A closer look at Ontario's northern and southern rural physician demographics.

INTRODUCTION In Ontario, Canada, there is a tendency to conflate rural and northern issues and although much of northern Ontario is rural, this is not exclusively the case. In this study, data were utilized from the licensing and regulatory body of physicians in Ontario to provide a more nuanced understanding of the distribution of the physician population across varying degrees of rurality in northern and southern regions. METHODS This is a report on the geographic distribution of the 22 688 GPs, and specialists certified by the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada who had their primary practice address in Ontario. Descriptive statistics were produced to determine differences in distribution of physician numbers, age, sex, international medical graduates (IMGs), and certification for physicians with primary practices coded as northern versus southern across varying degrees of rurality. RESULTS Differences were found in the Ontario physician population with regard to age, sex and IMG status between rural and urban areas and also from the northern versus southern perspective. There were more younger and male physicians in northern and rural areas. Female physicians were more frequently found in the south with decreasing proportions of females with increasing rurality. In the northern areas of the province, although the proportion of female physicians was lower than in the south, there was a slight increase in the proportion of female physicians as rurality increased. The largest proportions of IMGs were found in urban areas and the proportions of IMGs decreased with increasing rurality. However, northern rural regions did tend to have a higher proportion of IMG physicians than in corresponding rural areas in the south. CONCLUSIONS The results indicate that although there are similarities in physician demographics in rural and urban areas, there are clear differences between the rural north and the rural south. Likewise, although some patterns distinguish the south from the north, these areas are not homogeneous regions where the urban north is clearly different from the rural north.