Canadian medical graduates are more likely to establish a practice in the region where they complete postgraduate training than in the province where they went to medical school. This is an interesting – but not necessarily positive – finding from an analysis of graduates of Canadian medical schools over the past 20 years. The analysis was conducted by Lynda Buske, director of workforce research for the Canadian Medical Association.
Probably the most positive news from the analysis, based on the 2013-14 annual census of post-MD trainees, is that over the past two decades Canada has generally been able to retain its medical school graduates. The census is published by the Canadian Post-MD Education Registry, with the analysis of where physicians have chosen to practice based on data from the CMA Masterfile.
The analysis shows that within two years of finishing postgraduate training, 12% of those completing that level in 1995 could not be located in Canada. This was at a time when Canada was also losing 600 to 700 practising physicians a year, primarily to the United States.
Buske notes that losses from the original cohort may be due to migration, early retirement, death or simply the fact that there is no valid Canadian address in the data system.
Up to 15 years after graduation, the analysis showed there was no further loss of this cohort. At the 15-year mark, the number of graduates remaining in Canada was about 88%.
The study shows that as the number of practising physicians heading south lessened after 1995, so did the movement of new physicians to the US. By the time of the 2000 practice entry cohort, 94% were in Canada two years after completing training. At 10 years after graduation in 2010 this figure was 91%.
By 2005, Canada was retaining 93% of its medical postgraduates two years after graduation. Similarly, 95% of the 2008 group had Canadian addresses after two years in practice.
Looking at where 2011 graduates were located two years after graduating, Buske found retention seemed to be higher based on where postgraduate training was done rather than where undergraduate training was completed.
“In other words, while a physician may have done… undergraduate medical education in their home province, their move to another region to complete postgraduate training is more likely to be where they set up practice,” she said.
This is particularly striking in Atlantic Canada, which retained 60% of the overall graduates of the Dalhousie and Memorial university medical schools but 77% of those who completed their postgraduate training in the Atlantic region.
Retention of new physicians within the region where they completed postgraduate training is highest among those who finished training in the west — 83% retention in that region.
The analysis concludes that “while retention of physicians who have recently completed postgraduate training can vary by region, on the whole it would appear that Canada has been largely successful in keeping the graduates of Canadian medical schools practising in this country.”