Influence of undergraduate and postgraduate education on recruitment and retention of physicians in rural Alberta.

The composition of practising physicians in Alberta, with respect to medical school of graduation, changed between 1986 and 1991. The percentage of graduates of the 2 Alberta medical schools increased, and the percentage of graduates of foreign medical schools decreased. Graduates of the University of Calgary increased their percentage in family practice in urban and rural communities except in Edmonton, while graduates of the University of Alberta increased their percentage almost everywhere except in communities with populations of < 4,000. Although graduates of Alberta medical schools are locating their practices in rural regions, the smaller communities continue to depend on foreign medical graduates. Retention is a problem in communities of < 4,000, with greatest mobility demonstrated by non-Albertan Canadian graduates and foreign medical graduates while Alberta graduates demonstrate less mobility. Overall, 85% of new Alberta physicians have had undergraduate or postgraduate experience in Alberta or Canada. Those with no medical educational experiences in Canada are more likely to locate in small communities. Those with postgraduate training in Alberta or Canada are more likely to locate in urban centres. When both undergraduate and postgraduate influences are considered, Alberta graduates appear to locate in non-urban regions to a greater extent than other Canadian or foreign graduates. For family physicians and specialists, the city where postgraduate training was obtained has a profound influence on the choice of urban practice locations.