Trajectories of physicians in Manitoba, Canada: the influence of contact points of rural-focused professional learning

Abstract

Background: The Manitoba Office of Rural and Northern Health (ORNH) provided a multi-year series of elective opportunities for undergraduate medical students to support rural/remote medical practice. The purpose of this study was to examine the career trajectories of Manitoba physicians in eight matched cohorts over the period 2004-2007 between: 1) those who experienced a required rural clinical block rotation only during their undergraduate medicine training in Manitoba (Med 1 and Med 3), and; 2) those who engaged in and completed additional elective programs referred to here as “contact points”. Methods: The study utilized a retrospective/longitudinal matched cohort design which included the common factor of a mandated rural clinical one-week rotation and the differentiating factors of experiences in elective programming offered by the ORNH (contact points). Results: Of the 344 Manitoba-trained physicians whose location of current practice could be determined, 74 are presently in rural/remote communities and 270 in urban settings. Those physicians who are now in rural/remote practice were significantly more likely (p ≤ 0.05) to have continued contact with ORNH in addition to the mandatory rural rotation alone. For practitioners now located in rural/remote settings, a mean of 0.903 contact points per learner with ORNH programs is observed. For those now in urban practice the mean number of contact points per learner was 0.233. Conclusion: We conclude that there is an association between rural-focused contact points and rural and remote practice in Manitoba. Targeted professional learning where physician recruitment and retention remains a continuing challenge is discussed.

Keywords

• distributed medical education
• rural medicine
• DME Canada