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James Goertzen

Publications and source records attributed to James Goertzen.

6 recordsLinked to original sources
PubMed2006

Duration of rural training during residency: rural family physicians prefer 6 months.

OBJECTIVE: To determine whether rural family physicians thought they had received enough months of rural exposure during family medicine residency, how many months of rural exposure those who were satisfied with their training had had, and how many months of rural exposure those who were not satisfied with their training wanted. DESIGN: Mailed survey. SETTING: Rural Canada. PARTICIPANTS: Rural family physicians who had graduated between 1991 and 2000 from a Canadian medical school. MAIN OUTCOME MEASURES: Respondents' opinions about whether their exposure to rural medicine during training had been adequate. RESULTS: Response rate was 59% (382/651). After excluding physicians who had not had Canadian family medicine residency training, 348 physicians remained, and of those, 58% thought they had had adequate rural exposure during residency. Median duration of rural training among those who thought they had had enough rural exposure was 6 months; median duration of rural exposure among those who thought they had not had enough was 2 months. Median duration of rural exposure desired by those who thought they had not had enough rural training was 6 months. Some physicians wanted much more than 6 months of rural training; for example, one quarter of those satisfied with their rural training had had 10 or more months of rural rotations. Fewer than 1% of respondents thought they had received too much rural training. There was no significant difference in number of months of rural training preferred by men and women (P = .94). One third of respondents had graduated from rural-focused family practice residency programs. Rural program graduates were more likely than non-rural program graduates to report that the duration of their rural training was adequate (84% vs 46%, P < .0001) and to report more mean months of rural exposure (8.9 vs 3.4; P < .0001). CONCLUSION: Typical rural family physicians prefer to have 6 months of rural exposure during residency. This finding is consistent with the recommendation of a College of Family Physicians of Canada committee that rural family medicine training programs offer at least 6 months of rural rotations. Almost half of rural family physicians wished they had had more rural training. Both rural-focused and non-rural-focused programs should consider providing opportunities for pursuing elective rotations in rural areas in addition to mandatory rotations if they want to respond to these preferences for training.

Adult↗
PubMed2005

Factors influencing family physicians to enter rural practice: does rural or urban background make a difference?

OBJECTIVE: To examine where rural physicians grew up, when during their training they became interested in rural medicine, factors influencing their decision to practise rural medicine, and differences in these measures according to rural or urban upbringing. DESIGN: Mailed survey. SETTING: Rural Canada. PARTICIPANTS: Rural family physicians who graduated between 1991 and 2000 from a Canadian medical school. MAIN OUTCOME MEASURES: Backgrounds of recently graduated rural physicians, when physicians first became interested in rural practice during training, and most influential factors in decisions to practise rural medicine. RESULTS: Response rate was 59% (382/651). About 33% of rural physicians grew up in communities of less than 10 000 people, 44% in cities of 10 000 to 499 999 people, and 23% in cities of more than 500 000 people. Physicians raised in rural areas were more likely than those raised in urban areas to have some interest in rural family practice at the start and end of medical school (90% vs 67% at the start, 98% vs 91% at the end, respectively, P < .0001). Physicians raised in urban areas were more likely to state that rural medical training was the most influential factor in their choice of rural practice (19% vs 9%, P = .015). Other factors cited as influential were the challenge of rural practice (24% for both urban and rural upbringing), rural lifestyle (14% for urban and 18% for rural upbringing) and, for physicians raised in rural areas, having grown up or spent time in a rural area (27% for rural and 4.1% for urban upbringing, P < .001). Financial incentives were least frequently cited as the most influential factor (7.5% for urban and 4.9% for rural upbringing, P = .35). CONCLUSION: Although other studies have suggested that physicians with a rural upbringing are more likely to practise rural medicine and policy makers might still wish to target students raised in rural areas as candidates for rural medicine, this study shows that physicians raised in urban areas remain the main source of human resources for rural communities. They account for two thirds of new physicians in rural areas. Education in rural medicine during medical training has a stronger influence on physicians raised in urban areas than on physicians raised in rural areas. Undergraduate and postgraduate training periods, therefore, offer an important opportunity for recruiting physicians raised in urban areas to rural practice.

Adult↗