Fully Matched

This year, students graduating from Dalhousie Medical School are opting for careers in family medicine in impressive numbers. 

In fact, half of the graduating class will begin their residency training in family medicine this summer, marking a significant increase since 2018 when only 25 per cent of the class chose to enter a career path in family medicine.

Dalhousie’s Family Medicine program has also seen success, once again filling all available residency positions, a remarkable feat, especially considering the expansion of our residency seats from 70 in 2022 to 91 in 2024. While many programs nationwide face challenges in filling positions, this accomplishment is not merely fortuitous but rather the result of systematic changes implemented five years ago.

In 2018, concern arose when the Faculty of Medicine graduating class witnessed only a 25 per cent match rate to family medicine. Recognizing the pivotal role of family medicine in healthcare, the Faculty of Medicine identified the need for deliberate and sustained efforts to elevate it as a career choice. The Family Medicine Project Charter was launched in response later that year, led by Dr. Jennifer Hall, family physician and then Associate Dean of Dalhousie Medicine New Brunswick, with a goal of achieving a 50 per cent match rate by 2023.

Under the guidance of the charter, initiatives were developed to boost exposure to family medicine across the Dalhousie medicine curriculum. Among them, the longitudinal family medicine clinical exposure experience was introduced for first year medical students; a two-week rural rotation based largely in family medicine was created; enhanced Longitudinal Integrated Clerkship (LIC) opportunities were offered; and career nights were organized for medical students to explore career options within family medicine. Efforts were also made to acknowledge and reward the contributions of family medicine residents and faculty. Continuous feedback from students and tracking career choice data has informed subsequent strategies.

Hidden Curriculum 

"Addressing the notion of the 'hidden curriculum' in which Family Medicine is seen as the least desirable career choice, was a challenging yet essential objective,” states Dr. Kath Stringer, Family Medicine Department Head. “By intentionally integrating family physicians as educators and role models in the undergraduate curriculum we aimed to shift perceptions.”

The results of the Charter’s efforts were promising. One year after its implementation in 2018, the match rate had climbed to 41 per cent. 

In 2023, the Faculty of Medicine transitioned to a more systematic approach to address the hidden curriculum, with the progression from the Family Medicine Project Charter to the Family Medicine Specialty Committee. 

The Family Medicine Specialty Committee led by Dr. Stringer and comprised of various leaders across the Faculty of Medicine, continues to identify and find solutions to the multifactorial barriers students face in choosing family medicine as a desired career. 

The Committee’s work is integral to the Faculty of Medicine’s strategic plan, Realizing Our Ambition, which affirms the university’s commitment to advancing family medicine education and recognizing family medicine as a specialty of choice.

“The solutions lie within both the educational and practice environments, such as deliberate changes to the curricular structure, the development of well supported interprofessional team based primary care clinics and appropriate remuneration models for community-based academic physicians,” says Dr. Stringer, “All of these are being worked on by the Family Medicine Specialty Committee in collaboration with supporting stakeholders.” 

A Group Effort

The work does not end when students choose family medicine as a specialty. Producing competent family doctors, is not possible without the many practicing family physicians across the Maritimes who choose to share their time and expertise with these students. 

“Taking on the role of preceptors, and welcoming learners into their practices, is a clear indicator that these doctors understand the value of medical education for themselves and their communities” says Dr. Stringer. “I am grateful to our preceptors for the work they do as educators and mentors, and to the learners who see the value in pursuing the impactful and rewarding career that is family medicine.” 

A Way Forward

With half of Dalhousie's medical graduates opting for family medicine in 2024, the efforts initiated by the Family Medicine Project Charter and now carried forward by the Family Medicine Specialty Committee are yielding significant results. 

“The choice to pursue family medicine reflects our learners’ dedication to the field and embodies their profound understanding of the pivotal role family medicine plays in healthcare,” says Dr. David Anderson, Dean of the Faculty of Medicine. “I congratulate each of them on making this very important decision, and want to express sincere gratitude to the dedicated staff and faculty who helped achieve this impressive accomplishment,”

These positive developments come at a critical time for the Faculty of Medicine, as the Cape Breton Medical Campus, in partnership with Cape Breton University, is slated to open in the fall of 2025. With a focus on rural and family medicine, future students will reap the benefits of a curriculum that values and prioritizes the speciality of family medicine. 

The remarkable increase in Dalhousie's Family Medicine match rate underscores the collective commitment of stakeholders who, over the past five years, have reshaped the narrative around family medicine. Thanks to their efforts, the necessity for continued investment and collaboration in healthcare education reform have been highlighted, and continue to be addressed to meet the ever changing needs of Maritime communities.