The Rural Road Map for Action: an examination of undergraduate medical education in Canada
DOI:
https://doi.org/10.36834/cmej.74649Abstract
Background: There is currently a maldistribution of physicians across Canada, with rural areas facing a greater physician shortage. The taskforce between the College of Family Physicians and the Society of Rural Physicians created a report, “The Rural Road Map for Action” (RRMA) to improve rural Canadians' health by training and retaining an increased number of rural family physicians. Using the RRMA as a framework, this paper aims to examine the extent to which medical schools in Canada are following the RRMA.
Methods: Researchers used cross-sectional survey and collected data from 12 of 17 medical school undergraduate Deans from across Canada using both closed and open ended survey questions. Results were analyzed using quantitative (frequencies) and qualitative methods (content analysis).
Results: Medical schools use different policies and procedures to recruit rural and Indigenous students. Although longitudinal integrated clerkships offer many benefits, few students have access to them. Leadership representation on decision-making education committees differed across medical schools pointing to a variation in the value of rural physicians’ perspectives.
Conclusion: This study illustrated that medical schools are making efforts that align with the RRMA. It is critical they continue to make strategic decisions embedded in educational policy and leadership to reinforce the importance of and influence of rural medical education to support workforce planning.
Metrics
References
Shah TI, Clark AF, Seabrook JA, Sibbald S, Gilliland JA. Geographic accessibility to primary care providers: comparing rural and urban areas in Southwestern Ontario. Can Geogr 2020;64(1):65–78. http://dx.doi.org/10.1111/cag.12557
Sibley LM, Weiner JP. An evaluation of access to health care services along the rural-urban continuum in Canada. BMC Health Serv Res. 2011;11. https://doi.org/10.1186/1472-6963-11-20
Rourke JTB. Postgraduate medical education for family practice in Canada. J Rural Heal. 2000;16(3):280–7. https://doi.org/10.1111/j.1748-0361.2000.tb00474.x
Canadian Institute for Health Information. Supply, distribution and migration of physicians in Canada 2015 – data tables. [Internet]. Ottawa, ON: Canadian Institute for Health Information; 2016. Available from https://secure.cihi.ca/estore/productSeries.htm?pc=PCC34 [Accessed on Sep 25, 2022].
Bosco C, Oandasan I. Review of family medicine within rural and remote Canada: education, practice, and policy. College of Family Physicians of Canada. 2016.
Ketcheson M. Desperate for help’ as nursing vacancies soar in northern Manitoba, union says in urgent plea. CBC News. 2021 Nov 30; https://www.cbc.ca/news/canada/manitoba/gillam-manitoba-nursing-shortage-1.6268039
World Health Organization. The world health report 2008: primary health care – now more than ever. 2008. https://apps.who.int/iris/handle/10665/43949
Starfield B, Shi L, Mackinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457–502. https://doi.org/10.1111/j.1468-0009.2005.00409.x
Verma P, Ford JA, Stuart A, Howe A, Everington S, Steel N. A systematic review of strategies to recruit and retain primary care doctors. BMC Health Serv Res. 2016;16(1). http://dx.doi.org/10.1186/s12913-016-1370-1
Advancing rural family medicine: the Canadian collaborative taskforce. The rural road map for action - directions [Internet]. 2017. www.cfpc.ca/arfm.%0Ahttp://www.cfpc.ca/uploadedFiles/Directories/Committees_List/Rural Road Map Directions ENG.pdf
Soles T, Wilson R, Oandasan IF. Family medicine education in rural communities as a health service intervention supporting recruitment and retention of physicians. Can Fam Physician. 2017;63:32–8.
Wilson CR, Rourke J, Oandasan IF, Bosco C. Progress made on access to rural health care in Canada. Can Fam Physician. 2020;66(1):31–6. https://doi.org/10.4103/CJRM.CJRM_84_19
Curran V, Rourke J. The role of medical education in the recruitment and retention of rural physicians. Med Teach. 2004;26(3):265–72. https://doi.org/10.1080/0142159042000192055
Pong R, Heng D. The link between rural medical education and rural medical practice location: literature review and synthesis. Sudbury, ON: Laurentian University. 2005. http://cranhr.com/pdf/Physician_Planning_Unit_report_Final.pdf
Rourke J, Wilson R, Oandasan IF, Bosco C, Rural road map implementation committee. A case study of Canada’s rural practice training 21st-Century journey. Soc Innov J. 2020; https://socialinnovationsjournal.com/index.php/sij/article/view/423/366
Parker K, Oandasan I. The Interprofessional collaborative organization map and preparedness assessment tool (IP-COMPASS). MedEdPORTAL. 2012. https://doi.org/10.15766/mep_2374-8265.9257
Canadian Institutes of Health Research, Canada NS and ERC of, Social Sciences and Humanities Research Council of Canada. Ethical conduct for research involving humans. 2018.
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88. https://doi.org/10.1177/1049732305276687
Hart LG, Larson EH, Lishner DM. Rural definitions for health policy and research. Am J Public Health. 2005;95(7):1149–55. https://doi.org/10.2105/AJPH.2004.042432
Oler Q. Access to Aboriginal doctors a struggle for Indigenous population. Global News. 2018; https://globalnews.ca/news/4769750/access-aboriginal-doctors-struggle-indigenous-population/
Truth and Reconciliation Commission of Canada. Honouring the truth, reconciling for the future: summary of the final report of the Truth and Reconciliation Commission of Canada. 2015.
Mian O, Hogenbirk JC, Marsh DC, Prowse O, Cain M, Warry W. Tracking Indigenous applicants through the admissions process of a socially accountable medical school. Acad Med. 2019;94(8):1211–9. https://doi.org/10.1097/ACM.0000000000002636
Royston PJ, Mathieson K, Leafman J, Ojan-Sheehan O. Medical student characteristics predictive of intent for rural practice. Rural Remote Health. 2012;12(3). https://doi.org/10.22605/RRH2107
Birden H, Barker J, Wilson I. Effectiveness of a rural longitudinal integrated clerkship in preparing medical students for internship. Med Teach. 2016;38(9):946–56. https://doi.org/10.3109/0142159X.2015.1114594
Walters L, Greenhill J, Richards J, et al. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Med Educ. 2012;46(11):1028–41. https://doi.org/10.1111/j.1365-2923.2012.04331.x
Hirsh D, Walters L, Poncelet AN. Better learning, better doctors, better delivery system: possibilities from a case study of longitudinal integrated clerkships. Med Teach. 2012;34(7):548–54. https://doi.org/10.3109/0142159X.2012.696745
Couper I, Worley PS, Strasser R. Rural longitudinal integrated clerkships: lessons from two programs on different continents. Rural Remote Health. 2011;11(1):1–11. https://doi.org/10.22605/RRH1665
Snow SC, Gong J, Adams JE. Faculty experience and engagement in a longitudinal integrated clerkship. Med Teach. 2017;39(5):527–34. https://doi.org/10.1080/0142159X.2017.1297528
Curran V, Rourke L, Snow P. A framework for enhancing continuing medical education for rural physicians: A summary of the literature. Med Teach. 2010;32(11). https://doi.org/10.3109/0142159X.2010.519065
LaDonna KA, Taylor T, Lingard L. Why open-ended survey questions are unlikely to support rigorous qualitative insights. Acad Med. 2018;93(3):347–9. https://doi.org/10.1097/ACM.0000000000002088
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Brenton Button, Megan Gao, John Dabous, Ivy Oandasan, Carmela Bosco, Erin Cameron
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Submission of an original manuscript to the Canadian Medical Education Journal will be taken to mean that it represents original work not previously published, that it is not being considered elsewhere for publication. If accepted for publication, it will be published online and it will not be published elsewhere in the same form, for commercial purposes, in any language, without the consent of the publisher.
Authors who publish in the Canadian Medical Education Journal agree to release their articles under the Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 Canada Licence. This licence allows anyone to copy and distribute the article for non-commercial purposes provided that appropriate attribution is given. For details of the rights an author grants users of their work, please see the licence summary and the full licence.
