Trajectories of physicians in Manitoba, Canada: the influence of contact points of rural-focused professional learning.

BACKGROUND

The Manitoba Office of Rural and Northern Health (ORNH) provided a multi-year series of elective opportunities for undergraduate medical students to support rural/remote medical practice. The purpose of this study was to examine the career trajectories of Manitoba physicians in eight matched cohorts over the period 2004-2007 between: 1) those who experienced a required rural clinical block rotation only during their undergraduate medicine training in Manitoba (Med 1 and Med 3), and; 2) those who engaged in and completed additional elective programs referred to here as "contact points".

METHODS

The study utilized a retrospective/longitudinal matched cohort design which included the common factor of a mandated rural clinical one-week rotation and the differentiating factors of experiences in elective programming offered by the ORNH (contact points).

RESULTS

Of the 344 Manitoba-trained physicians whose location of current practice could be determined, 74 are presently in rural/remote communities and 270 in urban settings. Those physicians who are now in rural/remote practice were significantly more likely () to have continued contact with ORNH in addition to the mandatory rural rotation alone. For practitioners now located in rural/remote settings, a mean of 0.903 contact points per learner with ORNH programs is observed. For those now in urban practice the mean number of contact points per learner was 0.233.

CONCLUSION

We conclude that there is an association between rural-focused contact points and rural and remote practice in Manitoba. Targeted professional learning where physician recruitment and retention remains a continuing challenge is discussed.