More than 80% of RFS doctors in NL fulfill their RFS contract (either by work or by reimbursement). The vast majority of RFS physicians who do so (96 out of 108, 89.0%) complete their service commitment in full. These results support our hypothesis that the majority of RFS physicians meet their service obligation (instead of buying their commitment or failure). The RFS implementation rate of 80.6% is lower than that reported by RFS program managers in Nova Scotia (89%) and Quebec (90%-95%), but these programs were not formally evaluated at the time of this study (Neufeld and Mathews 2012). The 89% service graduation rate in NL is higher than the 50%-60% found in Ontarios Underserviced Area Program – Rural assessments of the 1980s (Copeman 1979, 1987). A meta-analysis showed that 71% of RFS participants fully fulfilled their service obligations or were in the process of fulfilling their obligations (Bärnighausen and Bloom 2009). If we calculated graduation rates with the methods used in these studies (including the 53 RFS doctors who are in the process of fulfilling their service obligation), the graduation rate for NL is 86.1% (161 out of 187 RFS doctors). The RFS program improves physician engagement in NL. Most RFS doctors (71.9%) fulfil their benefit obligations. 9% of them would fulfil their contractual obligations either by reimbursing their financing in full (with applicable penalties/interest) or by combining work and reimbursement. The RFS agreements on the financing of scholarships have been more effective than the RFS agreements on the financing of places of stay. Physicians Special Funded RFS agreements were more than 11 times less likely than physicians who entered into RFS family medicine agreements to fulfill their service obligations. RFS doctors remained in the province rather than non-RFS doctors.
More than half of the RFS doctors stayed in their starting offices. Based on this study, we recommend limiting RFS agreements to optional, bursary-type incentives and improving the tracking of RFS physicians to increase service completion and retention rates. Four-16 (71.6%) of rsa`s 134 physicians fulfilled their duty of service. Physicians who received funding from the Special Funding Residency Position program were 11.1 times rarer (95% CI: 4.0-33.3) than physicians who received the Family Medicine Bursary program. In the group of 60 OS and 67 non-OS physicians, 16.9% of os physicians, compared to 41.8% of non-OS physicians, had already left TN in 2010 (p=0.004). OS physicians were 3.22 times less likely (95% CI: 1.41-7.14) that physicians did not leave the SYSTEM. Four years after starting the practice, about 90% of OS doctors, compared to 60% of non-OS doctors, are still in TN; after 10 years, 70% of OS doctors, compared to 60% of non-OS doctors, still at TN (p=0.006). On the program: The goal of the re-entry program is to increase flexibility in the medical education system by offering experienced physicians the opportunity to return to a new area of interest while meeting the needs of a large number of medical services in Ontario. . . .