUN medical graduates were working in rural Canada, and 57 (5.1%) were working in rural Newfoundland and Labrador. Having a rural background and being a family physician were predictors of working in rural Canada, and having a rural background, doing at least part of the residency at MUN, being from Newfoundland and Labrador and being a family physician were predictors of working in rural Newfoundland and Labrador. Seventy-four (13.6%) and 33 (6.1%) of 1989-1998 graduates worked in rural Canada and rural Newfoundland and Labrador, respectively, compared to 53 (9.3%) and 24 (4.2%), respectively, of 1999-2008 graduates. Conclusion: The proportion of MUN medical graduates who worked in rural communities early in their career decreased among recent cohorts. The results show the impact of changes in the characteristics of MUN medical graduates, who increasingly opt for specialist practice and residency training outside the province, and the important role of local postgraduate training. Introduction: Une etude anterieure a revele une baisse du nombre de diplomes en medecine de l'Universite Memorial de Terre-Neuve (MUN) exercant en region rurale, plus particulierement a Terre-Neuve-et-Labrador. L'etude actuelle portait sur le lieu de travail de diplomes recents et sur les predicteurs du travail en milieu rural au Canada et dans la province de Terre-Neuve-et-Labrador dans les 15 premieres annees suivant l'obtention du diplome. Methodes: Nous avons etabli un lien entre les listes de diplomes, les bases de donnees des anciens et des postdoctorants et la Base de donnees medicales Scott's afin de creer un dossier de tous les diplomes de 1973 a 2008, y compris de leur lieu de travail. Nous avons etabli des differences et des predicteurs importants pour chaque resultat et avons ensuite decrit et compare les caracteristiques de 4 cohortes de classes de diplomes. Resultats: Au debut de leur carriere, 127 sur 1113 (11,4 %) diplomes en medecine de MUN travaillaient en region rurale au Canada et 57 (5,1 %) en region rurale a Terre-Neuve-et-Labrador. Le fait de venir d'un milieu rural et d'etre un medecin de famille etait des predicteurs de travail en milieu rural au Canada alors que le fait de venir d'un milieu rural, d'avoir fait au moins une partie de sa residence a MUN, d'etre originaire de Terre-Neuve-et-Labrador et d'etre medecin de famille etaient des predicteurs de travail en milieu rural a Terre-Neuve-et-Labrador. Soixante-quatorze (13,6 %) et 33 (6,1 %) diplomes de 1989 a 1998 travaillaient en milieu rural au Canada et en milieu rural a Terre-Neuve-et-Labrador, respectivement, par comparaison a 53 (9,3 %) et a 24 (4,2 %), respectivement, pour les diplomes de 1999 a 2008. Conclusion: La proportion de diplomes en medecine de MUN qui ont travaille dans des localites rurales au debut de leur carriere a diminue au sein des cohortes recentes. Les resultats de notre etude montrent l'incidence du changement des caracteristiques des diplomes en medecine de MUN, lesquels choisissent de plus en plus de se specializer et de faire leur residence a l'exterieur de la province, ainsi que le role important de la formation medicale postdoctorale a l'echelle locale., INTRODUCTION Part of the social accountability mandate of medical schools is to address the local, regional and national physician workforce. (1, 2) Medical schools, through their 'organization, location and mission [...]
- Published
- 2017