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"Few choose Family Medicine"


Guest Ian Wong

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Guest Ian Wong

Here's an interesting article from today's Globe and Mail. I have also included a link to the CMAJ article "Career choice of new medical students at three Canadian universities: family medicine versus specialty medicine" which prompted this discussion.

 

The authors of the study surveyed first year medical students at three western Canadian med schools (U of A, U of C, and UBC), and asked them to rank their current specialty interests. These results were then compared against their demographic information, and other personality factors which were self-supplied by each respondant, and the data was analyzed for correlations. 89% of the surveys were returned.

 

In total, only 20% of students ranked Family Medicine as their #1 career choice. However, in total 50% of students did rank Family Medicine in their top 3 choices. Logistic regression revealed that students who identified family medicine as their first choice tended to be older, to be concerned about medical lifestyle and to have lived in smaller communities at the time of completing high school; they were also less likely to be hospital oriented. Moreover, students who chose family medicine were much more likely to demonstrate a societal orientation and to desire a varied scope of practice.

 

Ian

 

www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20040622/HDOCTORS22/TPHealth/

 

Few choose family medicine

 

By SHERYL UBELACKER

Canadian Press

Tuesday, June 22, 2004 - Page A17

 

Just one-fifth of students entering medical schools consider family practice as their first career choice -- a continuation of a more than decade-long trend that is eroding Canadians' access to primary-care practitioners across the country, a new study suggests.

 

The study, published today in the Canadian Medical Association Journal, surveyed more than 500 first-year medical students at three Western Canadian universities in 2001 and 2002, asking them to list their top-three career choices in medicine and to identify the reasons why.

 

Just 19.5 per cent of the 519 respondents rated family medicine as their No. 1 pick, while about half included it among their top-three choices, said the study's authors, noting that the proportion of students choosing family medicine as a residency specialty across Canada has been falling steadily.

 

In 1992, 44 per cent picked family medicine as a career path; by 2003, that proportion had dropped to 25 per cent -- the lowest ever -- leaving dozens of residency positions in hospitals for family practice unfilled this year, they said.

 

The study looked at five classes of students (two in 2001 and three in 2002) at the University of Calgary, the University of Alberta and the University of British Columbia, who were given a six-page questionnaire within the first two weeks of starting medical school.

 

Those who chose family medicine tended to be older than those who opted for other specialties, with an average age of 26 compared with 23.7, the study showed. Sex also seemed to play a role, with 23 per cent of women choosing family practice first compared to 16 per cent of men.

 

"Students who identified family medicine as their first choice were more likely to be older, to be concerned about medical lifestyle (hours of practice) and to have completed high school in smaller communities, and they were less likely to be hospital-oriented," wrote the authors, who are affiliated with the three universities.

 

The authors say their findings suggest serious implications for Canada's health-care system, which is based on an individual's access to a primary-care doctor.

 

Calvin Gutkin, head of the College of Family Physicians of Canada, said the health-care system has been built on the premise that half the country's doctors should be family physicians and the other half specialists.

 

"If we only produce 25 to 30 per cent of our graduates as family physicians, we're not going to be able to sustain that ratio," said Dr. Gutkin, who was not involved in the study.

 

He added that the widening shortfall would make access to primary-care doctors more difficult for Canadians.

 

In what will likely be considered a controversial solution, the study's authors suggest that medical schools could be required to alter their admission criteria to ensure that students are "selected, in part, because they want to be family physicians."

 

"I wouldn't favour that," Dr. Gutkin said. "I think that what we have to do is pick the students that we think would be the best doctors, and I think that they should be oriented when they're coming in." He said those who choose medicine as a career should realize that 45 to 50 per cent will be family doctors.

 

"They should know when they are making this career choice that our country needs half of them to be family doctors and we highly value them and the public highly values them, and they should be looking positively at the opportunity of becoming one of those family physicians."

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