Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science


Epidemiology and Biostatistics


Mathews, Maria


Recruiting and retaining family physicians (FP) in rural communities has been an ongoing issue in Canada and other developed nations. The objective of this thesis was to analyze the long-term contribution that Memorial University medical graduate FP make to the physician workforce in Newfoundland and Labrador (NL). We found that 47% of our sample ever worked in NL, 15% ever worked in rural NL and 58% who ever worked in NL stayed for at least 10 years. Being from NL was a predictor of working in NL for at least 5 years and 10 years, respectively. Doing at least some residency at MUN was a predictor of working in rural NL. The study supports policies that encourage the admission of NL students to undergraduate and post-graduate medical programs at Memorial University. Future research should examine retention of Memorial University graduate specialists.

Summary for Lay Audience

In Canada, approximately 75% of individuals who do not have a regular family physician live in rural/remote communities. Medical schools are an important resource to increase rural physician supply. For this reason, a number of medical schools, including Memorial University of Newfoundland (MUN) in Newfoundland and Labrador (NL), have implemented a variety of initiatives to attract, train and support rural physicians. Despite these initiatives, rural physician shortages and high physician turnover persists in NL.

Prior research indicated that MUN has substantially contributed to the physician supply in NL, graduating 55.4% of the workforce in 2014. It has also found that students with rural hometowns and students who complete rural residency programs are more likely to enter rural practice. These studies, however, only provide information on the recruitment or short-term retention factors of the NL physician workforce. Therefore, it is important to understand the retention or long-term contribution that MUN family physicians make to the physician workforce.

The overall goal of this thesis was to analyze the long-term contribution that MUN medical graduate FP had on the physician workforce in NL by identifying the predictors of MUN FP who work in NL, work in rural NL, and who work in these locations for 5 and 10 years respectively. We also wanted to identify work-location predictors of physicians who leave NL within 5 and 10 years of starting practice. We used two administrative databases to track MUN FP who graduated between 1997 and 2014 and who began practice in NL between 2000 and 2017.

We found that recruitment and retention of MUN graduates was related to individual physician characteristics and not location specific factors. We found that the biggest contributor to working in NL and rural NL was being from NL and that doing at least some residency at MUN was a predictor of working in rural NL. These findings highlight the need to continue policies that favour acceptance of medical students from NL to contribute further to the physician workforce in NL.