Association between family medicine residents’ practice intentions and their initial professional activities

Context: Amidst the ongoing crisis in family medicine (FM) in Canada, there is an increased need to gauge the future practice patterns of family physicians (FPs). Examining the intentions of FM learners provides insight into the future practice behaviors of FPs.

Objective: This study examines the trends in FM residents’ intentions regarding different FM care domains compared with the actual practice patterns observed among early career FPs post-residency training

Study design and analysis: Weighted, self-reported data from exiting FM residents and practicing FPs were analyzed over five years. The same cohorts at exit from training and three years into practice were examined and trends were analyzed across the years for the care domains

Datasets: Data from the FM Longitudinal exit and in-practice surveys was used. Exiting cohorts of FM residents from 2016 to 2020 (average cohort n=862, average response rate=60%) and corresponding early career FPs at three years post-residency, from 2019 to 2023 (average n=318, average response rate=20%).

Population Studied: Canadian FM residents and FPs at three years post-residency

Instrument: The FM Longitudinal survey which is administered by Canadian FM residency programs and the College of Family Physicians of Canada

Outcome measures: Practice trends in 15 domains of care

Results: Analysis reveals a high correlation between reported practice intentions by exiting FM residents and the choices made in determining their future practice scope across all domains of care (r2 = 0.93). A declining trend in practice intentions among exiting FM residents was observed for over half the domains of care. In contrast, upward practice trends were observed for 9 out of 15 domains among early career FPs.

Conclusion: The correlation between practice intentions when exiting residency training and decisions on actual future practice scope in early career is consistent with earlier published findings. These findings offer insight into how residency training influences the practice choices of early career FPs. The FM Longitudinal Survey data can serve as a valuable source for forecasting the future scope of family practice and help enhance health workforce planning.