How underserviced rural communities approach physician recruitment: changes following the opening of a socially accountable medical school in northern Ontario

摘要

Introduction: The Northern Ontario School oí Medicine (NOSM) opened in 2005 with a social accountability mandate to address a long history ot physician shortages in northern Ontario. The objective ot this qualitative study was to understand the school's effect on recruitment oí lamily physicians into medically underserviced rural communities oí northern Ontario.Methods: We conducted a multiple case study ot 8 small rural communities in northern Ontario that were considered medically underserviced by the provincial ministry of health and had successfully recruited NOSM-trained physicians. We interviewed 10 people responsible for physician recruitment in these communities. Interview transcripts were analyzed by means of an inductive and iterative thematic method.Results: All 8 communities were NOSM medical education sites with populations ol 1600—16 000. Positive changes, linked to collaboration with NOSM, included achieving a lull complement of physicians in 5 communities with previous chronic shortages of 30%-50% of the physician supply, substantial reduction in recruitment expenditures, decreased reliance on locums and a shift from crisis management to long-term planning in recruitment activities. The magnitude ol positive changes varied across communities, with individual leadership and communities' active engagement being key factors in successful physician recruitment.Conclusion: Locating medical education sites in underserviced rural communities in northern Ontario and engaging these communities in training rural physicians showed great potential to improve the ability of small rural communities to recruit family physicians and alleviate physician shortages in the region.