Decreasing supply of family physicians and general practitioners - Seriousimplications for the future

OBJECTIVE To document a decrease in the supply of family physicians (FPs) a nd general practitioners among Canadian graduates of medical schools since rotating internships ceased to serve as a route to national licensure. DESIGN Review of data from the Association of Canadian Medical Colleges, th e Canadian Post-M.D. Education Registry, and the Canadian Institute for Hea lth Information to track final training fields and eventual types of practi ce of graduates of Canadian faculties of medicine from 1987 to 1997. SETTING Canadian faculties of medicine and residency training programs. MAIN OUTCOME MEASURES Number of Canadian medical graduates entering family medicine training programs from 1991 to 1995, number of Canadian graduate p hysicians exiting from these training programs, and proportion of each grad uating class (1987 to 1994) practising as FPs or GPs in Canada in 1997. RESULTS In 1993, 890 physicians (51% of graduates) were trained as FPs or G Ps. By 1994, although the proportion remained at 40%, the number of Canadia n graduates entering family medicine had dropped to 646, and by 1998, to 61 9. CONCLUSIONS A deficit of FPs is already noticeable in the practice environm ent. For the way in which medical care is delivered in Canada, with FPs ser ving as first contact for patients, the authors conclude that the number of graduating FPs in Canada will not be sufficient to provide the primary car e services Canadians need.