Location of family medicine graduates' practices. What factors influence Albertans' choices?

OBJECTIVE To examine factors that influence family medicine graduates' choice of practice location.

DESIGN Cross-sectional, retrospective survey employing a self-administered, mailed questionnaire.

SETTING Family medicine residency programs at the University of Alberta (U of A) and the University of Calgary (U of C) in Alberta.

PARTICIPANTS Graduates (n = 702) who completed the family medicine residency program at U of A or U of C between 1985 and 1995.

MAIN OUTCOME MEASURES Current practice location; 23 factors influencing current practice location; physicians' sex; community lived in until 18 years of age.

RESULTS Response rate was 63% (442 graduates completed the questionnaire). Overall, the most influential factors in attracting graduates to their current practice locations were spousal influence, type of practice, and proximity to extended family. Type of practice, income, community effort to recruit, medical need in the area, and loan repayments had a substantial influence on family physicians' decisions to practise in rural areas. Male physicians ranked type of practice, whereas female physicians ranked spousal influence, as having the most influence on choice of practice location. Significantly more female than male physicians identified working hours, familiarity with the medical community or resources, and availability of support facilities and personnel as having a moderate or major influence on their decisions.

CONCLUSION Differences between rural and metropolitan residents and between sexes affect family medicine graduates' choices of practice location. These differences should be taken into account in recruitment strategies.