Associations between education policies and the geographic disposition of family physicians: a retrospective observational study of McMaster University education data.

التفاصيل البيبلوغرافية
العنوان:	Associations between education policies and the geographic disposition of family physicians: a retrospective observational study of McMaster University education data.
المؤلفون:	Grierson L; Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W, Hamilton, ON, L8P 1H6, Canada. griersle@mcmaster.ca.; McMaster Education Research, Innovation and Theory, Faculty of Health Sciences, McMaster University, Hamilton, Canada. griersle@mcmaster.ca.; McMaster Community and Rural Education Program, McMaster University, Hamilton, Canada. griersle@mcmaster.ca., Mercuri M; Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada., Elma A; Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W, Hamilton, ON, L8P 1H6, Canada., Mahmud M; Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W, Hamilton, ON, L8P 1H6, Canada., Bakker D; Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W, Hamilton, ON, L8P 1H6, Canada.; McMaster Community and Rural Education Program, McMaster University, Hamilton, Canada., Johnston N; Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada., Aggarwal M; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada., Agarwal G; Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W, Hamilton, ON, L8P 1H6, Canada.
المصدر:	Advances in health sciences education : theory and practice [Adv Health Sci Educ Theory Pract] 2024 May; Vol. 29 (2), pp. 641-657. Date of Electronic Publication: 2023 Aug 15.
نوع المنشور:	Journal Article; Observational Study
اللغة:	English
بيانات الدورية:	Publisher: Springer Netherlands Country of Publication: Netherlands NLM ID: 9612021 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-1677 (Electronic) Linking ISSN: 13824996 NLM ISO Abbreviation: Adv Health Sci Educ Theory Pract Subsets: MEDLINE
أسماء مطبوعة:	Publication: <2009- > : [Dordrecht] : Springer Netherlands Original Publication: Dordrecht ; Boston : Kluwer Academic Publishers, c1996-
مواضيع طبية MeSH:	Professional Practice Location/statistics & numerical data , Physicians, Family/statistics & numerical data, Humans ; Retrospective Studies ; Male ; Canada ; Female ; Medically Underserved Area ; Adult ; Internship and Residency/statistics & numerical data
مستخلص:	The maldistribution of family physicians challenges equitable primary care access in Canada. The Theory of Social Attachment suggests that preferential selection and distributed training interventions have potential in influencing physician disposition. However, evaluations of these approaches have focused predominantly on rural underservedness, with little research considering physician disposition in other underserved communities. Accordingly, this study investigated the association between the locations from which medical graduates apply to medical school, their undergraduate preclerkship, clerkship, residency experiences, and practice as indexed across an array of markers of underservedness. We built association models concerning the practice location of 347 family physicians who graduated from McMaster University's MD Program between 2010 and 2015. Postal code data of medical graduates' residence during secondary school, pre-clerkship, clerkship, residency and eventual practice locations were coded according to five Statistics Canada indices related to primary care underservedness: relative rurality, employment rate, proportion of visible minorities, proportion of Indigenous peoples, and neighbourhood socioeconomic status. Univariate and multivariable logistic regression models were then developed for each dependent variable (i.e., practice location expressed in terms of each index). Residency training locations were significantly associated with practice locations across all indices. The place of secondary school education also yielded significant relationships to practice location when indexed by employment rate and relative rurality. Education interventions that leverage residency training locations may be particularly influential in promoting family physician practice location. The findings are interpreted with respect to how investment in education policies can promote physician practice in underserved communities. (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
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فهرسة مساهمة:	Keywords: Health workforce; Medical School admissions; Physician maldistribution; Policy; Postgraduate medical education; Undergraduate medical education
تواريخ الأحداث:	Date Created: 20230815 Date Completed: 20240508 Latest Revision: 20240618
رمز التحديث:	20240619
DOI:	10.1007/s10459-023-10273-4
PMID:	37581856
قاعدة البيانات:	MEDLINE

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تدمد:	1573-1677
DOI:	10.1007/s10459-023-10273-4