Vernon R Curran, Lisa Fleet, Raymond W Pong, Stephen Bornstein, Michael Jong, Roger P Strasser, Geoffrey Tesson
{"title":"A survey of rural medical education strategies throughout the medical education continuum in Canada.","authors":"Vernon R Curran, Lisa Fleet, Raymond W Pong, Stephen Bornstein, Michael Jong, Roger P Strasser, Geoffrey Tesson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In many countries the sustainability of rural health care systems is being challenged by a shortage of rural physicians and difficulties in recruiting and retaining physicians in rural practice. Research does suggest that specific medical education strategies can be introduced to enhance rural physician recruitment and retention initiatives. The purpose of this paper is to summarize the current strategies of Canadian rural medical education programs. A survey of all Canadian medical schools was undertaken to profile specific programs and activities at the undergraduate, postgraduate, and continuing medical education/continuing professional development (CME/CPD) levels. The majority of medical schools reported either mandatory or elective rural medicine placement/learning experiences during undergraduate medical education, as well as Rural Family Medicine streams or programs as components of postgraduate medical education. The majority of medical schools reported that they provide clinical traineeships to enhance clinical competencies in rural medicine as well as CME outreach programming, including the use of telehealth or distance learning technologies. Canadian medical schools all have substantial programs covering the full range of approaches found in the literature to help recruit and retain rural physicians. Not surprisingly, the most extensive programs are found in medical schools that have a specific rural mandate.</p>","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 4","pages":"445-68"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27244562","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}
{"title":"Not on the radar: the impact of rural health realities on Canadian public policy and HHR migration from Sub-Saharan Africa.","authors":"Arminée Kazanjian, Lars E Apland, Ronald Labonté","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The policy environment of Health Human Resource (HHR) demands in rural and remote areas of Canada seems to compel health system planners either to ignore or only pay lip service to memoranda of understanding and other non-binding international agreements on ethical principles of recruitment. Despite common acknowledgement that the migration of health professionals from Sub-Saharan Africa (SSA) and the resultant loss of capacity to deliver health services are devastating for populations in that region, Canadian public policy consideration of the \"brain drain\" of health human resources from SSA seems cursory, at best. As a result, broadly based domestic HHR policies and international development policy objectives invariably seem to conflict and produce unsatisfactory results that continue to be detrimental to populations of source countries in the developing world, while doing little to alleviate the continued reliance of Canada's rural and remote \"'gateways\" on foreign-trained health professionals. A key challenge for Canadian public policy, at all levels of government, is to coordinate and find common ground, whereby brain drain issues and specific domestic Canadian HHR needs can be simultaneously and effectively addressed. This research explored the congruity between rural HHR policy principles and international development objectives in the context of federal, provincial, and territorial government relations in Canada.</p>","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 4","pages":"407-26"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27244477","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}
{"title":"Considering the paraprofessional: one option for overcoming rural health human resource deficits.","authors":"J Bruce Minore, Margaret Boone, Alison Arthur","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Canada's rural shortage of health professionals can be offset by employing specially trained, locally-based paraprofessionals to implement professionally developed plans of care. Ontario's Integrated Services for Northern Children Program demonstrated the viability of this option. A review of 327 patient records and interviews with 100 parents, paraprofessionals, and professionals found that there was good continuity of care and satisfaction with care quality because the multidisciplinary professional team of consultants provided constant and consistent monitoring of the paraprofessionals. Ongoing treatment occurred in the community, eliminating the disruption to the children's lives that repeated trips to the city would cause. Rural residents place a premium on care at home. Liability issues for employers and for professionals who delegate caregiving tasks currently restrict the use of paraprofessionals; these can be addressed through certification based on practice standards and improved education programs.</p>","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 4","pages":"511-34"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27244478","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}
{"title":"The joint operation. \"The single wealth is man\".","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 4","pages":"535-43"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27244479","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}
{"title":"Rural net migration of Canada's rehabilitative and technical health care workers.","authors":"J Roger Pitblado","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recruitment and retention of health care providers continue to be problematic for rural Canada. Both imply movement from source to destination areas. But analyses of mobility patterns, especially to and from rural areas, do not exist for most of Canada's health care occupational groups. As an exploratory study, this paper presents national summaries of internal migration trends of personnel in selected rehabilitative and technical occupations. Census data are employed to determine migration counts and rates with a focus on rural net migration of these health care providers. In general, their mobility patterns are similar to that of the general population: rural net losses in the 1980s during the \"turnaround of the turnaround,\" rural net gains in the early 1990s during the \"rural rebound\" and then rural losses again in the late 1990s, the \"turnaround of the rural rebound.\" However, there are a number of differences for some of these health care occupations, and these are examined in the paper using data from three 5-year census migration periods: 1986-1991, 1991-1996 and 1996-2001.</p>","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 4","pages":"427-44"},"PeriodicalIF":0.0,"publicationDate":"2007-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27244480","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}
{"title":"A health workforce strategy for Portugal.","authors":"Gilles Dussault, Paulo Ferrinho","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 3","pages":"235-40"},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26858283","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}
{"title":"The state of the health workforce in Portugal.","authors":"André Biscaia, José Martins, Margarida Carrolo","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper discusses the state of the health workforce in Portugal's mainland during the past four decades. Healthcare workers represent 3.76% of the Portuguese workforce. All health professional groups significantly increased since 1960. Growth has been continuous for hospital physicians and nurses in general, as well as for primary care nurses. Primary care physicians are an exception, growing until the late 1970s but steadily decreasing afterwards. The density of physicians per 1000 inhabitants is above the European average. For nurses, Portugal is at the lowest European limit. However, the regional distribution of nurses, and also of pharmacists, across the country is more equitable than for physicians. The number of workers employed by the Health Ministry has grown by 44.6% between 1985 and 2004, with 127 013 employees registered in 2004. There has also been a marked increase in the number of female employees. Only 23.6% of healthcare workers employed by the Health Ministry, work at primary care level. Data on the private sector is insufficient in spite of its rising importance. The right number and mix of healthcare workers for an optimal healthcare system performance is a complex question and answering it requires an adequate information system. Portugal does not have such a system yet.</p>","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 3","pages":"259-73"},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26858284","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}
Paulo Ferrinho, Ana Rita Antunes, Augusto Paulo Silva, Mário R Dal Poz, Dussault Gilles
{"title":"The Portuguese contribution to the brain drain from Portuguese speaking African countries.","authors":"Paulo Ferrinho, Ana Rita Antunes, Augusto Paulo Silva, Mário R Dal Poz, Dussault Gilles","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the first part of this paper, a secondary analysis of multiple data sources was done to identify how many nurses, physicians, dentists, pharmacists and other health workers have migrated from the Portuguese speaking African countries (PSAC) to Portugal between 1998 and 2002. In the second part, the results of a 2003 questionnaire based survey of 45 nurses, from Guinea-Bissau, residing in Portugal are reported. Health professionals are increasing as a proportion of total immigrants into Portugal. Relatively to the countries' of origin population, the PSAC contribute the most with foreign health professionals to the Portuguese healthcare system. Our study of Guinea-Bissau nurses in Portugal replicates the results of other studies and suggests that the decision to emigrate is multiply determined. The implication for policy makers is that the causal complexity among factors spurring emigration makes that the marginal effect of policy reforms addressing one or more of the multiple determinants of emigration may be sufficient to retain some proportion of health professionals, even when other determinants of emigration are present. The situation observed is also indicative of the need of programs for social integration of these professionals.</p>","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 3","pages":"377-91"},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26860339","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}
{"title":"Determinants of violence against health workers in Portugal.","authors":"Isabel Craveiro, Inês Fronteira, Anabela Candeias","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The focus of this article is on the determinants of workplace violence against health workers identified in two cross-sectional analytical studies. The prevalence of victims of the several types and of any-type of workplace violence was estimated in each study, as well as the relative frequency of the associated characteristics. Each dependent variable was also analyzed, in relation to the dichotomized independent variables using a stepwise logistic regression strategy. The Ministry of Health has adopted strategies, which include guidelines on what to do to prevent and correct violence against health workers and a workplace violence observatory. Workplace violence has societal, organizational and individual determinants that can be prevented and monitored.</p>","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 3","pages":"347-59"},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26860340","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}
{"title":"Health workforce policies in Portugal: ideas for modernization.","authors":"Vítor Ramos","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75662,"journal":{"name":"Cahiers de sociologie et de demographie medicales","volume":"47 3","pages":"232-4"},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26858282","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}