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Can Fam Physician
Vol. 55, No. 9, September 2009, pp.e29 - e34
Copyright © 2009 by The College of Family Physicians of Canada
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Le Programme d’enseignement décentralisé et la rétention des médecins omnipraticiens dans la région du Bas-Saint-Laurent au Québec

Ray Bustinza, MD
Agent de planification, de programmation et de recherche à l’Institut national de santé publique du Québec

Suzanne Gagnon, MD MA FCMF CCMF
Profes-seure agrégée au département de médecine familiale à l’Université Laval

Guillaume Burigusa, MD
Professionnel de recherche au département de médecine social et préventive à l’Université Laval

Correspondance Dr S. Gagnon, Direction de santé publique de Québec, 2400 d’Estimauville, Beauport, QC G1E 7G9; téléphone 418 666-7000, poste 286; télécopieur 418 666-2776; courielsuzanne.gagnon{at}ssss.gouv.qc.ca

OBJECTIVE To assess the effect of decentralized training programs, financial incentives, and physicians’ origins on whether general practitioners continue to practise in an area.

DESIGN Our data were obtained from the physician database maintained by the Bas-Saint-Laurent Regional Department of Health and Social Services and from responses to a mailed questionnaire completed by physicians in the study.

SETTING  The Lower St. Lawrence Region of Quebec.

PARTICIPANTS  General practitioners who practised in the area between 1985 and 2003.

METHOD We used the Cox proportional hazards model of survival analysis to ascertain which variables were related to retaining physicians in the area.

RESULTS The adjusted probability of physicians remaining in Bas-Saint-Laurent after being exposed to the area through rural rotations had an odds ratio of 2.12 (P = .15). The probability of remaining in the area climbed to an odds ratio of 4.5 (P < .01) for physicians originally from the Bas-Saint-Laurent region. Financial incentives appeared to make little difference to whether physicians were retained in the area.

CONCLUSION The most promising strategies for retaining rural general practitioners are recruiting candidates from rural areas and exposing medical students to rural practice through decentralized training.






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