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1 [poster presentation]
Nature of practice and job satisfaction of physicians who completed internal medicine training at the University of Toronto over a 10-year period. L. Chodirker, A. Rothman, K. Imrie, Y. Rohlehr. Department of Medicine, University of Toronto, Toronto, Ont.
Objectives: Internal medicine is a specialty that offers a wide variety of career options in terms of practice setting as well as clinical subspecialty. To ensure the relevance of postgraduate training, it is important to seek input not only from current residents but also from recent graduates of the program. To this end we conducted a survey of all residents who completed core internal medicine training at the University of Toronto over a 10-year period (1988-1998), primarily to gather data on practice address, practice setting (community or academic), clinical subspecialty, timing of the career decision and satisfaction with practice. Secondary objectives included self-evaluation of their preparedness for practice upon completion of training, and identification of factors that influenced their choice of career. The study was predominantly descriptive. Methods: Program records identified 359 residents, of whom 324 completed their training in internal medicine. Their practice addresses and subspecialties were obtained from the Canadian Medical Directory database and registries of American and international physicians. A 2-page, 26-question survey was mailed to all physicians identified; 192 (59%) responded. (Respondents were found to be similar to nonrespondents in terms of practice setting, subspecialty and year of completion of training.) Results: Graduates are located in Europe as well as across Canada and the United States, but 76% are in Toronto. Cardiology was the single largest subspecialty, accounting for 20% of graduates. Among respondents, 42% entered academic practice. Most indicated that they decided on their subspecialty in their PGY2 (third) year. Academic opportunities and lifestyle were the 2 major factors cited as influencing their choice of practice setting. Job satisfaction was very high--93% of respondents indicated they were either satisfied or highly satisfied with their practice--for which 83% felt well or very well prepared by their residency. Conclusions: Graduates of the University of Toronto internal medicine program practise in a variety of locations, practice settings and subspecialties. The great majority are satisfied with their practice, and most find that their training prepared them well.
2 [oral presentation]
Are general internal medicine training programs in Canada providing what general internists need in practice? A survey of clinical practice preparation among recent graduates. S.E. Card, L. Snell, B.D. O'Brien. Divisions of General Internal Medicine, University of Saskatchewan, Saskatoon, Sask.; McGill University, Montreal, Que.; and University of Alberta, Edmonton, Alta.
Objectives: It has been about 10 years since the curriculum provided in Canada to fourth-year trainees in general internal medicine (GIM) has been evaluated. To assist in curriculum development and assessment, we gathered information from 10 years' graduates of Canadian GIM programs. Methods: To explore the perceived importance of training and preparation for various aspects of Canadian practice in GIM, a survey was designed and piloted extensively, including a pilot survey of 2 universities to improve the questionnaire. The names of graduates were obtained from GIM program directors at each of the 16 universities. Thirty-nine percent were returned completed. Results: Graduates felt best prepared in cardiology, respirology, nephrology and critical care, and least prepared in physical medicine and rehabilitation, dermatology and immunology. The medical disciplines with the widest gaps between perceived importance and preparation were palliative care, dermatology and clinical pharmacology. Procedures considered very important by current GIM trainees (average Likert score > 4 out of 5) were advanced cardiac life-support/cardiopulmonary resuscitation, ambulatory electrocardiogram interpretation, endotracheal intubation, lumbar puncture and paracentesis. Computer/Internet access training, community GIM rotations, ambulatory care rotations and peripartum care were areas demonstrating large gaps between perceived need and preparation. Conclusions: Graduates of Canadian GIM training programs over the last 10 years have identified …