Millions of Canadians don’t have a family doctor, and it’s no secret that it can be difficult or impossible to find one nearby who is accepting new patients. Without access to regular primary care, people often rely on walk-in clinics or emergency rooms, and research shows they are more likely to end up hospitalized.
Nowhere is this gap wider than in rural and Indigenous communities.
Western University President Alan Shepard and Dean of Medicine John Yoo argue that closing that gap will require us to rethink where we train the next generation of doctors.
Personal connections are powerful. Where a physician grew up and where they trained are the top two predictors of where they will choose to practice.
It makes sense that this is the case. The mentors and peers they trained with over the past several years live there. They already have friends and favourite places, and for those training near their hometowns, their families may be nearby. For many graduates, it feels like home.
So there may be no stronger way to convince family doctors to practice across a more distributed variety of regions than to start by training them in a more decentralized network of medical schools.
It’s a concept that spurred Western University to expand their school of medicine and dentistry onto the University of Windsor campus in 2008, with the support of the provincial Ministry of Health.
According to Shepard and Yoo, the impact on the Windsor-Essex region has been “transformative”.
Since opening, 80 percent of their graduates choosing to specialize in family medicine have stayed in Windsor-Essex. That has translated into a 35 percent increase in family doctors for the region, and a 31 percent increase in specialists.
Put another way, the program has added 100 doctors to the local region in just 15 years. Historically, Windsor-Essex had been one of the most underserved regions in the province.
Building on this early success, they are now creating a specialized family medicine stream for incoming students who want to practice rural medicine. They would be paired with postgraduate training at one of six academies serving various rural areas around Ontario.
As we work to train more doctors and build our healthcare capacity, how we build that capacity matters. Recruiting more family doctors to the places that need them most will be most persuasive if we let them train there. More distributed access to schools may even lower the friction for rural students to choose a career in medicine, creating a more diverse set of trainees who are more likely to represent the regions where they grew up.
Combined with incentives to help boost the number of graduates who choose family medicine, these programs will have real benefits for Canadian health.