In recent weeks, there has been a surge in media coverage concerning the extended length of family medicine residency training. The SRPC’s position is that any extension of residency training should be approached only after thorough consideration of risks, and with robust evidence of a potential to benefit rural medical education, physicians and communities.
Our primary objective is to advocate for the well‐being of rural communities and the healthcare providers who serve them, and many of our members are actively involved in teaching future generations of rural physicians. While the College of Family Physicians of Canada’s (CFPC) decision to pursue this change may be well‐intended, we believe that it presents several significant challenges that warrant caution.
Potential Exacerbation of Work Shortages in Rural Areas
Rural communities in Canada are already struggling with a shortage of healthcare providers. The decision to extend the duration of residency training may further exacerbate this issue by delaying the entry of family physicians into rural practice. This delay could have adverse consequences for patients in underserved areas who urgently require access to primary care.
Rural Residents Feel Prepared
The majority of family medicine residents who go through a rural training program feel well-prepared to handle the unique complexities of rural healthcare. Their training equips them with the generalist skillset necessary to address a broad range of medical issues in resource‐limited settings.
Potential Career Deterrence, Including Those with Advanced Skills Training
Prolonging family medicine residency training may discourage graduates from pursuing family medicine as a career. The additional year of training could make other specialties more appealing and diminish the already small pool of family physicians available to serve rural communities, particularly those with enhanced skills such as anesthesia, obstetrics, and surgical services. In an SRPC survey of learners performed this year, 44% did not feel the new curriculum would make them more likely to practice comprehensive family practice at the end of their residency, 63 % felt that extension of residency would affect their choice in a family medicine residency program, and 68 % felt that extension of training would change their choice of an enhanced skills program.
Lack of Evidence‐Based Decision‐Making
The SRPC is concerned about the lack of comprehensive evidence that led to the decision to alter the training duration. A decision of this magnitude should be grounded in robust research and data analysis, considering the potential health human resource and financial implications for both urban and rural healthcare settings.
There is a crisis in primary care, and it is strongly felt in rural communities. The SRPC firmly believes that the issues, and solutions to this crisis, extend well beyond a lack of confidence by family medicine residents. In fact, the broader challenges lie in the urgent need to reform and modernize primary care practices, including shifting to team‐based care, reducing administrative burdens, and developing support networks for those in practice. Addressing these issues will enhance the quality of care delivered by family physicians and reduce burnout.
While not consulted as an organization prior to decisions being made, as this issue evolves, the SRPC continues to actively engage with the College of Family Physicians of Canada (CFPC) in efforts to ensure that the rural perspective is heard. We are a member of the CFPC’s Education Reform Taskforce, and are committed to working collaboratively to minimize unintended consequences for rural physicians and their communities.
The healthcare landscape is ever‐changing, and it is our collective responsibility to ensure that these changes are made with the utmost consideration for patients and healthcare providers alike.
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