title: The role of distributed education in recruitment and retention of family physicians.
abstract: BACKGROUND
  Distributed medical education (DME) programmes, in which training occurs in underserviced areas, have been established as a strategy to increase recruitment and retention of new physicians following graduation to these areas. Little is known about what makes physicians remain in the area in which they train.
  
  
  OBJECTIVE
  To explore the factors that contributed to family physician's decisions to practice in an underserviced area following graduation from a DME programme.
  
  
  METHODS
  Semistructured inperson interviews were conducted with 19 family physicians who graduated from a DME residency training programme. Programme records were reviewed to identify practice location of DME programme graduates.
  
  
  RESULTS
  Of the 32 graduates to date from this DME programme, 66% (N=21) and all of the interview participants established their practices in this region after completing their residency training. Five key themes were identified from the interview analysis as impacting physicians' decisions to establish their practice in an underserviced area following graduation: familial ties to the region, practice opportunities, positive clerkship and residency experiences, established relationships with specialists and services in the area and lifestyle opportunities afforded by the location.
  
  
  CONCLUSIONS
  This study suggests that DME programmes can be an effective strategy for equalising the distribution of family physicians and highlights the ways in which these programmes can facilitate recruitment and retention in underserviced areas, including being responsive to residents' personal preferences and objectives for learning and shaping their residency experiences to meet to these objectives.
authors: Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
authors: Joseph
authors: J
authors: Lee
authors: Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada.
authors: Andrzej
authors: A
authors: Walus
authors: Hennepin-Regions Psychiatry Residency Program, Minneapolis, Minnesota, USA.
authors: Rajeev
authors: R
authors: Billing
authors: Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada Specialized Geriatric Services, St. Joseph's Health Care London, London, Ontario, Canada Aging, Rehabilitation and Geriatric Care Research Centre of the Lawson Health Research Institute, London, Ontario, Canada.
authors: Loretta M
authors: LM
authors: Hillier
mesh_terms: D000328:Adult; D002170:Canada; D003657:Decision Making; D004503:Education, Medical, Graduate; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008507:Medically Underserved Area; D010549:Personal Satisfaction; D010821:Physicians, Family / Q000523:psychology / Q000706:statistics & numerical data; D011365:Professional Practice Location / Q000706:statistics & numerical data*; D015397:Program Evaluation; D017132:Workplace
keywords: MEDICAL EDUCATION & TRAINING; PRIMARY CARE