Factors Influencing Choice To Practise In Rural And Remote Communities Throughout A Physician'S Career Cycle

Introduction: Although a large portion of the Canadian population lives in rural areas, there remains a deficit in the number of family physicians serving these populations. We explored the factors that influence a family physician's decision to work in rural/remote communities in order to identify strategies that may aid in the recruitment and retention of family physicians to such communities.Methods: Qualitative study using a participatory research approach. Interview questions were developed based on a literature search of factors influencing family physicians' decisions to practise in a rural/remote location. Semistructured interviews were conducted with rural physicians from across Canada to identify influential factors, and subsequent thematic analysis was performed. Responses to the interview questions were categorized into 3 main themes: factors influencing physicians to work in rural locations, factors influencing physicians to leave or avoid rural practice, and strategies for improving recruitment and retention.Results: Seventeen interviews were conducted; saturation was achieved after 12. A wide scope of practice and rural training exposure were important factors in encouraging physicians to practise in rural/remote areas. The biggest challenges were issues relating to family and spousal support, ability to attend continuing professional educational opportunities and ability to connect with specialists and tertiary care centres.Conclusion: Effective strategies are required to increase family physician recruitment to rural communities. Our results provide several strategies for addressing low rates of recruitment and retention of family physicians in rural/remote communities, including, but not limited to, providing opportunities for professional development and having a supportive work environment.