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Biomedical subjects

James T B Rourke

Publications and source records attributed to James T B Rourke.

6 recordsLinked to original sources
PubMed2006

National and provincial retention of medical graduates of Memorial University of Newfoundland.

BACKGROUND: Memorial University of Newfoundland (MUN) established its medical school in 1967 to meet the growing demand for physicians and alleviate the reliance on other Canadian and international medical schools for physicians. However, it is unclear how many of the graduates remained to practise in Canada and in Newfoundland and Labrador (NL). We conducted this study to identify the characteristics and predictors of MUN medical graduates working in Canada and NL after residency training. METHODS: We linked data from class lists, and alumni and postgraduate databases with data from the Southam Medical Database to determine 2004 practice locations for MUN graduates from 1973 to 1998. Multiple logistic regression analysis was used to identify predictors for working in Canada and in NL. RESULTS: Of the 1322 MUN graduates in our study, 1147 (86.8%) were working in Canada and 406 (30.7%) in NL in 2004. Predictors of physicians working in Canada included female sex (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.01-2.04), being from Canada (OR 3.71, 95% CI 1.15-2.21), graduating in the 1980s (OR 1.52, 95% CI 1.02-2.24) and 1990s (OR 2.01, 95% CI 1.31-3.09) and having done some or all residency training at MUN (OR 1.59, 95% CI 1.53-9.01). Predictors of physicians working in NL included having a rural background (OR 1.37, 95% CI 1.04-1.81), being from NL (OR 9.23, 95% CI 5.52-15.44) and having done some or all residency training at MUN (OR 5.28, 95% CI 3.80-7.34). INTERPRETATION: The MUN medical school has made a substantial contribution to the local physician supply, producing over half the physicians working in the province in 2004. Initiatives to increase national and provincial retention of medical graduates include attracting rural students to medical careers, increasing admission of local students and providing incentives for graduates to complete their residency training in the province.

Humans↗
PubMed2005

A rural and regional community multi-specialty residency training network developed by the University of Western Ontario.

BACKGROUND: Traditionally, specialty vocational/residency training is totally done in tertiary care university-hospital settings, making it very difficult for specialty residents to learn about the joys and challenges of rural and regional patient care. DESCRIPTION: The University of Western Ontario's Multi-Specialty Community Training Network (MSCTN) was developed to provide specialty residents with the opportunity to do part of their postgraduate vocational training in rural and regional practice settings. The network involves 10 medical school departments/divisions and 7 rural/regional communities. From 1997 to 2004, 174 residents have completed 287 months of rural/regional training. EVALUATION: Residents rated their overall learning experience at 6.41 on a 7-point scale. Nineteen of the 39 graduating residents have chosen to practice in rural and regional underserviced communities. CONCLUSION: Rural/regional specialty postgraduate vocational training rotations can provide excellent learning experiences. Preliminary results indicate that this exposure encourages many specialty residents to establish rural and regional practices.

Data Collection↗
PubMed2005

Relationship between practice location of Ontario family physicians and their rural background or amount of rural medical education experience.

INTRODUCTION: The present study was designed to determine if there was a difference in rural background and rural medical education experience between practising rural physicians and practising urban physicians in Ontario. METHOD: A cross-sectional survey was mailed to 507 strictly defined rural family physicians and 505 urban family physicians practising in Ontario. The main outcome measures were population of the community while growing up, rural medical education and medical school attended. RESULTS: Responses of 264 rural physicians were compared with 179 urban physician responses. The groups were comparable in years of practice. Rural physicians were significantly more likely to have grown up in a rural community (34.9% v. 14.6%), to have had clinical training in a rural setting during medical school (55.4% v. 35.2%) and to have had clinical training in a rural setting of 8 weeks or more during postgraduate residency training (38.8% v. 20.2%). During residency training, longer duration of rural placements (more than 6 months) was significantly associated with practice in a rural area (15.5% of rural physicians, 1.7% of urban physicians). After controlling for other predictors, each of the following were independent variables: growing up in a community of less than 10 000 people (odds ratio [OR] 3.31), having had some undergraduate rural clinical training (OR 2.46), having had postgraduate rural training of 8 weeks or more (OR 2.17), attending a Canadian medical school outside Ontario (OR 3.80) and being male (OR 2.57). CONCLUSION: Practising rural physicians compared with urban physicians were significantly more likely to have come from a rural background, to have had an undergraduate rural medical education, to have had postgraduate rural training, to have graduated from a Canadian medical school outside Ontario, and to be male. Each of these had an independent effect on practice location.

Adult↗
PubMed2003

Keeping family physicians in rural practice. Solutions favoured by rural physicians and family medicine residents.

OBJECTIVE: To determine how family medicine residents and practising rural physicians rate possible solutions for recruiting and sustaining physicians in rural practice. DESIGN: Cross-sectional mailed survey. SETTING: Rural family practices and family medicine residency programs in Ontario. PARTICIPANTS: Two hundred seventy-six physicians and 210 residents. MAIN OUTCOME MEASURES Ratings of proposed solutions on a 4-point scale from "very unimportant" to "very important". RESULTS: Rural family physicians rated funding for learner-driven continuing medical education (CME) and limiting on-call duty to 1 night in 5 as the most important education and practice solutions, respectively. Residents rated an alternate payment plan to include time off for attending and teaching CME and comprehensive payment plans with a guaranteed income for locums as the most important education and practice solutions, respectively. CONCLUSION: Residents and physicians rated solutions very similarly. A comprehensive package of the highest-rated solutions could help recruit and sustain physicians in rural practice because the solutions were developed by experts on rural practice and rated by family medicine residents and practising rural physicians.

Cross-Sectional Studies↗
PubMed2002

Building the new Northern Ontario Rural Medical School.

The new Northern Ontario Rural Medical School is to be developed to have a significant impact on the education, recruitment, and retention of physicians in rural and northern Ontario and Canada. It will be a collaborative partnership between Laurentian University, Sudbury and Lakehead University, Thunder Bay (1000 km apart), and will have a network of learning sites throughout Northern Ontario (almost 1,000,000 km2). The curriculum will be patient-centred, clinical problem-based, and systems-organised, with a significant health determinant focus, and Aboriginal health content and context. Small group learning will be used in a distributed learning network with advanced information technology support. The new Northern Ontario Rural Medical School will aim to graduate highly qualified physicians with state-of-the-art medical education, with enhanced knowledge, skills, and interest, in Aboriginal, rural, northern, and under serviced health care.

Curriculum↗