Promoting Family Medicine
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By: Dr. Kathleen Horrey
Undergraduate Medical Education Program Director
Department of Family Medicine
The rate of students selecting family medicine as a career has been declining over the past several years. Medical schools have a social accountability mandate to ensure patient populations are matched with the appropriate mix of providers to support a sustainable health care system. In order to serve our communities and meet this health care system need, 40-50% of medical students will be needed to select family medicine as their chosen career. 1
There are numerous factors that influence career choice. Family medicine is perceived as being less intellectually stimulating, repetitive, less prestigious, and more poorly remunerated. 2 Interest in a career in family medicine also decreases over the course of medical education, implicating contributory factors during training. 3
In response to the declining rates of students selecting family medicine at Dalhousie, Dean David Anderson initiated a project charter to increase the profile of family medicine within the school. This project charter outlines milestones and deliverables with the goal of increasing interest in family medicine. These outcomes are intended to ensure that the speciality of family medicine is better understood by all within the medical school and seen as a fulfilling and challenging career.
During the first two years of training at Dalhousie Medical School, there have been rare opportunities for medical students to encounter family physicians, particularly at the Nova Scotia campus. Students comment that they just don’t ‘see’ family physicians in their training.
With the goal of enhancing meaningful exposures to the specialty of family medicine, this past academic year approximately 50% of the class was paired with a family physician for shadow-a-physician day (which occurs within the first few days of their training). A mandatory longitudinal Family Medicine Experience was introduced, pairing all Med 1 students with a family physician for six half-days. New funding has permitted the Nova Scotia campus to expand the number of family physician tutors facilitating the Med 1 and 2 tutorial groups, modelling the New Brunswick campus approach. The tutorial cases have been reviewed to address negative portrayals of family physicians.
As new leadership positions become available, the Department of Family Medicine works to ensure that family physicians consider applying to these positions. This expands the number of family physicians influencing the curriculum and also demonstrates to students the important role family physicians play within the medical school.
Critical partnerships with external stakeholders (professional associations, health authorities, communities and family physicians themselves) across the Maritimes are being developed and nurtured to build joint strategies around a shared vision of increasing family physician recruitment.
As the life of the project charter continues into its second year, there will be additional endeavors seeking to enhance interest in family medicine. While it will take a few years to see the outcomes of these changes, the establishment of the project charter has enabled the medical school to make focused changes to support this common goal – to increase the number of students choosing a career in family medicine. And in accomplishing this, we will better serve our communities.
- Family Medicine In Canada–Vision For The Future https://www.cfpc.ca/uploadedFiles/Resources/Resource_Items/FAMILY_MEDICINE_IN_CANADA_English.pdf
- Selva Olid, A., Zurro, A.M., Villa, J.J. et al. Medical students’ perceptions and attitudes about family practice: a qualitative research synthesis. BMC Med Educ 12, 81 (2012).
- Bethune C, Hansen PA, Deacon D, Hurley K, Kirby A, Godwin M. Family medicine as a career option: how students’ attitudes changed during medical school. Can Fam Physician. 2007;53(5):881-885, 880.
Questions for further reflection on this topic:
- How do the measures to increase the number of family physicians reflect an ethical commitment of the health care system to provide excellent care for all Nova Scotians?
- How might having a family physician help prevent ethics issues from arising (for example, around end of life decision making)?
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Plain Language Definitions – Ethics Health Care Terms
Straightforward Definitions of Terms in Health Ethics
Talking about values and principles in health care ethics can be confusing, especially if some of the words are unfamiliar. NSHEN created a plain language definitions document which have short definitions to help make it clearer what some of the words that we use in ethics work mean.
Click on the link below to download the file.
NSHEN Plain Language Definitions -Ethics Health Care Terms
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