Mathews Maria, Ryan Dana, Samarasena Asoka
Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, NL.
Postgraduate Medical Education, Faculty of Medicine, Memorial University, St. John's, NL.
Can J Rural Med. 2017 Spring;22(2):54-61.
In a previous study, we found a decline in the proportion of Memorial University of Newfoundland (MUN) medical alumni practising in rural areas, particularly in Newfoundland and Labrador. The current study focused on the work location of recent graduates and examined the predictors of working in rural Canada and in rural Newfoundland and Labrador within the first 15 years following graduation.
We linked data from graduating class lists and the alumni and postgraduate databases with Scott's Medical Database to create a record of all graduates from 1973 to 2008, including their work location. We identified differences and significant predictors for each outcome and then described and compared the characteristics of 4 cohorts of graduating classes.
In their early career, 127/1113 (11.4%) MUN medical graduates were working in rural Canada, and 57 (5.1%) were working in rural Newfoundland and Labrador. Having a rural background and being a family physician were predictors of working in rural Canada, and having a rural background, doing at least part of the residency at MUN, being from Newfoundland and Labrador and being a family physician were predictors of working in rural Newfoundland and Labrador. Seventy-four (13.6%) and 33 (6.1%) of 1989-1998 graduates worked in rural Canada and rural Newfoundland and Labrador, respectively, compared to 53 (9.3%) and 24 (4.2%), respectively, of 1999-2008 graduates.
The proportion of MUN medical graduates who worked in rural communities early in their career decreased among recent cohorts. The results show the impact of changes in the characteristics of MUN medical graduates, who increasingly opt for specialist practice and residency training outside the province, and the important role of local postgraduate training.
在之前的一项研究中，我们发现纽芬兰纪念大学（MUN）医学院的校友在农村地区执业的比例有所下降，尤其是在纽芬兰和拉布拉多地区。当前的研究聚焦于近期毕业生的工作地点，并考察了毕业后头15年内，在加拿大农村地区以及纽芬兰和拉布拉多农村地区工作的预测因素。
我们将毕业班级名单、校友及研究生数据库中的数据与斯科特医学数据库进行关联，以创建1973年至2008年所有毕业生的记录，包括他们的工作地点。我们确定了每种结果的差异和显著预测因素，然后描述并比较了4个毕业班级队列的特征。
在职业生涯早期，1113名MUN医学院毕业生中有127名（11.4%）在加拿大农村地区工作，57名（5.1%）在纽芬兰和拉布拉多农村地区工作。拥有农村背景以及成为家庭医生是在加拿大农村地区工作的预测因素，而拥有农村背景、至少在MUN完成部分住院医师培训、来自纽芬兰和拉布拉多以及成为家庭医生是在纽芬兰和拉布拉多农村地区工作的预测因素。1989 - 至1998年毕业的学生中，分别有74名（13.6%）和33名（6.1%）在加拿大农村地区和纽芬兰和拉布拉多农村地区工作，相比之下，1999 - 至2008年毕业的学生中这一比例分别为53名（9.3%）和24名（4.2%）。
在近期的队列中，MUN医学院毕业生在职业生涯早期在农村社区工作的比例有所下降。结果显示了MUN医学院毕业生特征变化的影响，他们越来越多地选择在省外进行专科实践和住院医师培训，以及当地研究生培训的重要作用。
