Fulfilling a social mission: examining practice locations of residency graduates over two decades
DOI:
https://doi.org/10.36834/cmej.81307Abstract
Background: Medical schools play a critical role in shaping the physician workforce. Tracking the practice locations of medical graduates is essential for addressing healthcare disparities and workforce shortages in underserved regions. This study examines the geographic distribution of residency graduates from a Canadian francophone university, aligning their practice locations with the university’s social accountability mandate.
Methods: A cross-sectional descriptive study was conducted using data from the Canadian Post-M.D. Education Registry (CAPER) for 2,410 residency graduates (2000-2020) from 35 residency training programs. We analyzed practice locations at two-, five-, and 10-years post-graduation across medical specialties, sex, and geographic region, with a focus on Quebec’s administrative health regions.
Results: There were 2,410 graduates from 35 residency training programs. Family medicine accounted for 57.8% of all graduates and 42.2% were from all other specialties. Most graduates (77.7%) practiced in the province of Quebec, with concentrations in the regions of the Eastern Townships (19.4%), Montérégie (14.6%), and Saguenay-Lac-St-Jean (7.6%).
Conclusion: This study demonstrates the important regional impact of the university’s role in training family physicians and addressing healthcare needs in Quebec. The findings suggest the importance of tracking to inform evidence-based workforce planning and policy development. Medical schools can leverage such data to align training programs with societal health needs and enhance their contributions to regional healthcare systems.
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References
1. Boelen C, Woollard B. Social accountability and accreditation: a new frontier for educational institutions. Med Educ. 2009;43(9):887-94. https://doi.org/10.1111/j.1365-2923.2009.03413.x
2. Chen C, Petterson S, Phillips RL, et al. Toward graduate medical education (GME) accountability: measuring the outcomes of GME institutions. Acad Med. 2013;88(9):1267-80. https://doi.org/10.1097/ACM.0b013e31829a3ce9
3. Gibbs T, McLean M. Creating equal opportunities: the social accountability of medical education. Med Teach. 2011;33(8):620-5. https://doi.org/10.3109/0142159X.2011.558537
4. World Health Organization. Chapter 4: where do graduates go? Developing a graduate tracking system: the experience of THEnet. In: Strengthening the collection, analysis and use of health workforce data and information: A handbook. Geneva: WHO; 2022. p. 53-79.
5. Boelen C. Building a socially accountable health professions school: towards unity for health. Educ Health. 2004;17(2):223-31. https://doi.org/10.1080/13576280410001711049
6. Ellaway R, Van Roy K, Preston R, et al. Translating medical school social missions to student experiences. Med Educ. 2018;52(2):171-81. https://doi.org/10.1111/medu.13417
7. Strasser R, Lanphear J, McCready W, et al. Canada’s new medical school: The Northern Ontario School of Medicine: social accountability through distributed community engaged learning. Acad Med. 2009;84(10):1459-64. https://doi.org/10.1097/ACM.0b013e3181b6c5d7
8. Committee on Accreditation of Canadian Medical Schools (CACMS). CACMS standards and elements: standards for accreditation of medical education programs leading to the M.D. degree. Ottawa, ON: CACMS; 2021.
9. Canadian Residency Accreditation Consortium. 2024 Available from: http://www.canrac.ca/canrac/about-e [Accessed on January 30, 2025]
10. Reddy AT, Lazreg SA, Phillips RL Jr, et al. Toward defining and measuring social accountability in graduate medical education: a stakeholder study. J Grad Med Educ. 2013;5(3):439-45. https://doi.org/10.4300/JGME-D-12-00274.1
11. Canadian Institute for Health Information (CIHI). Changes in practice patterns of family physicians in Canada. 2024. Available from: https://www.cihi.ca/en/changes-in-practice-patterns-of-family-physicians-in-canada [Accessed on January 30, 2025]
12. Canadian Institute for Health Information. Scott’s Medical Database. Canadian Medical Directory. 2024.
13. Barber C, van der Vleuten C, Leppink J, Chahine S. Social accountability frameworks and their implications for medical education and program evaluation: a narrative review. Acad Med. 2020;95(12):1945-54. https://doi.org/10.1097/ACM.0000000000003731
14. Stufflebeam DL. The CIPP model for evaluation. In: Stufflebeam DL, Kellaghan T, editors. The international handbook of educational evaluation. Boston: Kluwer Academic Publishers; 2003. Chapter 2. https://doi.org/10.1007/978-94-010-0309-4_4
15. Boelen C. Consensus mondial sur la responsabilité sociale des facultés de médecine. Santé Publique. 2011;23:247-50. https://doi.org/10.3917/spub.113.0247
16. Ross SJ, Preston R, Lindemann IC, et al. The training for health equity network evaluation framework: a pilot study at five health professional schools. Educ Health. 2014;27(2):116-26. https://doi.org/10.4103/1357-6283.143727
17. Barber C, van der Vleuten C, Chahine S. Validity evidence and psychometric evaluation of a socially accountable health index for health professions schools. Adv Health Sci Educ. 2024;29(1):147-72. https://doi.org/10.1007/s10459-023-10248-5
18. Thelen AE, George BC, Burkhardt JC, et al. Improving graduate medical education by aggregating data across the medical education continuum. Acad Med. 2024;99(2):139-45. https://doi.org/10.1097/ACM.0000000000005313
19. Weinstein D, Thibault G. Illuminating graduate medical education outcomes in order to improve them. Acad Med. 2018;93(7):975-8. https://doi.org/10.1097/ACM.0000000000002244
20. Triola MM, Hawkins RE, Skochelak SE. The time is now: using graduates’ practice data to drive medical education reform. Acad Med. 2018;93(6):826-8. https://doi.org/10.1097/ACM.0000000000002176
21. World Health Organization. Towards unity for health : challenges and opportunities for partnership in health development : a working paper / Charles Boelen. World Health Organization. 2000. Available from https://apps.who.int/iris/handle/10665/66566 [Accessed on January 30, 2025]
22. Government of Quebec. Ministère de la Santé et des Services sociaux. 2024. https://www.msss.gouv.qc.ca/professionnels/medecine-au-quebec/ [Accessed on January 30, 2025]
23. Statistics Canada. Health regions: boundaries and correspondence with census geography. Geographic files and documentations. 2020. p. 82-402-X. Available from: https://www150.statcan.gc.ca/n1/en/catalogue/82-402-X [Accessed on January 30, 2025]
24. Government of Quebec. Integrated health and social services centres (CISSS) and integrated university health and social services centres (CIUSSS). 2024; Available from https://www.quebec.ca/en/health/health-system-and-services/service-organization/cisss-and-ciusss [Accessed on January 30, 2025]
25. Integrated university health and social services network (RUISSS) of the University of Sherbrooke. 2024. Available from https://ruisss.ca [Accessed on January 30, 2025]
26. Grimes DA, Schulz KF. Descriptive studies: what they can and cannot do. Lancet. 2002;359(9301), 145-149. https://doi.org/10.1016/S0140-6736(02)07373-7
27. Kesmodel U.S. Cross-sectional studies - what are they good for? Acta obstetricia et gynecologica Scandinavica. 2018;97(4), 388-393. https://doi.org/10.1111/aogs.13331
28. Canadian Post M.D. Education Registry (CAPER). 2024. Available from https://caper.ca [Accessed on January 30, 2025]
29. Statistics Canada. Statistical Area Classification (SAC). 2024. Available from https://www.statcan.gc.ca/en/start [Accessed on January 30, 2025]
30. Boelen C, Pearson D, Kaufman A., et al. Producing a socially accountable medical school: AMEE Guide No. 109. Med Teach. 2016;38(11), 1078-1091. https://doi.org/10.1080/0142159X.2016.1219029
31. Health Canada. Caring for Canadians: Canada’s future health workforce - The Canadian health workforce education, training and distribution study. Government of Canada. 2025. Available from https://publications.gc.ca/collections/collection_2025/sc-hc/H22-4-42-2025-eng.pdf [Accessed on April 30, 2025]
32. Batra S, Orban J, Guterbock TM, Butler LA, Mullan F. Social mission metrics: developing a survey to guide health professions schools. Acad Med. 2020;95(12), 1811-1816. https://doi.org/10.1097/ACM.0000000000003324
33. Cumyn A, Larouche C, Dubé T et al. Use of Boelen’s conceptual model to develop a synopsis of the evolution of social accountability at a Canadian medical school. Can Med Educ J. 2025;16(1), 26-37. https://doi.org/10.36834/cmej.77994
34. Dubé TV, Cumyn, A, Fourati M, et al. Pathways, journeys and experiences: Integrating curricular activities related to social accountability within an undergraduate medical curriculum. Med Educ. 2024;58(5), 556-565. https://doi.org/10.1111/medu.15260
35. Canadian Institute for Health Information. A profile of physicians in Canada. 2024. Available from https://www.cihi.ca/en/a-profile-of-physicians-in-canada. [Accessed on January 30, 2025]
36. Bates J, Grand'Maison P, Banner SR, Lovato CY, Eva KW. Exploring the contributions of combined model regional medical education campuses to the physician workforce. Acad Med. 2021;96(3), 409-415. https://doi.org/10.1097/ACM.0000000000003560
37. Kulasegaram KM, Grierson L, Barber C, et al. Data sharing and big data in health professions education: Ottawa consensus statement and recommendations for scholarship. Med Teach. 2024;46(4), 471-485. https://doi.org/10.1080/0142159X.2023.2298762
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Copyright (c) 2025 Tim Dubé, Matthieu Touchette, Linda Bergeron, Mariem Fourati, Cassandra Barber, Christina St-Onge
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