Determinants of First Practice Location among Canadian Geriatric Medicine Trainees and Recent Graduates: Findings of a Cross-sectional Survey in 2023

Jasmine C Mah; Tharsan Kanagalingam; Sarah Best; Sallie Elhayek; Jenny Thain; José A Morais; Marianne Lamarre; Jaspreet Bhangu; Michael J Borrie; Luxey Sirisegaram

doi:10.5770/cgj.27.774

Determinants of First Practice Location among Canadian Geriatric Medicine Trainees and Recent Graduates: Findings of a Cross-sectional Survey in 2023

Can Geriatr J. 2024 Dec 1;27(4):485-499. doi: 10.5770/cgj.27.774. eCollection 2024 Dec.

Authors

Affiliations

¹ Division of Geriatric Medicine, Dalhousie University, Halifax, NS.
² Schulich School of Medicine and Dentistry, Western University, London, ON.
³ Lawson Health Research Institute, London, ON.
⁴ Division of Geriatric Medicine, Department of Medicine, Western University, London, ON.
⁵ Division of Geriatric Medicine, McGill University, Montreal, QC.
⁶ Quebec Network Geriatric Program.
⁷ Department of Geriatric Medicine, University of Toronto, University Health Network and Sinai Health Systems, Toronto, ON.

Abstract

Background: There is a projected and growing gap of geriatricians in Canada. Geriatricians play a crucial role in addressing the health needs of older adults. We aimed to understand the factors that influence the choice of first-practice location for new geriatricians in the context of an aging Canadian population.

Methods: We distributed an online survey to geriatric medicine subspecialty residents and recently licensed geriatricians in Canada. The survey was developed through expert opinions, career planning sessions, and a literature review. There were nine survey sections: general characteristics, location determinants, practice determinants, colleague determinants, support and space, non-clinical opportunities, income models, lifestyle factors, and recruitment determinants. The data were analyzed descriptively.

Results: A total of 61 respondents (51 English, 10 French) completed the survey. The respondents were new practicing geriatricians (37) and geriatric medicine residents (24). Most planned to practice in Ontario (26.2%) or Quebec (27.9%), and 75.4% were women. Flexibility in work-life balance (95.1%), collegiality (93.4%) and reasonable call schedules (93.4%) were the most important factors influencing first practice location. Income did not rank among the highest priorities for choosing the first practice location relative to other factors but was mentioned in open-ended responses to recruitment questions.

Conclusions: This is the first survey identifying the determinants of first practice location in geriatric medicine in Canada. Work-life balance and collegial support are a priority for new geriatricians and may be the strongest incentives a program can provide. For recruitment, income incentives may be beneficial to building new specialized geriatric services. Future research will examine determinants of first practice location among Care of the Elderly clinicians.

Keywords: Canadian; geriatric residents; geriatricians; geriatrics; practice location; recruitment; rural medicine; survey.