Rourke James T B, Incitti Filomena, Rourke Leslie L, Kennard MaryAnn
Dept. of Family Medicine, University of Western Ontario, London.
Can J Rural Med. 2005 Fall;10(4):231-40.
The present study was designed to determine if there was a difference in rural background and rural medical education experience between practising rural physicians and practising urban physicians in Ontario.
A cross-sectional survey was mailed to 507 strictly defined rural family physicians and 505 urban family physicians practising in Ontario. The main outcome measures were population of the community while growing up, rural medical education and medical school attended.
Responses of 264 rural physicians were compared with 179 urban physician responses. The groups were comparable in years of practice. Rural physicians were significantly more likely to have grown up in a rural community (34.9% v. 14.6%), to have had clinical training in a rural setting during medical school (55.4% v. 35.2%) and to have had clinical training in a rural setting of 8 weeks or more during postgraduate residency training (38.8% v. 20.2%). During residency training, longer duration of rural placements (more than 6 months) was significantly associated with practice in a rural area (15.5% of rural physicians, 1.7% of urban physicians). After controlling for other predictors, each of the following were independent variables: growing up in a community of less than 10 000 people (odds ratio [OR] 3.31), having had some undergraduate rural clinical training (OR 2.46), having had postgraduate rural training of 8 weeks or more (OR 2.17), attending a Canadian medical school outside Ontario (OR 3.80) and being male (OR 2.57).
Practising rural physicians compared with urban physicians were significantly more likely to have come from a rural background, to have had an undergraduate rural medical education, to have had postgraduate rural training, to have graduated from a Canadian medical school outside Ontario, and to be male. Each of these had an independent effect on practice location.
本研究旨在确定安大略省执业乡村医生与执业城市医生在农村背景和农村医学教育经历方面是否存在差异。
向安大略省507名严格界定的乡村家庭医生和505名城市家庭医生邮寄了一份横断面调查问卷。主要观察指标为成长过程中所在社区的人口规模、农村医学教育情况以及就读的医学院校。
将264名乡村医生的回复与179名城市医生的回复进行了比较。两组在执业年限方面具有可比性。乡村医生在农村社区长大的可能性显著更高（34.9%对14.6%），在医学院期间在农村环境中接受临床培训的可能性显著更高（55.4%对35.2%），以及在研究生住院医师培训期间在农村环境中接受8周或更长时间临床培训的可能性显著更高（38.8%对20.2%）。在住院医师培训期间，农村实习时间较长（超过6个月）与在农村地区执业显著相关（15.5%的乡村医生，1.7%的城市医生）。在控制了其他预测因素后，以下各项均为独立变量：在人口少于10000人的社区长大（优势比[OR]3.31）、接受过一些本科农村临床培训（OR 2.46）、接受过8周或更长时间的研究生农村培训（OR 2.17）、在安大略省以外的加拿大医学院就读（OR 3.80）以及为男性（OR 2.57）。
与城市医生相比，执业乡村医生来自农村背景、接受过本科农村医学教育、接受过研究生农村培训、毕业于安大略省以外的加拿大医学院以及为男性的可能性显著更高。这些因素中的每一个都对执业地点有独立影响。
