title: [Demography of psychiatrists and attractiveness factors: the example of Franche-Comté].
abstract: BACKGROUND
  In France, the challenges of replacing departing psychiatrists with a new generation are compounded by an increased demand for psychiatric care, which threatens the accessibility of health care, particularly in rural and semi-rural areas. The objective of this study was to describe the location of psychiatrists trained in the Franche-Comté region, and to analyze the factors associated with establishing their practice in the region, particularly in the most understaffed areas.
  
  
  METHODS
  We conducted a retrospective observational study, completed by a qualitative investigation with semi-directive interviews with psychiatrists and psychiatry residents.
  
  
  RESULTS
  Between 1994 and 2013, 160 students entered psychiatry residencies in Franche-Comté. As of October 2013, 87 of them were full-time psychiatry practitioners and, 57% of them worked in Franche-Comté. The region of practice was associated with their birthplace (p=0.03). The qualitative investigation showed that, apart from family- and quality of life-related factors (work opportunities for the spouse, family closeness, desire to live in urban areas), opportunities to work in a team, implementation of dynamic and innovative projects and values of the establishment were also considered when choosing a site of practice.
  
  
  CONCLUSIONS
  While the current increase in the number of psychiatry residents may respond, in the long run, to health care demographic problems in Franche-Comté, more specific interventions also seem necessary. Creation of time-shared jobs, facilitating the establishment of psychiatric practices within multidisciplinary clinics, task shifting and telemedicine may allow improvement of the psychiatric care offered in Franche-Comté.
authors.forename: Marie
authors.initials: M
authors.lastname: Barba-Vasseur
authors.forename: Maxime
authors.initials: M
authors.lastname: Desmarets
authors.forename: My Maï
authors.initials: MM
authors.lastname: Cao
authors.forename: François
authors.initials: F
authors.lastname: Baudier
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D006297:Health Services Accessibility; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D010820:Physicians / Q000600:supply & distribution*; D011365:Professional Practice Location; D011570:Psychiatry; D011788:Quality of Life; D012189:Retrospective Studies; D019035:Rural Health Services / Q000458:organization & administration / Q000600:supply & distribution; D013337:Students, Medical / Q000706:statistics & numerical data; D000078329:Workforce; D055815:Young Adult