Article Figures & Data
Figures
- Figure 1
Comprehensiveness of care provided by graduates of core 2-year family medicine programs in Ontario
- Figure 2
Comprehensiveness of care provided by graduates of third-year programs in emergency medicine in Ontario
- Figure 3
Comprehensiveness of care provided by graduates of third-year programs in anesthesia in Ontario
- Figure 4
Comprehensiveness of care provided by graduates of third-year programs in care of the elderly and palliative care in Ontario
- Figure 5
Comprehensiveness of care provided by graduates of third-year programs other than emergency medicine (all years) or anesthesia (2000–2001 to 2002–2003) from the Northeastern Ontario Family Medicine Program or the Northwestern Ontario Medical Program
- Figure 6
Comprehensiveness of care provided by graduates of all other third-year programs (excluding emergency medicine, anesthesia, care of the elderly or palliative care, and northern program graduates) in Ontario
- Figure 7
Proportion of total billings derived from work in the emergency department for graduates of core 2-year family medicine programs (seeing = 50 emergency medicine patients/y) in Ontario
- Figure 8
Proportion of total billings derived from work in the emergency department for third-year emergency medicine program graduates (seeing = 50 emergency medicine patients/y) in Ontario
- Figure 9
Proportion of total billings derived from work in the emergency department for third-year anesthesis program students (seeing = 50 emergency medicine patients/y)
- Figure 10
Proportion of total billings derived from work in the emergency department for third-year care of the elderly and palliative care program graduates (seeing = 50 emergency medicine patients/y) in Ontario
- Figure 11
Proportion of total billings derived from work in the emergency department for third-year program graduates from the Northeastern Ontario Family Medicine Program or the Northwestern Ontario Medical Program
- Figure 12
Proportion of total billings derived from work in the emergency department for graduates (seeing = 50 emergency medicine patients/y) of all other third-year programs (excluding emergency medicine, anesthesia, care of the elderly or palliative care, or northerm programs)
Tables
- Table 1
Practice patterns of Ontario family medicine graduates (academic years 1995–1996 to 2002–2003) working in Ontario during fiscal years 1996 to 2004: A) First 2 years of practice after residency; B) years 3 to 5 in practice; C) years 6 and more in practice.
A) PROPORTION OF PHYSICIAN YEARS TYPE OF TRAINING TOTAL NO. OF PHYSICIAN YEARS ANESTHESIA EM HOME VISITS HOSPITAL VISITS NURSING HOME VISITS OBSTETRICS OFFICE ONLY PALLIATIVE CARE RURAL PGY2 (all) 2051 0.7 35.7 32.4 48.8 10.1 11.1 13.8 0.8 15.7 EM 347 6.3* 98.6* 8.1* 68.3* 3.2* 1.7* 0.3* 0.0 13.8 Anesthesia 47 91.5* 72.3* 19.1 68.1† 10.6 6.4 0.0† 0.0 31.9† Elderly or palliative care 31 0.0 25.8 61.3‡ 71.0§ 41.9* 3.2 6.5 6.5‡ 19.4 NOFM or NOMP 53 20.8* 86.8* 17.0† 88.7* 18.9§ 39.6* 1.9§ 1.9 73.6* All others 224 10.7* 48.2† 24.1§ 63.8* 8.0 33.0* 12.9 0.9 12.9 B) PROPORTION OF PHYSICIAN YEARS TYPE OF TRAINING TOTAL NO. OF PHYSICIAN YEARS ANESTHESIA EM HOME VISITS HOSPITAL VISITS NURSING HOME VISITS OBSTETRICS OFFICE ONLY PALLIATIVE CARE RURAL PGY2 (all) 2422 0.8 30.8 33.4 47.4 9.8 8.6 14.6 2.0 14.6 EM 346 9.0* 95.7* 10.4* 67.1* 2.9* 1.4* 0.9* 0.3§ 11.9 Anesthesia 34 91.2* 55.9† 26.5 64.7§ 17.6 14.7 0.0§ 0.0 23.5 Elderly or palliative care 24 0.0 29.2 33.3|| 62.5 37.5* 0.0 16.7 4.2 16.7 NOFM or NOMP 48 16.7* 72.9* 20.8 79.2* 20.8§ 43.8* 14.6 0.0 64.6* All others 246 15.0* 44.7* 24.4† 62.6* 6.9 30.9* 9.4§ 2.0 10.6 C) PROPORTION OF PHYSICIAN YEARS TYPE OF TRAINING TOTAL NO. OF PHYSICIAN YEARS ANESTHESIA EM HOME VISITS HOSPITAL VISITS NURSING HOME VISITS OBSTETRICS OFFICE ONLY PALLIATIVE CARE RURAL PGY2 (all) 1389 1.0 23.2¶ 31.7 41.2¶ 10.2 6.4¶ 19.3# 3.4# 11.7** EM 159 15.7*†† 91.2*¶ 13.8*‡‡ 66.0* 3.8† 0.6† 0.6* 1.3‡‡ 8.2 Anesthesia Cell numbers too small to report Elderly or palliative care Cell numbers too small to report NOFM or NOMP 22 22.7* 86.4* 18.2 77.3‡ 18.2 45.5* 0.0§ 9.1 50.0*|| All others 168 14.3 44.0 22.0 51.8|| 4.2 25.0 13.7 1.8 10.7 -
EM emergency medicine, NOFM Northeastern Ontario Family Medicine Program, NOMP Northwestern Ontario Medical Program, PGY2 postgraduate year 2.
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Data from the Ontario Ministry of Health and Long-Term Care, April 2006.
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↵* P < .0001 compared with PGY2 graduates.
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↵† P < .01 compared with PGY2 graduates.
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↵‡ P < .001 compared with PGY2 graduates.
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↵§ P < .05 compared with PGY2 graduates.
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↵|| Decreased (P < .05) compared with years 1 and 2 in same program (years 3–5 for anesthesia and elderly or palliative care, years ≥ 6 for all others).
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↵¶ Decreased (P < .0001) compared with years 1 and 2 in same program.
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↵# Increased (P < .0001) compared with years 1 and 2 in same program.
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↵** Decreased (P < .001) compared with years 1 and 2 in same program.
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↵†† Increased (P < .001) compared with years 1 and 2 in same program.
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↵‡‡ Increased (P < .05) compared with years 1 and 2 in same program.
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- Table 2
Proportion of physician years worked by physicians providing some EM (emergency department billings accounting for 0%–20% of total billings), moderate EM (21%–50%), mostly EM (51%–80%), or almost all EM (81%–100%) care, by type of training: A) First 2 years of practice after residency; B) years 3 to 5 in practice; C) years 6 and more in practice.
A) PROPORTION OF TOTAL PHYSICIAN YEARS BY TYPE OF TRAINING (PROPORTION OF PHYSICIAN YEARS BY AMOUNT OF EM CARE) TYPE OF TRAINING* TOTAL NO. OF PHYSICIAN YEARS SOME EM N = 596 PHYSICIAN YEARS MODERATE EM N = 285 PHYSICIAN YEARS MOSTLY EM N = 327 PHYSICIAN YEARS ALMOST ALL EM N = 55 PHYSICIAN YEARS PGY2 (all) 733 63.4 (78.0) 26.1 (67.0) 8.9 (19.9) 1.6 (21.8) EM 342 7.6 (4.4) 16.1 (19.3) 64.3 (67.3) 12.0 (74.6) Anesthesia 34 76.5 (4.4) 23.5 (2.8) 0 (0) 0 (0) Elderly or palliative care Cell numbers too small to report NOFM or NOMP 46 76.1 (5.9) 17.4 (2.8) 6.5 (0.9) 0 (0) All others 108 40.7 (7.3) 21.3 (8.1) 36.1 (11.9) 1.9 (3.6) B) PROPORTION OF TOTAL PHYSICIAN YEARS BY TYPE OF TRAINING (PROPORTION OF PHYSICIAN YEARS BY AMOUNT OF EM CARE) TYPE OF TRAINING†‡§ TOTAL NO. OF PHYSICIAN YEARS SOME EM N = 508 PHYSICIAN YEARS MODERATE EM N = 274 PHYSICIAN YEARS MOSTLY EM N = 354 PHYSICIAN YEARS ALMOST ALL EM N = 104 PHYSICIAN YEARS PGY2 (all) 745 55.0 (80.7) 25.2 (68.6) 16.1 (33.9) 3.7 (26.0) EM 331 6.3 (4.1) 15.1 (18.2) 59.9 (55.9) 18.7 (59.6) Anesthesia 19 63.1 (2.4) 31.6 (2.2) 5.3 (0.3) 0 (0) Elderly or palliative care Cell numbers too small to report NOFM or NOMP 35 74.3 (5.1) 14.3 (1.8) 11.4 (1.1) 0 (0) All others 110 35.4 (7.7) 22.8 (9.1) 28.2 (8.8) 13.7 (14.4) C) PROPORTION OF TOTAL PHYSICIAN YEARS BY TYPE OF TRAINING (PROPORTION OF PHYSICIAN YEARS BY AMOUNT OF EM CARE) TYPE OF TRAINING‡||§ TOTAL NO. OF PHYSICIAN YEARS SOME EM N = 198 PHYSICIAN YEARS MODERATE EM N = 125 PHYSICIAN YEARS MOSTLY EM N = 176 PHYSICIAN YEARS ALMOST ALL EM N = 61 PHYSICIAN YEARS PGY2 (all) 322 45.6 (74.2) 25.7 (65.6) 22.1 (40.4) 6.6 (36.1) EM 145 9.6 (7.1) 15.9 (18.4) 56.6 (46.6) 17.9 (42.6) Anesthesia Cell numbers too small to report Elderly or palliative care Cell numbers too small to report NOFM or NOMP 19 68.4 (6.6) 0 (0) 26.3 (2.8) 5.3 (1.6) All others 74 32.4 (12.1) 27.0 (16.0) 24.3 (10.2) 16.3 (19.7) -
EM emergency medicine, NOFM Northeastern Ontario Family Medicine Program, NOMP Northwestern Ontario Medical Program, PGY2 postgraduate year 2.
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Data from the Ontario Ministry of Health and Long-Term Care, April 2006.
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↵* First 2 years of practice: Distribution by type of training significantly different between those completing EM training and all other groups (P < .0001) and between “All others” and all other groups (P < .0001), but not between PGY2 and anesthesia or NOFM/NOMP.
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↵† Years 3–5 in practice: Distribution by type of training significantly different between those completing EM training and all other groups (P < .0001) and between “All others” and all other groups (P < .0001 vs EM, PGY2, and NOFM/NOMP; P = .03 vs anesthesia), but not between PGY2 and anesthesia or NOFM/NOMP.
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↵‡ Distribution of amount of EM within a particular type of training program significantly different later in practice (years 3–5 for elderly or palliative care, years ≥ 6 for all others vs years 1 and 2) for PGY2 (P < .001), NOFM/NOMP (P = .02), and “All others” (P = .002), but not for EM or anesthesia.
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↵§ Over time the relative contribution of training programs other than EM to the “Mostly EM” (P < .0001) and “Almost all EM” (P = .003) categories increases significantly.
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↵|| Years ≥ 6 in practice: Distribution by type of training significantly different between those completing EM training and all other groups (P < .0001) and between “All others” and all other groups (P < .0001 vs EM, P = .03 vs PGY2, P = .01 vs NOFM/NOMP), but not between PGY2 and NOFM/NOMP.
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- Table 3
Proportion of physician years worked by physicians with quasi-specialty designations, by type of training program: A) First 2 years of practice after residency; B) years 3 to 5 in practice; C) years 6 and more in practice.
A) PROPORTION OF PHYSICIAN YEARS (95% CI) TYPE OF TRAINING TOTAL NO. OF PHYSICIAN YEARS HOSPITALIST SURGERY SURGICAL ASSISTANT ANESTHESIA PSYCHOTHERAPY PGY2 (all) 2051 1.1 (0.7–1.7) 0 0.15 (0.03–0.4) 0.1 (0.01–0.3) 0.8 (0.5–1.3) EM 347 0 0 0.3 (0.01–1.6) 0.6 (0.1–2.1) 0 Anesthesia 47 0 0 0 42.6 (28.3–57.8)* 0 Elderly or palliative care 31 25.8 (11.9–44.6)* 0 0 0 0 NOFM or NOMP 53 1.9 (0.5–10.1) 0 0 5.7 (1.2–15.7)† 0 All others 224 1.3 0.3–3.9) 0.9 (0.1–3.2) 0 2.2 (0.7–5.1)‡ 1.8 (0.5–4.5) B) PROPORTION OF PHYSICIAN YEARS (95% CI) TYPE OF TRAINING TOTAL NO. OF PHYSICIAN YEARS HOSPITALIST SURGERY SURGICAL ASSISTANT ANESTHESIA PSYCHOTHERAPY PGY2 (all) 2422 1.0 (0.1–1.5) 0.04 (0.001–0.2) 0.1 (0.01–0.3) 0.3 (0.1–0.6) 0.7 (0.4–1.1) EM 346 0 0 0.3 (0.01–1.6) 0.9 (0.2–2.5) 0 Anesthesia 34 0 0 0 41.2 (24.6–59.3)* 0 Elderly or palliative care 24 16.7 (4.7–37.4)* 0 0 0 0 NOFM or NOMP 48 0 0 0 4.2 (0.5–14.3)‡ 0 All others 246 1.2 (0.3–3.5) 1.6 (0.4–4.1) 0 6.1 (3.5–9.9)* 0.4 (0.01–2.2) C) PROPORTION OF PHYSICIAN YEARS (95% CI) TYPE OF TRAINING TOTAL NO. OF PHYSICIAN YEARS HOSPITALIST SURGERY SURGICAL ASSISTANT ANESTHESIA PSYCHOTHERAPY PGY2 (all) 1389 1.8 (1.2–2.6)§ 0 0.5 (0.2–1.0) 0.43 (0.2–0.9) 0.6 (0.2–1.1) EM 159 1.3 (0.2–4.4) 0 0 1.3 (0.2–4.4) 0 Anesthesia Cell numbers too small to report Elderly or palliative care Cell numbers too small to report NOFM or NOMP 22 0 0 0 0 0 All others 168 0 1.8 (0.4–5.1) 0 10.1 (6.0–15.7)* 0 -
CI confidence interval, EM emergency medicine, NOFM Northeastern Ontario Family Medicine Program, NOMP Northwestern Ontario Medical Program, PGY2 postgraduate year 2.
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Data from the Ontario Ministry of Health and Long-Term Care, April 2006.
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↵* Significantly greater than a hypothesized value of ≤ 1% (1-sided test of proportions), P < .0001.
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↵† Significantly greater than a hypothesized value of ≤ 1% (1-sided test of proportions), P < .001.
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↵‡ Significantly greater than a hypothesized value of ≤ 1% (1-sided test of proportions), P < .05.
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↵§ Significantly greater than a hypothesized value of ≤ 1% (1-sided test of proportions), P < .01.
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