Pub Date : 2025-04-01Epub Date: 2025-05-20DOI: 10.4103/cjrm.cjrm_68_24
Laura Harkness, Sabrina Slade, Nusha Ramsoondar, Tracy L Wilson, Sarah M Giles
{"title":"The Occasional elbow reduction.","authors":"Laura Harkness, Sabrina Slade, Nusha Ramsoondar, Tracy L Wilson, Sarah M Giles","doi":"10.4103/cjrm.cjrm_68_24","DOIUrl":"10.4103/cjrm.cjrm_68_24","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 2","pages":"96-100"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-05-20DOI: 10.4103/cjrm.cjrm_26_25
Peter Hutten-Czapski
{"title":"À nouveau en milieu rural !","authors":"Peter Hutten-Czapski","doi":"10.4103/cjrm.cjrm_26_25","DOIUrl":"https://doi.org/10.4103/cjrm.cjrm_26_25","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 2","pages":"60"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-05-20DOI: 10.4103/cjrm.cjrm_84_24
Brian M Ross, Sarah Newbery, Erin Cameron, Margaret French
{"title":"Rurally focussed undergraduate medical education at the Northern Ontario School of Medicine University.","authors":"Brian M Ross, Sarah Newbery, Erin Cameron, Margaret French","doi":"10.4103/cjrm.cjrm_84_24","DOIUrl":"10.4103/cjrm.cjrm_84_24","url":null,"abstract":"","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 2","pages":"101-102"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-03-11DOI: 10.4103/cjrm.cjrm_27_24
Druvtej Ambati, Karen Lemay, Anne Steen, Shan Jin, Jeffrey Smith, Gary E Garber
<p><strong>Introduction: </strong>Anaesthesiologist medico-legal risk is well reported in the literature, however, there is little data regarding the medico-legal risk of family practice anaesthetists (FPAs) in Canada. We aimed to describe the expert criticisms from medico-legal cases involving family physicians providing care within the scope of anaesthesia.</p><p><strong>Methods: </strong>Medico-legal cases involving FPAs providing anaesthesia-related care were identified from a national repository at the Canadian Medical Protective Association. Civil legal cases, medical regulatory authority (college) complaints and hospital complaints were included in the descriptive analysis where medical coding was available. Cases were closed between 1 January 2013 and 31 December 2022.</p><p><strong>Results: </strong>There were 50 medico-legal cases involving 50 FPAs providing anaesthesia-related care to 50 patients. At least half of the cases involved American Society of Anaesthesiologists Physical Status Classification I and II patients in an outpatient or ambulatory setting. Thirty patients experienced healthcare-related harm, of which most were classified as moderate, severe or death. Expert criticisms were mainly associated with situational awareness, clinical decision-making, documentation and communication issues with the patient, family or substitute decision-maker.</p><p><strong>Conclusion: </strong>This study presents family physicians providing anaesthesia-related care with an opportunity to increase their awareness of commonly identified expert criticisms from medico-legal cases related to their area of practice. While the medico-legal risk we report is predominantly associated with provider and team factors, the retrospective nature of medico-legal cases makes the assessment of system factors difficult and thus requires further investigation. Nonetheless, FPAs are pivotal to and growing in number in the Canadian healthcare context and, therefore, this study could contribute to developing targeted training and education programmes to promote patient safety within their scope of practice.</p><p><strong>Introduction: </strong>Les risques médico-légaux auxquels sont exposés les anesthésiologistes sont bien étayés par la littérature. En revanche, peu de données ont été publiées sur les risques médico-légaux auxquels font face les médecins de famille exerçant l'anesthésie au Canada. Dans cette étude, nous avons cherché à décrire les critiques formulées par des expertes et experts dans des dossiers médico-légaux qui mettent en cause des médecins de famille prodiguant des soins qui relèvent de l'anesthésie.</p><p><strong>Mthodes: </strong>Des dossiers médico-légaux portant sur des médecins de famille prodiguant des soins ayant trait à l'anesthésie ont été recensés dans une base de données d'envergure nationale à l'Association canadienne de protection médicale. Des actions civiles, des plaintes auprès d'organismes de réglementation de la médecine (Col
{"title":"Ten-year retrospective study on medico-legal risk of family physicians providing anaesthesia care in Canada, 2013-2022.","authors":"Druvtej Ambati, Karen Lemay, Anne Steen, Shan Jin, Jeffrey Smith, Gary E Garber","doi":"10.4103/cjrm.cjrm_27_24","DOIUrl":"10.4103/cjrm.cjrm_27_24","url":null,"abstract":"<p><strong>Introduction: </strong>Anaesthesiologist medico-legal risk is well reported in the literature, however, there is little data regarding the medico-legal risk of family practice anaesthetists (FPAs) in Canada. We aimed to describe the expert criticisms from medico-legal cases involving family physicians providing care within the scope of anaesthesia.</p><p><strong>Methods: </strong>Medico-legal cases involving FPAs providing anaesthesia-related care were identified from a national repository at the Canadian Medical Protective Association. Civil legal cases, medical regulatory authority (college) complaints and hospital complaints were included in the descriptive analysis where medical coding was available. Cases were closed between 1 January 2013 and 31 December 2022.</p><p><strong>Results: </strong>There were 50 medico-legal cases involving 50 FPAs providing anaesthesia-related care to 50 patients. At least half of the cases involved American Society of Anaesthesiologists Physical Status Classification I and II patients in an outpatient or ambulatory setting. Thirty patients experienced healthcare-related harm, of which most were classified as moderate, severe or death. Expert criticisms were mainly associated with situational awareness, clinical decision-making, documentation and communication issues with the patient, family or substitute decision-maker.</p><p><strong>Conclusion: </strong>This study presents family physicians providing anaesthesia-related care with an opportunity to increase their awareness of commonly identified expert criticisms from medico-legal cases related to their area of practice. While the medico-legal risk we report is predominantly associated with provider and team factors, the retrospective nature of medico-legal cases makes the assessment of system factors difficult and thus requires further investigation. Nonetheless, FPAs are pivotal to and growing in number in the Canadian healthcare context and, therefore, this study could contribute to developing targeted training and education programmes to promote patient safety within their scope of practice.</p><p><strong>Introduction: </strong>Les risques médico-légaux auxquels sont exposés les anesthésiologistes sont bien étayés par la littérature. En revanche, peu de données ont été publiées sur les risques médico-légaux auxquels font face les médecins de famille exerçant l'anesthésie au Canada. Dans cette étude, nous avons cherché à décrire les critiques formulées par des expertes et experts dans des dossiers médico-légaux qui mettent en cause des médecins de famille prodiguant des soins qui relèvent de l'anesthésie.</p><p><strong>Mthodes: </strong>Des dossiers médico-légaux portant sur des médecins de famille prodiguant des soins ayant trait à l'anesthésie ont été recensés dans une base de données d'envergure nationale à l'Association canadienne de protection médicale. Des actions civiles, des plaintes auprès d'organismes de réglementation de la médecine (Col","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 1","pages":"31-38"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-03-11DOI: 10.4103/cjrm.cjrm_64_23
Aishwarya Roshan, Margot Gowans, Ian Scott
<p><strong>Introduction: </strong>Despite efforts by Canadian medical schools to recruit students who are intent on rural practice, rural communities in Canada still face disparities in their physician workforce. Our study aims to identify the variables which predict those physicians who will not only enter rural practice but will remain in rural practice.</p><p><strong>Methods: </strong>Between 2002 and 2004, 2070 Canadian 1st-year medical students were invited to participate in an entry survey delineating career choice, attitudes and sociodemographic data. Of these, 1542 were included in a 2013 analysis to assess the influences on early practice in rural family medicine (FM), and a total of 1530 were included in the current analyses to assess influences on both mid-career rural FM practice and rural FM retention. Variables identified by bivariate analyses as being associated with rural family practice were entered into backward stepwise logistic regression analyses to identify their relative predictive strength on choosing and sustaining a career in rural FM.</p><p><strong>Results: </strong>Of the 1530 physicians included in this study, where 88 (5.8%) physicians were practising in a rural setting in 2013, now 61 (4.0%) were practising rural FM with the remainder practising urban FM (n = 505; 33%) or speciality medicine (n = 964; 63%). Our study found that an early preference for rural practice, having parents with less formal education, being married or in a common-law relationship at medical school entry, coming from a smaller hometown and expressing a desire for a shorter postgraduate training on entry to medical school were predictive of mid-career rural practice location. We also found that having parents with postgraduate education and placing greater emphasis on medical lifestyle at medical school entry were predictive of a mid-career switch away from a rural practice location to a non-rural practice location.</p><p><strong>Conclusion: </strong>These characteristics can be considered by medical school leaders to support the recruitment of candidates to, and retention of, physicians in rural communities.</p><p><strong>Introduction: </strong>Malgré les efforts déployés par les facultés de médecine canadiennes pour recruter des étudiants désireux d'exercer en milieu rural, les communautés rurales du Canada sont toujours confrontées à des disparités au niveau de leurs effectifs médicaux. Notre étude vise à identifier les variables qui prédisent les médecins qui non seulement entreront dans la pratique rurale, mais y resteront.</p><p><strong>Mthodes: </strong>Entre 2002 et 2004, 2 070 étudiants canadiens en première année de médecine ont été invités à participer à un sondage d'entrée décrivant le choix de carrière, les attitudes et les données sociodémographiques. De ce nombre, 1 542 ont été inclus dans une analyse de 2013 visant à évaluer les influences sur la pratique précoce de la médecine familiale rurale (MF), et un total de 1 530 ont ét
引言：尽管加拿大医学院努力招收有意从事农村实践的学生，但加拿大农村社区的医生队伍仍然存在差距。我们的研究旨在确定预测那些不仅进入农村实践而且将继续在农村实践的医生的变量。方法：在2002 - 2004年间，对2070名加拿大一年级医学生进行了职业选择、态度和社会人口学数据的调查。其中，1542人被纳入2013年的分析，以评估对农村家庭医学（FM）早期实践的影响，共有1530人被纳入当前的分析，以评估对职业中期农村FM实践和农村FM保留的影响。通过双变量分析确定的与农村家庭实践相关的变量被输入到反向逐步逻辑回归分析中，以确定它们在选择和维持农村FM职业方面的相对预测强度。结果：在纳入本研究的1530名医生中，2013年88名（5.8%）医生在农村执业，现在61名（4.0%）医生从事农村FM，其余从事城市FM (n = 505；33%)或专科医学(n = 964；63%)。我们的研究发现，早期对农村实践的偏好，父母受正规教育程度较低，在进入医学院时已婚或处于普通法关系，来自较小的家乡，并且在进入医学院时表达了希望接受较短研究生培训的愿望，这些都预示着职业生涯中期的农村实践地点。我们还发现，父母受过研究生教育，并且在进入医学院时更加强调医学生活方式，预示着职业生涯中期从农村执业地点转向非农村执业地点。结论：这些特点可以被医学院领导考虑，以支持农村社区医生的候选人招聘和保留。简介:Malgre les工作部署par莱斯将进医学院学习法裔加拿大女子倒recruter des学生desireux d 'exercer农村环境,les communautes乡村骑警du加拿大始终是confrontees des disparites盟他们的实际水平medicaux。没有任何的可变因素，没有任何的可变因素，没有任何的可变因素，没有固定的可变因素，没有固定的可变因素，没有固定的可变因素，没有固定的可变因素。方法：2002年和2004年，2 070名加拿大人参加了第1期、第1期、第2期和第2期的调查。第2期、第2期、第2期、第3期、第3期、第3期、第3期和第4期的调查。2013年，有1 542个可变数据包括个人数据，2013年有1 530个可变数据包括个人数据分析，实际情况是，可变数据包括个人数据分析，可变数据包括个人数据分析，可变数据包括个人数据分析，可变数据包括个人数据分析，可变数据包括个人数据分析，可变数据包括个人数据分析，可变数据包括个人数据分析，可变数据包括个人数据，个人数据，个人数据，个人数据，个人数据，个人数据，个人数据，个人数据，个人数据，个人数据，个人数据，个人数据，个人数据。三个变量确定了可变因素，两个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素，三个变量确定了可变因素。结果：在2013年，共有1530例男性和女性变性人，其中包括女性和女性变性人，其中88例（5.8%）为女性变性人，61例（4.0%）为女性变性人，6例（505例）为女性变性人；33%) u - la - msametine - spsamcialiissame (n = 964；63%)。我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子，我们有一个简单的例子。目前的情况是，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业后，在大学毕业。结论：人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统的人力资源管理系统。
{"title":"Predictors of sustained rural practice.","authors":"Aishwarya Roshan, Margot Gowans, Ian Scott","doi":"10.4103/cjrm.cjrm_64_23","DOIUrl":"10.4103/cjrm.cjrm_64_23","url":null,"abstract":"<p><strong>Introduction: </strong>Despite efforts by Canadian medical schools to recruit students who are intent on rural practice, rural communities in Canada still face disparities in their physician workforce. Our study aims to identify the variables which predict those physicians who will not only enter rural practice but will remain in rural practice.</p><p><strong>Methods: </strong>Between 2002 and 2004, 2070 Canadian 1st-year medical students were invited to participate in an entry survey delineating career choice, attitudes and sociodemographic data. Of these, 1542 were included in a 2013 analysis to assess the influences on early practice in rural family medicine (FM), and a total of 1530 were included in the current analyses to assess influences on both mid-career rural FM practice and rural FM retention. Variables identified by bivariate analyses as being associated with rural family practice were entered into backward stepwise logistic regression analyses to identify their relative predictive strength on choosing and sustaining a career in rural FM.</p><p><strong>Results: </strong>Of the 1530 physicians included in this study, where 88 (5.8%) physicians were practising in a rural setting in 2013, now 61 (4.0%) were practising rural FM with the remainder practising urban FM (n = 505; 33%) or speciality medicine (n = 964; 63%). Our study found that an early preference for rural practice, having parents with less formal education, being married or in a common-law relationship at medical school entry, coming from a smaller hometown and expressing a desire for a shorter postgraduate training on entry to medical school were predictive of mid-career rural practice location. We also found that having parents with postgraduate education and placing greater emphasis on medical lifestyle at medical school entry were predictive of a mid-career switch away from a rural practice location to a non-rural practice location.</p><p><strong>Conclusion: </strong>These characteristics can be considered by medical school leaders to support the recruitment of candidates to, and retention of, physicians in rural communities.</p><p><strong>Introduction: </strong>Malgré les efforts déployés par les facultés de médecine canadiennes pour recruter des étudiants désireux d'exercer en milieu rural, les communautés rurales du Canada sont toujours confrontées à des disparités au niveau de leurs effectifs médicaux. Notre étude vise à identifier les variables qui prédisent les médecins qui non seulement entreront dans la pratique rurale, mais y resteront.</p><p><strong>Mthodes: </strong>Entre 2002 et 2004, 2 070 étudiants canadiens en première année de médecine ont été invités à participer à un sondage d'entrée décrivant le choix de carrière, les attitudes et les données sociodémographiques. De ce nombre, 1 542 ont été inclus dans une analyse de 2013 visant à évaluer les influences sur la pratique précoce de la médecine familiale rurale (MF), et un total de 1 530 ont ét","PeriodicalId":44615,"journal":{"name":"Canadian Journal of Rural Medicine","volume":"30 1","pages":"7-16"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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