Early funding opportunities accessed once matched by CaRMS can provide up to $70,000 to a family practice resident who accepts a return in service bursary for three consecutive years with similar packages being offered to specialists. Honoring the return in service agreement in a difficult to recruit community results in eligibility for a retention bonus which is payable during the return in service period. Therefore, a medical student determined to reduce a student loan has an opportunity to receive a maximum of $130,000 within three years of graduating. Additional income at very attractive rates is easily accessed during residency through locum arrangements.
Beyond loan payouts and competitive pay schedules, what are the recruitment challenges of an Atlantic province like Newfoundland and Labrador? The design of our hiring packages must reflect our unique lifestyle by the sea, our rich culture, our safety from harm’s way and our beautiful healthy living environment and strong family heritage. It must herald our skill in telemedicine, networking and distance education. We have a significant package to develop, but of greatest importance is our ability to sell this package to our graduating physicians. Our recruitment goal is to ensure an “attractive package” is repeatedly presented to our graduates with the right content at the right time.
Residents are quick to point out the positive experiences of site visits, personal contact and social support provided by some Medical Directors who seem to have perfected the art of the personal touch. Such consistent feedback provides valuable insight for the development of recruitment guidelines for others struggling to find that perfect mix. The Memorial University Family Medicine Program contributes to the solution of physician shortages by providing valuable exposure to rural medicine. The inclusion of even more sites would be a welcome strategy for recruitment as it delivers the potential candidate to our doorway; then the recruitment strategies must ensure that he/she returns. We plan to provide our future physicians with the type of hospitality only Newfoundland can deliver.
One resident discussed “the attitude of a place” as one of the most important factors in choosing to return as a physician. There is a strong recruitment opportunity here. Another resident put it this way, “I’m here already because I want to be, now help me stay.” It must be asked if recruitment is our biggest challenge. I suggest it is more likely our lack of understanding of retention. There is great optimism about this approach; perhaps it is influenced by the high number of practicing physicians who are Newfoundlanders/Labradoreans who have chosen to stay at home. Given that 40 Newfoundlanders enter our medical school each year, it is reasonable to conclude that they too enjoy our culture, they too enjoy the safety of our environment and cherish the upbringing they want for their children. They too want to maintain family ties and contribute to the well being of this province.
During a recent gathering of physicians interested in improving physician recruitment to Atlantic Canada it was evident that time for a lifestyle beyond work, easy access to continuing education, regular contact with colleagues and, of course, work environment and family happiness were paramount when a physician is deciding where to live and practice. This discussion by Atlantic Canada physicians confirmed that we in Newfoundland and Labrador are on the right path and we as a province have a great deal to offer.
A focus on retention means that communities need to take notice of their strengths and weaknesses. They need to know the boundaries of allowing a physician “a little time off”. Clinics need to determine the “employment package” so potential candidates can weigh the pros and cons of a position. That means information on potential income, work environments and accommodation subsidies. Recruiters need input from tourism and marketing experts who can help a community build on its strengths through WebPages, video and brochures. Health boards need to acknowledge the contribution of medical students regularly and host student visits at strategic times throughout the medical school experience.
Perhaps the greatest mistake we have made has been our tendency to take things for granted. While the rest of the world swoops down on our physicians and graduates with aggressive marketing, we have not reacted quickly enough. Today more than ever, physician recruitment is an international market, delivered as a service with a definite finesse, and we must become expert in order to compete.