A survey of rural medical education strategies throughout the medical education continuum in Canada.

In many countries the sustainability of rural health care systems is being challenged by a shortage of rural physicians and difficulties in recruiting and retaining physicians in rural practice. Research does suggest that specific medical education strategies can be introduced to enhance rural physician recruitment and retention initiatives. The purpose of this paper is to summarize the current strategies of Canadian rural medical education programs. A survey of all Canadian medical schools was undertaken to profile specific programs and activities at the undergraduate, postgraduate, and continuing medical education/continuing professional development (CME/CPD) levels. The majority of medical schools reported either mandatory or elective rural medicine placement/learning experiences during undergraduate medical education, as well as Rural Family Medicine streams or programs as components of postgraduate medical education. The majority of medical schools reported that they provide clinical traineeships to enhance clinical competencies in rural medicine as well as CME outreach programming, including the use of telehealth or distance learning technologies. Canadian medical schools all have substantial programs covering the full range of approaches found in the literature to help recruit and retain rural physicians. Not surprisingly, the most extensive programs are found in medical schools that have a specific rural mandate.

[Adapting medical education to meet the physician recruitment needs of rural and remote regions in Canada, the US and Australia]. / Les innovations de l'enseignement médical en vue du recr utement des médecins pour les régions rurales et éloignées au Canada, aux Etats-Unis et en Australie.

Australia, Canada and the United States have large land masses containing many sparsely populated regions. Each of these countries has experienced difficulty in meeting the physician recruitment needs of its rural and remote regions. This paper reports on a study of selected Australian, Canadian and American medical education programs designed to meet the health professional needs of rural and remote areas. The study is based on published material from the institutions studies, supplemented by a series of interviews with senior academic officials in the institutions involved. The paper focuses on a range of strategies, from recruitment and admissions policies, to exposure to rural clinical practice and modified curricula, each designed to produce medical graduates with a strong orientation to rural practice. The study highlights the important role played by special government funding targeted at rural medical education initiatives and discusses the challenges that such initiatives face.

Advances in rural medical education in three countries: Canada, the United States and Australia.

INTRODUCTION: This article documents a number of rural medical education initiatives in Australia, Canada and the United States. A typology is created reflecting the centrality the rural mandate and characterizing different features of each school's program. Interviews with school officials are drawn on to reflect the challenges these schools face. METHOD: Seven schools noted for their rural programs were selected from the three countries and interviews were conducted with senior officials. The interview data was supplemented by published material on the schools. RESULTS: The Typology: Three kinds of school are distinguished: Mixed Urban/Rural Schools (University of Washington, US, the University of British Columbia, Canada and Flinders University, Australia); DeFacto Rural Schools (University of New Mexico, US and Memorial University, Canada) and Stand Alone Rural Schools (James Cook University, Australia and the Northern Ontario School of Medicine, Canada). The Pipeline Approach: All of the schools adopted in varying degrees a pipeline approach to meeting the need for rural doctors focusing on: (a) early recruitment; (b) admissions; (c) locating clinical education in rural settings; (d) rural health focus to curriculum; and (e) support for rural practice. CONCLUSION: The analysis does not strongly favor one model over others, although the Stand-Alone Rural schools had more opportunities to adopt innovative curricula reflecting rural health issues and to foster positive views of rural practice. Government funding targeting rural health needs will remain critical in the development of all these programs.