Regional and medical school variation in family medicine specialization choice: Canadian medical graduates from 2000 to 2023

Maya Gibb; Courtney Maskerine; Reiko Okamoto; Saredo Mohammed Bouraleh; Claire E. Kendall; Daniel T. Myran

doi:10.46747/cfp.7202115

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Table 1.

Characteristics of Canadian medical graduates from 2000 to 2023

CHARACTERISTICS	OVERALL, N (N=55,883)	FAMILY MEDICINE GRADUATES, n (%) n=22,849 (40.9%)	OTHER SPECIALTY GRADUATES, n (%) n=33,034 (59.2%)
Sex
• Female	31,425	14,302 (45.5)	17,123 (54.5)
• Male	24,458	8547 (34.9)	15,911 (65.1)
Age, y
• ≤26	31,914	12,104 (37.9)	19,810 (62.1)
• 27-28	12,259	5206 (42.5)	7053 (57.5)
• 29-30	5513	2335 (42.4)	3178 (57.6)
• ≥31	6197	3204 (51.7)	2993 (48.3)
School of graduation
• Memorial University of Newfoundland	1525	595 (39.0)	930 (61.0)
• Dalhousie University	2329	940 (40.4)	1389 (59.6)
• Laval University	4451	1992 (44.8)	2459 (55.2)
• University of Sherbrooke	3790	1814 (47.9)	1976 (52.1)
• University of Montréal	5578	2793 (50.1)	2785 (49.9)
• McGill University	3508	1112 (31.7)	2396 (68.3)
• University of Ottawa	3314	1429 (43.1)	1885 (56.9)
• Queen’s University	2235	711 (31.8)	1524 (68.2)
• University of Toronto	5188	1714 (33.0)	3474 (67.0)
• McMaster University	3979	1700 (42.7)	2279 (57.3)
• Western University	3371	1411 (41.9)	1960 (58.1)
• NOSM University	904	517 (57.2)	387 (42.8)
• University of Manitoba	2283	959 (42.0)	1324 (58.0)
• University of Saskatchewan	1796	669 (37.2)	1127 (62.8)
• University of Alberta	3398	1323 (38.9)	2075 (61.1)
• University of Calgary	3099	1121 (36.2)	1978 (63.8)
• University of British Columbia	5135	2049 (39.9)	3086 (60.1)
Region
• Central-Western	15,711	6121 (39.0)	9590 (61.0)
• Eastern	3854	1535 (39.8)	2319 (60.2)
• Ontario	18,991	7482 (39.4)	11,509 (60.6)
• Quebec	17,327	7711 (44.5)	9616 (55.5)
Graduation period
• 2000-2004	7610	2754 (36.2)	4856 (63.8)
• 2005-2009	10,072	3722 (37.0)	6350 (63.0)
• 2010-2014	12,876	5343 (41.5)	7533 (58.5)
• 2015-2019	14,036	6226 (44.4)	7810 (55.6)
• 2020-2023	11,289	4804 (42.6)	6485 (57.4)

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Table 2.

Likelihood of entering family medicine postgraduate training by medical school, sex, and age from 2000 to 2023

VARIABLE	IRR (95% CI)	P VALUE
Medical school
• McGill University	Reference	NA
• Memorial University of Newfoundland	1.17^* (1.06 to 1.30)	.002
• Dalhousie University	1.19^* (1.09 to 1.30)	<.001
• Laval University	1.40^* (1.30 to 1.50)	<.001
• University of Sherbrooke	1.56^* (1.44 to 1.68)	<.001
• University of Montréal	1.56^* (1.45 to 1.67)	<.001
• University of Ottawa	1.33^* (1.23 to 1.43)	<.001
• Queen’s University	0.99 (0.90 to 1.09)	.900
• University of Toronto	1.03 (0.95 to 1.11)	.500
• McMaster University	1.33^* (1.23 to 1.44)	<.001
• Western University	1.35^* (1.25 to 1.47)	<.001
• NOSM University	1.54^* (1.39 to 1.71)	<.001
• University of Manitoba	1.32^* (1.21 to 1.44)	<.001
• University of Saskatchewan	1.17^* (1.06 to 1.29)	.001
• University of Alberta	1.24^* (1.14 to 1.34)	<.001
• University of Calgary	1.06 (0.97 to 1.15)	.200
• University of British Columbia	1.18^* (1.09 to 1.27)	<.001
Sex
• Male	Reference	NA
• Female	1.30^* (1.26 to 1.33)	<.001
Age
• ≤26	Reference	NA
• 27-28	1.20^* (1.16 to 1.24)	<.001
• 29-30	1.21^* (1.15 to 1.26)	<.001
• ≥31	1.47^* (1.41 to 1.53)	<.001

CI—confidence interval, IRR—incidence rate ratio, NA—not applicable.
↵* Indicates statistical significance.

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Table 3.

Time trends in the proportion of Canadian medical graduates entering a family medicine postgraduate training program in Canada

UNIVERSITY OR REGION	OVERALL STUDY, N (%)	2000-2004,^* n (%)	2019-2023, n (%)	DIFFERENCE BETWEEN 2000-2004 AND 2019-2023, %		AVERAGE ANNUAL PERCENT CHANGE
UNIVERSITY OR REGION	OVERALL STUDY, N (%)	2000-2004,^* n (%)	2019-2023, n (%)	ABSOLUTE	RELATIVE	AVERAGE ANNUAL PERCENT CHANGE
Canada	22,849 (40.9)	2754^{^†} (36.2)	6082 (43.0)	6.8	18.8	0.36 (0.22 to 0.51)^{^‡}
Eastern	1535 (39.8)	238 (37.3)	399 (42.2)	4.9	13.2	0.07 (−0.17 to 0.30)
• Memorial University of Newfoundland	595 (39.0)	83 (33.7)	168 (42.8)	9.0	26.7	0.33 (−0.02 to 0.70)
• Dalhousie University	940 (40.4)	155 (39.4)	231 (41.8)	2.3	5.9	−0.14 (−0.51 to 0.23)
Quebec	7711 (44.5)	831 (37.6)	2180 (49.3)	11.7	31.2	0.52 (0.34 to 0.71)^{^‡}
• Laval University	1992 (44.8)	218 (37.5)	610 (51.2)	13.8	36.7	0.71 (0.38 to 1.03)^{^‡}
• University of Sherbrooke	1814 (47.9)	196 (42.4)	491 (51.2)	8.8	20.7	0.67 (0.22 to 1.13)^{^‡}
• University of Montréal	2793 (50.1)	312 (41.8)	757 (53.8)	12.0	28.6	0.64 (0.44 to 0.85)^{^‡}
• McGill University	1112 (31.7)	105 (24.9)	322 (37.2)	12.3	49.6	0.44 (0.20 to 0.69)^{^‡}
Ontario	7482 (39.4)	915^{^†} (34.5)	1878 (39.7)	5.2	15.2	0.33 (0.16 to 0.50)^{^‡}
• University of Ottawa	1429 (43.1)	169 (39.3)	335 (41.1)	1.8	4.6	0.33 (−0.11 to 0.77)
• Queen’s University	711 (31.8)	107 (28.6)	150 (30.1)	1.5	5.1	−0.06 (−0.43 to 0.30)
• University of Toronto	1714 (33.0)	252 (29.9)	424 (33.5)	3.6	12.1	0.16 (−0.08 to 0.39)
• McMaster University	1700 (42.7)	227 (43.3)	401 (39.9)	3.4	7.8	0.10 (−0.24 to 0.45)
• Western University	1411 (41.9)	160 (33.3)	401 (48.3)	14.9	44.8	0.63 (0.26 to 1.00)^{^‡}
• NOSM University	517 (57.2)	170^{^†} (62.0)	167 (53.7)	8.4	13.5	−1.01 (−1.65 to −0.37)^{^‡}
Central-Western	6121 (39.0)	770 (36.5)	1625 (40.1)	3.6	9.8	0.25 (0.01 to 0.49)^{^‡}
• University of Manitoba	959 (42.0)	128 (35.7)	260 (47.6)	12.0	33.6	0.70 (0.38 to 1.03)^{^‡}
• University of Saskatchewan	669 (37.3)	100 (37.0)	189 (38.7)	1.7	4.6	0.26 (−0.13 to 0.64)
• University of Alberta	1323 (38.9)	195 (37.6)	317 (38.9)	1.3	3.5	0.09 (−0.31 to 0.49)
• University of Calgary	1121 (36.2)	143 (37.3)	276 (35.6)	1.7	4.6	0.06 (−0.35 to 0.46)
• University of British Columbia	2049 (39.9)	204 (35.4)	583 (40.9)	5.4	15.4	0.41 (0.13 to 0.69)^{^‡}

↵* The beginning of the study period for NOSM University is from 2009-2013.
↵† NOSM University opened in 2005 and the first class graduated in 2009. The value for NOSM University presented here represents graduates from 2009-2013. The 2009-2013 value for NOSM University is not included in total for Canada or Ontario in years 2000-2004.
↵‡ Indicates statistical significance.