Choosing family medicine residency programs: what factors infuence residents’ decisions?

OBJECTIVE: To describe key determinants for residents' selection of a new community-based, interprofessional site for their family medicine training, and to evaluate residents' satisfaction with their programs. DESIGN: Combined qualitative and quantitative methods using in-depth interviews and a survey. SETTING: McMaster University, including the new site of the Centre for Family Medicine in Kitchener-Waterloo, Ont, and a long-established site in Hamilton, Ont. PARTICIPANTS: Eleven first-year and second-year family medicine residents from the Kitchener-Waterloo site participated in in-depth interviews. Forty-four first-year and second-year family medicine residents completed the survey, 22 in Kitchener-Waterloo and 22 in Hamilton. METHODS: Kitchener-Waterloo residents participated in in-depth interviews during their residency programs in 2008 to 2009 using a semistructured format to explore their choice of site and the effect of an interprofessional environment on their education. Common themes were established using qualitative analysis techniques; based on these themes, a survey was developed and distributed to residents from both sites to further explore factors influencing site selection, satisfaction, and effects of interprofessional education. MAIN FINDINGS: Residents identifIed several reasons for selecting a new community-based, interprofessional family medicine residency program. Reasons included preference for the location and opportunities to learn in an interprofessional teaching environment. A less hierarchical structure and greater opportunities for one-on-one teaching also influenced their choices. Perception of poor communication from the well established site was identified as a challenge. Residents at both sites indicated similarly high levels of program satisfaction. CONCLUSION: Residents selected the new community-based family medicine site for reasons of geographic location and the potential for clinical learning experiences and interprofessional education. High program satisfaction was achieved at both the new and well established sites. Family medicine residency programs developing community-based networks might consider and encourage the positive influence of interprofessional care and education. Good communication between distributed sites remains a challenge.