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Margrete Gaski National Centre of R ural Medicine

Physician retention in Norway’s northernmost county : How effective has the tailored internship strategy been ?. Margrete Gaski National Centre of R ural Medicine University of Tromsø – The Arctic University of Norway. Internship in Norway → 1. M arch 2014 .

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Margrete Gaski National Centre of R ural Medicine

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  1. Physicianretention in Norway’s northernmost county: How effective has thetailoredinternshipstrategybeen? Margrete Gaski National Centre of Rural Medicine University of Tromsø – The Arctic University of Norway

  2. Internship in Norway → 1. March 2014 Medical education in Norway: 6 years Internshipin Norway 1.5 years of training after completing medical education: 1 year in hospital + ½ year in primary health care → Regular internship: Allocation by raffle Tailored internship strategy: Students in 10th term can sign up for internship in Finnmark, in advance of raffle: • Category 1: geographical affiliation to Finnmark • Category 2: others Intension: to recruit and retain more doctors to Finnmark Period of tailored internship strategy: 1. August 2009 – 1. March 2014

  3. Finnmark County - Rural and Remote Area • Population of 75 000 • 19 municipalities: • 4 major municipalities • (≥ 6000) • 15 remote municipalities (<6000) • 2 hospitals Comparison area: Another vulnerable area (Sogn og Fjordane county), • Population of 109 000 • 25 municipalities: • 5 major municipalities (≥ 6000) • 20 remote municipalities (<6000) • 3 hospitals

  4. Finnmark Comparison area

  5. How effective is the tailored internship strategy? Employment today: Figure: Share of doctors still working in and outside their “internship county” (N=388)

  6. Tailored Internship Strategy:Not very effective for the 15 remote municipalities Doctors completing tailored internship ► 75 % chose the 4 major municipalities Internship in primary health care 1. August 2009-1. March 2014: • Tailored internship: All 10 of the remaining GPs work in the 4 major municipalities • Regular internship in Finnmark: 8 of the 13 remaining GPs, work in major municipalities • Comparison area: 3 of the remaining 9 GPs , work in major municipalities. VS

  7. Significance of geographical affiliation to Finnmark among doctors* working in Finnmark N=23 N=18 * internship in primary health care 1. August 2009-1. March 2014

  8. Possible Explanations The tailored internship strategy is effective - The rural background effect Other possible explanations of the results: • The labour market • Different education models • The Hawthorne effect (the observer effect) • Other recruit and retain-measures: • The Action Zone for Finnmark and Northern Troms • Doctor recruitment project in hospitals in Finnmark (2005 -)

  9. Internships in the Future What about the significance of local affiliation as a qualification?

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