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First practice: family physicians initially locating in rural areas.

Lynda Buske1

  • 1Workforce Research, Canadian Collaborative Centre for Physician Resources, Canadian Medical Association, Ottawa, Ont, Canada. Buske; lynda.buske@cma.ca

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Canadian and international medical graduates differ in rural practice patterns. While international graduates initially favored rural settings, Canadian graduates showed steadier rural practice rates over time, suggesting different motivations for choosing rural medicine.

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Area of Science:

  • Medical Workforce Research
  • Rural Health Policy
  • Physician Distribution Analysis

Background:

  • Quantifying the proportion of family physicians in rural practice is crucial for understanding healthcare access.
  • Examining differences between Canadian and international medical school graduates in rural practice provides insights into physician migration and retention.
  • Initial rural practice patterns are important for addressing physician shortages in underserved areas.

Purpose of the Study:

  • To quantify the proportion of family physicians in rural practice in Canada.
  • To analyze differences in initial rural practice between Canadian and international medical school graduates.
  • To track changes in rural practice patterns from 2000 to 2011.

Main Methods:

  • Utilized the Canadian Medical Association postal code master file for physician distribution data.
  • Defined rural practice as physicians located outside census metropolitan areas or agglomerations.
  • Estimated initial rural practices based on the year of undergraduate medical degree completion.

Main Results:

  • In 2011, two-thirds of rural family physicians graduated from Canadian medical schools.
  • Between 2000-2011, international medical graduates had a higher proportion in rural practice but a greater drop-off rate.
  • Recent international graduate cohorts showed decreasing proportions in rural practice, unlike steady rates for Canadian graduates.

Conclusions:

  • International and Canadian medical graduates exhibit distinct approaches to rural practice.
  • International graduates may use rural practice as a pathway to Canadian licensure or to fulfill obligations.
  • Declining international rural practice may stem from increased Canadian postgraduate training and licensure opportunities.