Physician supply

[Guest macdaddyeh]

Having examined the post underneath one about the CARMS match stats, I am intrigued that of the schools posted thus far, most are still matching to Family meds.

 

So, although my statistics knowledge is a little rusty, does this not run contrary to the so-called "declining trend" of med students choosing family medicine as a career choice?

 

So as not to appear uninformed, I do realize that broadly speaking the OVERALL number of people choosing family meds has likely declined, but the largest percentage of those making career decisions are still going into family meds (and the post below shows that clearly).

 

Moreover, given these stats, is it not safe to say that any apparent "shortage" is not necessarily understood in terms of "supply", but rather "distribution"? (again this latter point is a gross generalization, but an observation nonetheless).

[Guest moo]

The most popular specialty is still FP. About 25-30% matched into FP last year, if I'm not mistaken. So, even though FP is the most popular specialty, it is nowhere near the levels in the 90s, where 50% were matching into FP. There will continue to be a shortage of FPs because the Canadian health care system relies on FPs as the gatekeeper of the medical system. Without them, the system will falter.

[Guest aneliz]

Moo is correct...although 22% of the UWO class matched family, this is the LOWEST that it has ever been....in years gone by, as many as 50% + matched family...and the 'target' that I have heard is ~40% of the class should do family...

[Guest Ian Wong]

The thing is that the "ideal" ratio of family physicians to specialists is roughly 1:1. That means that each school should have roughly half of its graduates going into Family Medicine. This number has been declining on a frighteningly consistent basis over the last ten or so years, from the 50% it used to be ten years ago, to a miniscule 24% last year across Canada (that 24% is the number of applicants who ranked Family Medicine as their #1 career choice, so it doesn't include people who matched into Family Med who were using it as a backup specialty). It's unclear what the number will be this year, as the stats haven't been released yet.

 

Worse yet is that many of those who enter Family Medicine are unlikely to ever practice long-term in a rural community, where they are in the shortest supply.

 

One thing is for certain though, and that is that we are nowhere NEAR that ideal 50% ratio (with many med schools running in the 20-30% ratio), and that means that we still have a significant problem convincing medical student graduates to go into Family Medicine (especially given its attractive short 2 year residency compared with the 5-6 years for a specialty residency).

 

Ian

[Guest UWOMED2005]

As many UWO students matched to Family (both Rural and Urban) this year as matched to Internal Medicine alone.

 

That's scary (in terms of Family Physician supply).

[Guest Sarah371]

But less than 30% will actually end up setting up family practices.....lots of people are now doing the 3rd year in emerg. or anesthesia....as such most of them will practice full time in that capacity.....a more interesting stat would be of the family medicine R2s how many actually set up their own or joined a family practice?

[Guest marbledust]

Are you sure on that less than 30% number? From speaking to practicing family docs it appeared to me that the 3rd year positions in popular specialties like emerg and anast. (when will I learn to spell this word?) are not really that numerous compared to the number of people that actually complete the CCFP 2 year program - I think Calgary has about 4-5 positions available in the EM program in a given year compared to 30-40 family med residents in each year of the program (including rural). I think in ana. takes in 1-2 people each year.

 

That's not saying that many don't pursue the extra training. I also realize that there are many other options available than a traditional family practice - but that number just seems impossibly low considering the already existing shortage of family docs. If that is the true number then medicine in this country is in trouble.

 

Having said that, a few years ago my rural-area hometown had to recruit 3/6 practicing family docs in the community from South Africa. Of the three Canadian docs: one is a general surgeon with a family practice on the side, another is an internal medicine specialist who also spends most of her time doing family medicine - only one completed the CCFP residency (and she is considering leaving to join the military). Not good...

[Guest UWOMED2005]

From the CCFP-ER docs I've talked to, rumours of competitiveness are grossly exagerated.

 

Besides, if you don't get into a CCFP-ER program, you can always practice emerg at small community hospitals with just the CCFP, as do some doctors I know.

[Guest everyoneloveschem]

Another thing too, is that many FM graduates take a while to do locums, get some cash, before they settle down to open a practice. So while they are seeing patients, they are patients who technically already have doctors. I wonder what the time is from graduation to setting up their own practice?

[Guest sn0w0wl]

Do you guys think that if current/planned efforts to graduate more family doctors don't succeed, that the relative number of residency spots for specialist training would ever be decreased? Is there a precedent for this (eg. for specific specialities)? Unfortunately, history seems to suggest that, in some cases, physician supply forecasts haven't always been the most accurate...

[Guest UWOMED2005]

They ARE decreasing the relative number of specialist spots.

 

They've added lots of future graduating med students to the match (with the increases in class size and the new medical school,) and will probably increase Family Med spots with only a sprinkling of new specialty spots.

 

But they WILL NOT decrease the total number of specialty spots. . . there's a shortage in many specialties as well! (unless you want to work in Toronto)