Skip to main content
PMC home page
CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1999 Apr 20;160(8):1159–1163.

Rural background and clinical rural rotations during medical training: effect on practice location

M Easterbrook 1, M Godwin 1, R Wilson 1, G Hodgetts 1, G Brown 1, R Pong 1, E Najgebauer 1
PMCID: PMC1230268  PMID: 10234346

Abstract

BACKGROUND: Providing health care services in rural communities in Canada remains a challenge. What affects a family medicine resident's decision concerning practice location? Does the resident's background or exposure to rural practice during clinical rotations affect that decision? METHODS: Cross-sectional mail survey of 159 physicians who graduated from the Family Medicine Program at Queen's University, Kingston, Ont., between 1977 and 1991. The outcome variables of interest were the size of community in which the graduate chose to practise on completion of training (rural [population less than 10,000] v. nonrural [population 10,000 or more]) and the size of community of practice when the survey was conducted (1993). The predictor or independent variables were age, sex, number of years in practice, exposure to rural practice during undergraduate and residency training, and size of hometown. RESULTS: Physicians who were raised in rural communities were 2.3 times more likely than those from nonrural communities to choose to practise in a rural community immediately after graduation (95% confidence interval 1.43-3.69, p = 0.001). They were also 2.5 times more likely to still be in rural practice at the time of the survey (95% confidence interval 1.53-4.01, p = 0.001). There was no association between exposure to rural practice during undergraduate or residency training and choosing to practise in a rural community. INTERPRETATION: Physicians who have roots in rural Canada are more likely to practise in rural Canada than those without such a background.

Full Text

The Full Text of this article is available as a PDF (127.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson E. A., Bergeron D., Crouse B. J. Recruitment of family physicians in rural practice. Minn Med. 1994 Jul;77(7):29–32. [PubMed] [Google Scholar]
  2. Barer M. L., Stoddart G. L. Toward integrated medical resource policies for Canada: 8. Geographic distribution of physicians. CMAJ. 1992 Sep 1;147(5):617–623. [PMC free article] [PubMed] [Google Scholar]
  3. Bowman R. C. Continuing family medicine's unique contribution to rural health care. Am Fam Physician. 1996 Aug;54(2):471-4, 479, 483. [PubMed] [Google Scholar]
  4. Craig M. Rural practice--time to teach. Med J Aust. 1995 Mar 6;162(5):231–231. doi: 10.5694/j.1326-5377.1995.tb139871.x. [DOI] [PubMed] [Google Scholar]
  5. Denton D. R., Cobb J. H., Webb W. A. Practice locations of Texas family practice residency graduates, 1979-1987. Acad Med. 1989 Jul;64(7):400–405. doi: 10.1097/00001888-198907000-00014. [DOI] [PubMed] [Google Scholar]
  6. Dorner F. H., Burr R. M., Tucker S. L. The geographic relationships between physicians' residency sites and the locations of their first practices. Acad Med. 1991 Sep;66(9):540–544. [PubMed] [Google Scholar]
  7. Furman G., Colliver J. A., Galofré A. Effects of student gender and standardized-patient gender in a single case using a male and a female standardized patient. Acad Med. 1993 Apr;68(4):301–303. doi: 10.1097/00001888-199304000-00019. [DOI] [PubMed] [Google Scholar]
  8. Kamien M. Undergraduate rural incentives program. Assisting medical schools to help solve the shortage of rural doctors. Med J Aust. 1995 Mar 6;162(5):228–229. doi: 10.5694/j.1326-5377.1995.tb139869.x. [DOI] [PubMed] [Google Scholar]
  9. Kassebaum D. G., Szenas P. L. Rural sources of medical students, and graduates' choice of rural practice. Acad Med. 1993 Mar;68(3):232–236. doi: 10.1097/00001888-199303000-00019. [DOI] [PubMed] [Google Scholar]
  10. Martel R. Rural medicine needs help. Can Fam Physician. 1995 Jun;41:974–976. [PMC free article] [PubMed] [Google Scholar]
  11. Norris T. E., Norris S. B. The effect of a rural preceptorship during residency on practice site selection and interest in rural practice. J Fam Pract. 1988 Nov;27(5):541–544. [PubMed] [Google Scholar]
  12. Rabinowitz H. K. Recruitment, retention, and follow-up of graduates of a program to increase the number of family physicians in rural and underserved areas. N Engl J Med. 1993 Apr 1;328(13):934–939. doi: 10.1056/NEJM199304013281307. [DOI] [PubMed] [Google Scholar]
  13. Riley K., Myers W., Schneeweiss R. Recruiting physicians to rural practice. Suggestions for success. West J Med. 1991 Nov;155(5):500–504. [PMC free article] [PubMed] [Google Scholar]
  14. Rourke J. T. Politics of rural health care: recruitment and retention of physicians. CMAJ. 1993 Apr 15;148(8):1281–1284. [PMC free article] [PubMed] [Google Scholar]
  15. Rourke J. T., Rourke L. L. Rural family medicine training in Canada. Can Fam Physician. 1995 Jun;41:993–1000. [PMC free article] [PubMed] [Google Scholar]
  16. Stratton T. D., Geller J. M., Ludtke R. L., Fickenscher K. M. Effects of an expanded medical curriculum on the number of graduates practicing in a rural state. Acad Med. 1991 Feb;66(2):101–105. doi: 10.1097/00001888-199102000-00012. [DOI] [PubMed] [Google Scholar]
  17. Vanselow N. A. Medical education and the rural health crisis: a personal perspective from experiences in five states. Acad Med. 1990 Dec;65(12 Suppl):S27–S31. doi: 10.1097/00001888-199012000-00031. [DOI] [PubMed] [Google Scholar]
  18. Verby J. E., Newell J. P., Andresen S. A., Swentko W. M. Changing the medical school curriculum to improve patient access to primary care. JAMA. 1991 Jul 3;266(1):110–113. [PubMed] [Google Scholar]

Articles from CMAJ: Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES