Abstract
BackgroundThe “rural pipeline” suggests that students educated in rural, or other underserviced areas, are more likely to establish practices in such locations. It is upon this concept that the Northern Ontario School of Medicine (NOSM) was founded. Our analysis answers the following question: Are physicians who were educated at NOSM more likely to practice in rural and northern Ontario compared with physicians who were educated at other Canadian medical schools?MethodsWe used data from the College of Physicians and Surgeons of Ontario. We compared practice locations of certified Ontario family physicians who had graduated from NOSM vs. other Canadian medical schools in 2009 or later. We categorized the physicians according to where they completed their undergraduate (UG) and postgraduate (PG) training, either at NOSM or elsewhere. We used logistic regression models to determine if the location of UG and PG training was associated with rural or northern Ontario practice location.ResultsOf the 535 physicians examined, 67 had completed UG and/or PG medical education at NOSM. Over two thirds of physicians with any NOSM education were practicing in northern areas and 25.4% were practicing in rural areas of Ontario compared with those having no NOSM education, with 4.3 and 10.3% in northern and rural areas, respectively. Physicians who graduated from NOSM-UG were more likely to have practices located in rural Ontario (OR = 2.57; p = 0.014) whereas NOSM-PG physicians were more likely to have practices in northern Ontario (OR = 57.88; p < 0.001).ConclusionsNOSM education was associated with an increased likelihood of practicing in rural (NOSM-UG) and northern (NOSM-PG) Ontario.
Highlights
The “rural pipeline” suggests that students educated in rural, or other underserviced areas, are more likely to establish practices in such locations
The population consisted of 535 family physicians (FPs), which included 67 (12.5%) who had some Northern Ontario School of Medicine (NOSM) education, either at both UG and PG (NOSM/NOSM), at UG only (NOSM/Other), or at PG only (Other/ NOSM) (Table 1)
FPs in the two categories with NOSM UG were significantly older than FPs in the two Other UG categories (ANOVA p < 0.001 and LSD post hoc tests)
Summary
The “rural pipeline” suggests that students educated in rural, or other underserviced areas, are more likely to establish practices in such locations It is upon this concept that the Northern Ontario School of Medicine (NOSM) was founded. Many attempts have been made to attract physicians to Wenghofer et al Human Resources for Health (2017) 15:16 rural and northern communities including offering financial incentives, “marketing” the rural and northern lifestyles to physicians, and enhancing medical practice support to reduce the demands placed on these providers [7]. These attempts have been largely unsuccessful, resulting in high turnover rates of physicians who return to the urban south once the financial incentives have run out or when the northern lifestyle has lost its appeal [8]
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