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Family medicine makes gains in funded postgrad slots

The increased availability of postgraduate training positions in family medicine is reflected in a new analysis of proportional trends in funded specialty positions over the past two decades.

The overview produced by the Canadian Post M.D. Education Registry (CAPER) shows the number of ministry funded postgraduate trainees in family medicine has increased from 23% to 25% of all funded positions across the continuum of training between 1995-96 and 2014-15.

This increase appears to have come at the expense of funded positions in surgical specialties, which decreased from 23% to 19% of all funded positions over the same time period.

The increase in family medicine positions is also seen in the analysis of all postgraduate year one (PGY-1) trainees with the number of first year family medicine trainees increasing 91% between 2004 and 2014. Over the same period, the number of general surgery PGY-1 trainees decreased by 11%.

Dr. Geneviève Moineau, president and CEO of the Association of Faculties of Medicine of Canada, said these statistics reflect the positive move towards increasing the number of family physicians.

“Family medicine has become a very desirable specialty,” said Moineau in a telephone interview, adding, “I think the increase in family medicine positions is definitely welcomed by those of us who are trying to ensure we have the right number, mix and distribution of physicians.”

Canadian Medical Association (CMA) president and family physician Cindy Forbes, who recently chaired a session at the CMA General Council meeting on finding the right mix of Canadian medical graduates to meet societal needs, joined Moineau in noting the positive nature of the trend in funded positions.

“These data show governments and medical schools have recognized the essential role of family medicine in delivering health care in Canada.”

However, Moineau said, because there are still issues with ensuring all Canadians have their own family physician, more has to be done to adjust the proportion of doctors being trained in various areas.

Moineau cautioned that because the data are aggregated at the national level, the figures do not provide details on trends at the provincial or regional level. However, she said, certain jurisdictions such as Quebec have stated they intend to ensure family physicians make up 50% or more of all doctors being trained in the province.

“That is a trend that should be happening in all provinces moving forward,” she said.

Moineau said the decline in funded positions for the surgical specialties over the past two decades may reflect a decision by governments to only fund the number of surgeons who can be supported by current operating room space and adequate number of surgical support staff.

The CAPER figures also show a slight growth in the number of funded slots for all medical specialists between 1995 and 2014. However, a proportionally explosive increase in the number of PGY-1 trainees in the specific fields of dermatology and plastic surgery were seen with the number of trainees entering these specialties increasing by 200% and 100% respectively between 2004 and 2014.

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