National family medicine resident survey. Part 2: Future practice profile.

Future practice profile Most (80.7%) respondents expected to practise as family physicians. Many different services are provided by family physicians across the country, as was shown by the 1997-1998 National Family Physician Survey conducted by the College of Family Physicians of Canada (CFPC). These services include obstetric and prenatal care, emergency care, inpatient care, child health, care of the elderly, adult health, alternative medicine, preventive medicine and lifestyle counseling, and mental health services. Reported intent to deliver these services once in practice, as well as perceived adequacy of training in these areas, was compared with the proportion of family physicians providing such services in the community. A similar proportion of residents intend to offer the same procedures the existing work force offers. More residents, however, intend to provide prenatal or full obstetric care. Many (39.6%) said they intend to provide full obstetric care, and 76.4% said they would provide prenatal care only. There was some overlap in responses; however, proportions are higher than those observed among physicians already in practice. The 1998 Janus Project showed 33.1% of all respondents provide prenatal care only, while 19% provide full obstetric care. This disparity could signal a promising trend in provision of obstetric care among future family practitioners. Another trend noted among residents was the intent to specialize in a specific area of health care in family medicine. Some (23.1%, or 221) indicated intent to specialize; 79 intend to practise emergency medicine, 26 obstetrics and gynecology, 48 sports medicine, 11 women’s health, and seven anesthesia. Nearly a quarter (24.8%, or 236) wished to do an additional third year of training. Few (4%, or 39) intended to change disciplines. More than half (58%) the residents anticipated they would practise in communities of more than 40 000 residents. When defining rural practices as communities with populations less than 10000, only 13.4% stated intent to practise in these areas. This finding was consistent with the projected 12.8% of graduates likely to choose rural practice upon completion of family medicine residency. Less than half (44.4%) the respondents were unsure they were adequately trained for independent practice, and 11.9% thought they were definitely not ready for independent practice. Most respondents reported they were adequately trained in the various roles of family practitioners. Residents felt less adequately trained in adolescent health (57.4%), mental health and psychotherapy (58%), minor surgery (56.7%), palliative care (58.6%), addiction medicine (18.7%), aboriginal health (11.7%), and human immunodeficiency virus and acquired immune deficiency syndrome (21.3%). Anxiety about being inadequately trained for independent practice could originate in factors indirectly related to delivery of medical care. Residents are This month, we present Part 2 of the National Family Medicine Resident Survey. The College website at www.cfpc.ca/CFP/2001/cfpfeb01respage.htm (English) or www.cfpc.ca/cfp/2001/mfcpageresfeb01.htm (French) of fers a more detailed report, including tables comparing the results of our survey to the 1998 Janus Project survey of Canadian family physicians in practice.