An Exploration of the Factors That Influence The Practice Choices of Family Medicine Residents
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Date
2011-12-20
Authors
Cervin, Catherine
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Abstract
Background and Objective: Comprehensiveness of practice is declining among family
physicians. This study was undertaken to discover what educational factors might influence
family medicine residents to undertake a more comprehensive practice.
Method: A survey was administered to first year residents at the beginning of their residency
asking them: their intentions to include 11 clinical and 4 non-clinical aspects of family medicine
in their future practice; the reasons for these choices and which province, type of community and
type of practice they envisioned for their future. They were also asked to rank the importance of
a series of factors influencing choice of community. A model of career (practice) choice was
developed from the literature, which infomned survey development and interpretation of the
survey results.
Results: The response rate was 80% or 36/45 residents. Many aspects of the proposed career
choice model were supported by the survey results. Influences on practice choice included:
resident attributes (personality, values, background), significant others, educational and life
experiences and aspects of future practice that were viewed as attractors or detractors. A
definition of comprehensive practice was created. Fifteen (47%) of the respondents intended to
undertake comprehensive practice and a further l4 (32%) were undecided (i.e. could still be
considering comprehensive practice). Twenty-seven (75%) intended to practice in the Maritimes
at some time and l2 (33%) were planning a rural practice. Employment for their spouse was the
most important factor in choosing a community for all respondents. The practice aspects were
sorted into two clinical groups: practice core and clinical challenges and a third non—clinical
group. Respondents chose many reasons to include the practice core and clinical challenges. At
the same time residents indicated that the clinical challenges could interfere with their family
lives, be too stressful and they feared not being well trained by the end of residency. Among the
non—clinical aspects of practice, teaching was viewed very positively and administration very
negatively.
Conclusion: Based on the survey results, the proposed career choice model and the literature,
recommendations for changes to family medicine residency programs to encourage graduates to
undertake a more comprehensive practice are suggested.
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Keywords
Family medicine -- Maritime Provinces , Physicians -- Vocational guidance -- Maritime Provinces. , Residents (Medicine) -- Maritime Provinces -- Attitudes