Bruyère Research Institute, Ontario, Canada.
Health Sciences Library, University of Ottawa, Ontario, Canada.
Can Med Educ J. 2023 Apr 8;14(2):61-88. doi: 10.36834/cmej.74205. eCollection 2023 Apr.
Physician characteristics such as education and sociodemographic attributes are associated with particular practice patterns, such as practice in rural settings. Understanding the Canadian context of such associations can inform medical school recruitment and health workforce decision-making.
The objective of this scoping review was to report the nature and extent of the literature on associations between characteristics of physicians in Canada and physicians' practice patterns. Eligibility criteria: We included studies reporting associations between 1) the education or sociodemographic attributes of practicing physicians or residents in Canada and 2) practice patterns, including career choice, practice setting, and populations served.
We searched five electronic databases (MEDLINE (R) ALL, Embase, ERIC, Education Source and Scopus) for quantitative primary studies and reviewed reference lists of included studies for additional studies. Data were extracted using a standardized data charting form.
Our search yielded 80 studies. Sixty-two examined education, evenly divided between undergraduate and postgraduate. Fifty-eight examined physicians' attributes, most focusing on sex/gender. The majority of studies focused on the outcome of practice setting. We found no studies examining race/ethnicity or socioeconomic status.
Many studies in our review found positive associations between (i) rural training or rural background and rural practice setting and (ii) location of training or physicians' origin and practice in that location, consistent with previous literature. Associations for sex/gender were mixed, suggesting it may be a less useful target for workforce planning or recruitment aiming to address gaps in health care provision. More research is needed on the association of characteristics, particularly race/ethnicity and socioeconomic status, with career choice and populations served.
医生的教育和社会人口统计学特征等与其特定的实践模式相关,例如在农村地区的实践。了解这些关联在加拿大的情况可以为医学院招生和卫生人力资源决策提供信息。
本范围综述的目的是报告加拿大医生特征与医生实践模式之间关联的文献的性质和范围。纳入标准:我们纳入了报告加拿大在职医生或住院医生的教育或社会人口统计学特征与实践模式(包括职业选择、实践地点和服务人群)之间关联的研究。
我们在五个电子数据库(MEDLINE(R)ALL、Embase、ERIC、Education Source 和 Scopus)中搜索了定量的原始研究,并对纳入研究的参考文献列表进行了额外研究的审查。使用标准化的数据图表形式提取数据。
我们的搜索结果产生了 80 项研究。其中 62 项研究考察了教育,其中本科和研究生教育各占一半。58 项研究考察了医生的属性,其中大多数关注性别。大多数研究集中在实践地点的结果上。我们没有发现研究种族/民族或社会经济地位的研究。
我们综述中的许多研究发现(i)农村培训或农村背景与农村实践地点之间以及(ii)培训地点或医生原籍与该地点的实践之间存在正相关关系,这与先前的文献一致。性别/性别之间的关联是混合的,这表明对于旨在解决医疗服务提供差距的劳动力规划或招聘来说,它可能不是一个有用的目标。需要更多关于特征(特别是种族/民族和社会经济地位)与职业选择和服务人群之间关联的研究。