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Regional differences in where and how family medicine residents intend to practise: a cross-sectional survey analysis.

ABSTRACT: BACKGROUND:Family medicine residents choose among a range of practice options as they enter the physician workforce. We describe the demographic and personal characteristics of Canadian family medicine residents and examine differences in the intentions of residents from Ontario, Quebec, Western Canada and Atlantic Canada at the completion of their training, in terms of practice comprehensiveness, organizational model, clinical domains, practice settings and populations served. METHODS:We analyzed national survey data collected by the College of Family Physicians of Canada and 16 university-based family medicine residency programs. We tabulated bivariable descriptive results and used logistic regression to estimate odds of practice intentions across regions, adjusting for family medicine resident characteristics. RESULTS:Of 1680 respondents (61.5% of 2731 family medicine residents invited to participate), 66.3% (n = 1095) reported it was somewhat or highly likely they would commit to providing comprehensive care to the same group of patients within their first 3 years of practice. This percentage varied from 40.3% in Atlantic Canada to 85.1% in Ontario. In addition, 31.5% (n = 522) reported it was somewhat or highly likely they would focus only on specific clinical areas. Most respondents reported it was somewhat or highly likely that they would practise in a group physician practice (93.8%) or interprofessional team-based practice (88.1%), and only 7.7% expected to have a solo practice. INTERPRETATION:Intentions for comprehensive and focused practice varied, but over 80% of family medicine residents indicated they intended to practise in a team-based model in all regions. Policy-makers and workforce planners should consider the impact of family medicine residents' intentions on policy objectives.

SUBMITTER: Lavergne MR

PROVIDER: S-EPMC6397032 | biostudies-literature | 2019 Jan-Mar

REPOSITORIES: biostudies-literature

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Regional differences in where and how family medicine residents intend to practise: a cross-sectional survey analysis.

Lavergne M Ruth MR Scott Ian I Mitra Goldis G Snadden David D Blackie Doug D Goldsmith Laurie J LJ Rudoler David D Hedden Lindsay L Grudniewicz Agnes A Ahuja Megan A MA Marshall Emily Gard EG

CMAJ open 20190101 1

<h4>Background</h4>Family medicine residents choose among a range of practice options as they enter the physician workforce. We describe the demographic and personal characteristics of Canadian family medicine residents and examine differences in the intentions of residents from Ontario, Quebec, Western Canada and Atlantic Canada at the completion of their training, in terms of practice comprehensiveness, organizational model, clinical domains, practice settings and populations served.<h4>Method ...[more]

PMID: 30819692

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Project description:BACKGROUND:Medical Assistance in Dying (MAID) in Canada came into effect in 2016 with the passing of Bill C-14. As patient interest and requests for MAID continue to evolve in Canada, it is important to understand the attitudes of future providers and the factors that may influence their participation. Attitudes towards physician hastened death (PHD) in general and the specific provision of MAID (e.g., causing death by lethal prescription or injection) are unknown among Canadian residents. This study examined residents' attitudes towards PHD and MAID, and identified factors (e.g., demographics, clinical exposure to death and dying) that may influence their decision to participate in PHD and provide MAID. METHODS:A cross-sectional survey was adapted from prior established surveys on MAID to reflect the Canadian setting. All Canadian family medicine programs were invited to participate. The survey was distributed between December 2016 and April 2017. Analysis of the results included descriptive statistics to characterize the survey participants and multivariable logistic regressions to identify factors that may influence residents' attitudes towards PHD and MAID. RESULTS:Overall, 247 residents from 6 family medicine training programs in Canada participated (response rate of 27%). While residents were most willing to participate in treatment withdrawal (52%), active participation in PHD (41%) and MAID by prescription of a lethal drug (31%) and lethal injection (24%) were less acceptable. Logistic regressions identified religion as a consistent and significant factor impacting residents' willingness to participate in PHD and MAID. Residents who were not strictly practicing a religion were more likely to be willing to participate in PHD (OR = 17.38, p < 0.001) and MAID (lethal drug OR = 10.55, p < 0.01, lethal injection OR = 8.54, p < 0.05). Increased clinical exposure to death and dying crudely correlated with increased willingness to participate in PHD and MAID, but when examined in multivariable models, only a few activities (e.g., declaring death, completing a death certificate) had a statistically significant association. Other significant factors included the residents' sex and location of training. CONCLUSIONS:Residents are hesitant to provide MAID themselves, with religious faith being a major factor impacting their decision.

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Dataset Information

Regional differences in where and how family medicine residents intend to practise: a cross-sectional survey analysis.

Publications

Regional differences in where and how family medicine residents intend to practise: a cross-sectional survey analysis.

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