Big cities and bright lights: rural- and northern-trained physicians in urban practice

Rural medical education is increasing in popularity in Canada. This study examines why some family physicians who completed their residency training in northern Ontario decided to practise in urban centres.

We used a qualitative research method. We interviewed 14 graduates of the Family Medicine North program and the Northeastern Ontario Family Medicine program. The interview transcripts were content-analyzed.

There were different pathways leading to urban practice. While some pathways were straightforward, others were more complicated. Most participants offered multiple reasons for choosing to work in urban areas, suggesting that the decision-making processes could be quite complex. Family and personal factors were most frequently mentioned as reasons for choosing the urban option. The needs of the spouse and the children were especially important. Most of the participants had no plans to return to rural medical practice, but even these physicians retained some vestiges of rural practice.

Most Canadian medical schools now offer some rural medical training opportunities. The findings of this study provide some useful insights that could help medical educators and decision-makers know what to expect and understand how practice location decisions are made by doctors.