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纽芬兰和拉布拉多省医生招聘障碍的混合方法研究结果。

Results of a mixed-methods study on barriers to physician recruitment in Newfoundland and Labrador.

机构信息

Discipline of Family Medicine, Memorial University of Newfoundland, St. John's, Canada.

Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada.

出版信息

Can J Rural Med. 2023 Jul-Sep;28(3):116-122. doi: 10.4103/cjrm.cjrm_56_22.

Abstract

BACKGROUND

Like many rural and remote parts of Canada, the province of Newfoundland and Labrador (NL) struggles to maintain a skilled healthcare workforce. As many as 20% of people in the province are thought to be without a primary care physician. The purpose of this study was to determine the barriers recent Memorial University of Newfoundland medical alumni have faced in establishing medical practice in NL.

METHODS

An online survey followed by question-standardised focus group sessions.

RESULTS

Two hundred and ninety-one physicians who graduated from Memorial University of Newfoundland medical school between the years of 2003 and 2018 completed the survey. Nearly 80% of respondents recalled that NL was their preferred practice location at some point during training: 79.4% (n = 231) at the beginning of medical school and 77.7% (n = 226) at the beginning of residency training. However, at the time of the survey, only 160 (55.0%) respondents were working in NL. Respondents reported significant cultural and systemic barriers in trying to work in NL, including ineffective recruitment offices, lack of transparency in communication with health authorities, inequitable distribution of resources and workloads, lack of appropriate resources to support new positions, and return-of-service agreements that are not honoured or followed-up.

CONCLUSION

Our study outlines a number of ways in which recruitment and retention could be improved, ultimately improving provincial health care and helping to fulfil the mandate of the medical school.

摘要

背景

与加拿大许多农村和偏远地区一样,纽芬兰和拉布拉多省(NL)难以维持熟练的医疗保健劳动力队伍。据估计,该省多达 20%的人没有初级保健医生。本研究旨在确定最近毕业于纽芬兰纪念大学医学院的校友在 NL 建立医疗实践所面临的障碍。

方法

在线调查后进行问题标准化焦点小组会议。

结果

2003 年至 2018 年期间从纽芬兰纪念大学医学院毕业的 291 名医生完成了这项调查。近 80%的受访者回忆说,NL 是他们在培训期间某个时候首选的执业地点:79.4%(n=231)在医学生开始时,77.7%(n=226)在住院医师培训开始时。然而,在调查时,只有 160 名(55.0%)受访者在 NL 工作。受访者报告说,在 NL 工作面临重大的文化和系统障碍,包括招聘办公室效率低下、与卫生当局沟通缺乏透明度、资源和工作量分配不公平、缺乏支持新职位的适当资源,以及服务协议未得到履行或未得到跟进。

结论

我们的研究概述了一些可以改进招聘和留用的方法,最终将改善省级医疗保健,并有助于履行医学院的任务。

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