Recruiting rural doctors: ending a Sisyphean task

Clearly, a variety of solutions is needed. The recently released From Education to Sustainability delineates over 150 recommendations spanning the career path of physicians. This publication was a joint effort of the Ontario section of the Society of Rural Physicians of Canada (SRPC) and the Professional Association of Internes and Residents of Ontario (PAIRO). The document also draws on individual and organizational expertise at both the national and provincial levels. Easterbrook and colleagues evaluate recommendations in 3 specific areas: the importance of recruitment of future physicians from rural settings, the need for exposure to rural medicine in medical school, and the role of exposure in residency training. These areas are also given a strong emphasis by the Ontario Task Force on Rural/Northern/Community Medical Education, which is designing a series of recommendations for the Ontario Ministry of Health. Easterbrook and colleagues' findings also underline the importance of exposure to rural practice in training, particularly during medical school. Although their sample was too small to support statistical significance, the results of their survey is congruent with existing evidence and with recommendations of the SRPC and PAIRO consensus document.2 Programs to facilitate electives in rural areas must be well funded to support student expenses (which are generally higher than those for electives in urban areas) as well as preceptor time and costs. Evidence that exposure to rural practice in the course of training can change perceptions is also needed. There may be a preselection bias with regard to which students and residents participate in rural electives. Dr. Tepper is a first-year family medicine resident in the University of Toronto Rural Residency Program and an Executive Member of both the Professional Association of Internes and Residents of Ontario and the Canadian Association of Internes and Residents. Dr. Rourke practises rural family medicine in Goderich, Ont., is an Associate Professor in the Department of Family Medicine at the University of Western Ontario, London, and is the Director of the Southwestern Ontario Rural Medicine Education, Research and Development Unit.