Russell MacDonald raises 2 important issues concerning rural practice not addressed in our study: maintenance of skills and scope of (rural) practice, and practice location.1 Perhaps, in the future, maintenance of skills and scope of practice could be evaluated using the results of the relevant and validated recertification process. A career tracking study of the graduates of the 2 family medicine training programs in northern Ontario suggested that approximately 50% to 70% of graduates begin practice in a rural or remote setting. In comparison, only 4–14% of all graduates of Ontario medical schools practice in a rural or remote location.2 Incomplete responses from graduates of family medicine training programs and a lack of standard definitions for terms such as “rural” and “retention” are among the problems encountered in researching an accurate answer to this important question.
William Eaton was disappointed that our description of the rural training programs was limited to 2 sentences contrasting urban and rural teaching settings. This information was sacrificed to stay within the prescribed word limits. We will put Eaton in touch with the directors of the 2 rural training programs in northern Ontario for a more informed description of the programs.
Signature
Robert J. McKendry
Professor of Medicine Faculty of Medicine University of Ottawa Ottawa, Ont.
References
- 1.McKendry RJ, Busing N, Dauphinee DW, Brailovsky CA, Boulais A-P. Does the site of postgraduate family medicine training predict performance on summative examinations? A comparison of urban and remote programs. CMAJ 2000;163(6):708-11. [PMC free article] [PubMed]
- 2.McKendry R. Physicians for Ontario: too many, too few for 2000 and beyond. Report to the Ontario Minstrity of Health and Long-Term Care. Toronto: The Ministry; 1999. p. 52