A one-year multi-province study on the best ways to train medical students for rural and northern medical practice has been funded by the Canadian Institutes of Health (CIHR) Rural Strategic Initiative.

The investigators involved in the proposed project are connected to two research centres — the Newfoundland and Labrador Centre for Applied Health Research (NLCAHR) at Memorial University and the Centre for Rural and Northern Health Research (CRaNHR) at Laurentian University and Lakehead University. Members of the research team include principal applicant Dr. Raymond Pong, research director of CRaNHR at Laurentian University; Dr. Stephen Bornstein, founding director of the NLCAHR at Memorial; Dr. Michael Jong, director of the Northern Family Medicine Program of Memorial University (NorFaM) and the medical director of the Health Labrador Corporation; Dr. Vernon Curran, director of academic development and assistant professor of medical education with the Faculty of Medicine at Memorial; Dr. Geoffrey Tesson, Laurentian University’s vice-president academic and executive director of health initiatives; and Dr. Roger Strasser, who recently took up the position of founding dean with the new Northern Ontario Medical School.

“This one-year grant of $98,000 will allow us to examine various models that exist, including Memorial’s, for training doctors who will then practice in rural locations. We’ll look at what helps to retain them and try to see what common features and interesting innovations distinguish the most successful models,” said Dr. Bornstein.

Memorial’s medical education places strong emphasis on community and rural exposure throughout the entire education process, including a two-week rural community visit in the first year of studies and a four-week rural family medicine rotation in the third year. Family medicine residents do most of their two-year training in rural locations and Memorial’s NorFaM program offers 28 weeks of family medicine training in Labrador.

The CIHR-funded project will provide the first systematic review of the scientific literature on rural/northern medical education as well as a critical appraisal of the literature’s quality and applicability to the Canadian scene. “It will provide a detailed and data-based understanding of the nature of rural practice in Canada and of the country’s rural doctors and their distinguishing features,” said Dr. Bornstein.

“Rural/northern medical education is more than simply requiring medical trainees to acquire some rural/northern experience during their four years of education,” he explained. “The rural/northern medical workforce is the cumulative outcome of many decisions made by pre-medical school students, medical trainees, and practising physicians at various ‘choice-points’ in their educational and professional careers. To the extent that efforts could be made to shape such decisions in favour of rural/northern, the medical workforce in non-urban or underserviced areas would benefit.”

Dr. Bornstein anticipates that this study will provide a foundation for future research, policy development, and program planning. “In terms of guiding future research endeavours, we plan to use the findings and experiences from this study as a basis for developing a much broader program of research with rural/northern medical education and the rural physician workforce as its focus. Our work will also serve as a basis for furthering rural/northern health research. It will put in place a multi-centred and interdisciplinary team linking researchers with a variety of community and decision-maker partners in two key rural regions – northern Ontario and Newfoundland. We expect to collaborate again in future research endeavours.”