The number and retention of physicians practicing in New Brunswick is a major issue in the province. This webinar aims to present demographic data to explore the factors linked to the retention of CFMNB medical graduates. Among the factors discussed are medical specializations, as well as graduates’ gender and place of origin (urban vs rural). This communication also discusses physicians from New Brunswick who have studied at the Université Laval or Université de Montréal through the NB – Québec Agreement.

1. Retention of CFMNB Graduates
in NB: Demographics and Trends
Dr. Michel H. Landry, director of the Centre de formation
médicale du Nouveau-Brunswick (Moncton)

2. My roles
• Associate Dean of Université de Sherbrooke’s
school of medicine
• Director of CFMNB
• Coordinator of the Francophone Medical
Formation Program of NB
o Program quality, its budgets and its outcomes
o Train to meet the needs of our community

3. Context and Timeline
• Hall Commission in early 1960:
– 4 new medical schools
– 3 were started
– Only one not put in place… in NB
• Instead… purchase seats in other medical
schools

4. Context and Timeline
• 1967 – NB negotiates an agreement with three Francophone medical
schools in Québec (U Laval, U de Montréal, and U de Sherbrooke)
• 1981 – Programme de formation médicale francophone du N.-B. (NB
Francophone Medical Education Program) is established at Moncton’s Dr.
Georges-L.-Dumont Regional Hospital
• 1999 – 24 months of the Family Medicine Program are offered in NB
through U de Sherbrooke
• 2006 – CFMNB is established in Moncton as a regional medical campus
(RMC) of U de Sherbrooke
• Limited number of places still reserved each year at U Laval and U de
Montréal

5. Currently:
• 30 seats in Québec:
– 24 in Sherbrooke – at the Centre de
formation médicale du N.-B. (CFMNB)
– 3 Laval
– 3 Montréal

6. Why is it important to track the
students?
• GNB invests a lot of taxpayers’ money…
– What is the return on the investment
• Major workforce shortage everywhere
– The main source of physician resources

7. Previous study conducted in 2011

8. Study highlights
• Greater exposure to New Brunswick during medical training is
associated with significantly better odds that doctors will be
recruited to and retained in the province.
• Some effects are perceived for exposure during both
undergraduate (most importantly in the final years) and
postgraduate programs.

9. • Tableau 3 de l’article

10. After 10 years of the CFMNB

11. All participants
(n=456) n (%)
Family
doctors
(n=282)
n (%)
Specialists
(n=174)
n (%)
Practice in Atlantic at time of tracking 311 (68%) 220 (78%) 91 (52%)
University attended (undergraduate)
Université de Sherbrooke, main campus (1973-2005) 208 (46%) 128 (46%) 80 (46%)
Université Laval (1973-2010) 121 (27%) 63 (22%) 58 (33%)
Université de Montréal (1973-2010) 61 (13%) 40 (14%) 21 (12%)
CFMNB (2006-2010) 66 (14%) 51 (18%) 15 (9%)
Sex, female 225 (49%) 133 (47%) 92 (53%)

12. Comparisons of
MDs trained at
CFMNB vs UdeS*
MDs trained at CFMNB
practicing in Atlantic
MDs trained at U de
S* practicing in
Atlantic
P value
(χ²
test)
Cramer
𝝋𝟐**
RR*** (CI 95%) of practicing in
Atlantic if trained at CFMNB instead
of U de S*
All 86% (57/66) 63% (132/208) < 0.001 0.21 1.36 [1.18 – 1.57]
Family doctors 88% (45/51) 78% (100/128) > 0.05 0.12 1.12 [0.99 – 1.29]
Specialists 80% (12/15) 40% (32/80) < 0.05 0.29 2 [1.38 – 2.89]
Comparisons of
MDs trained at
CFMNB vs ULaval
and UMontréal
MDs from
CFMNB
practicing in
Atlantic
MDs from ULaval
and UMontréal
practicing in Atlantic
P value
(χ² test)
Cramer
𝝋𝟐**
RR*** (CI 95%) of practicing in
Atlantic if trained at CFMNB
instead of U Laval and U de
Montréal
All 86% (57/66) 68% (123/182) < 0.05 0.19 1.29 [1.12 – 1.48]
Family doctors 88% (45/51) 73% (76/104) < 0.05 0.17 1.21 [1.04 – 1.41]
Specialists 80% (12/15) 59% (32/80) > 0.05 0.16 1.35 [0.99 – 1.84]

13. Location of practice – NB graduates from U de
Montréal, U Laval and pre-2006 U de Sherbrooke
63.7
43.1
36.3
56.9
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Family Physicians Specialists
Other
NB

14. General data on CFMNB graduates
257 MD
(2006-2021)
63% 37%
54% rural 46% urban
*Urban > 10,000 pop.
Area of origin
65.0%
17.5%
5.6%
1.7%
1.7%
8.5%
Family and emergency
medicine
Internal medicine
Surgery residency
Anesthesia
Radiology and nuclear
medicine
Other

15. Location of practice – family physicians
and specialists trained at the CFMNB
85.7
54
14.3
46
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Family Physicians Specialists
Other
NB

16. Location of practice – all CFMNB graduates
Province
# of
MDs
% of
MDs
NB 136 74.7
QC 31 17.0
ON 8 4.4
NS 4 2.2
AB 2 1.1
MB 1 0.6

17. Specialty Number of
graduates
Practice
in NB
n (%)
Practice
in QC
n (%)
Practice
elsewhere
n (%)
Family medicine and emergency 115 100 (87)7 (6) 8 (7)
Internal medicine 31 16 (52)11 (35) 4 (13)
Residency in surgery 10 6 (60)2 (20) 2 (20)
Pediatrics 5 2 (40)2 (40) 1 (20)
Psychiatry 4 1 (25)2 (50) 1 (25)
Anesthesia 3 2 (67)1 (33) 0 (0)
Radiology and nuclear medicine 3 1 (33)2 (67) 0 (0)
Obstetrics and gynecology 3 3 (100)0 (0) 0 (0)
Ophthalmology 2 1 (50)1 (50) 0 (0)
Dermatology 1 0 (0)1 (100) 0 (0)

18. Location of practice – Last 5 years
2016 2021
Family doctors 86.3% 85.7%
Specialists 70.5% 54.3%
• Specialists have increasingly stayed in
Quebec (36.5%) and Ontario (7.9%),
up from 14.7% and 0, respectively.
CFMNB graduates

19. Location of practice – Last 2 years
• 26 CFMNB graduates in family medicine,
and 18 specialists
• Of those family physicians, 92.3% are
now practicing in NB

20. Health zones – areas of origin and practice
0
10
20
30
40
50
60
70
Zone 1 Zone 2 Zone 3 Zone 4 Zone 5 Zone 6 Zone 7
Area of origin
Practice fam. med.
Practice spec.

21. NB north-south distribution
Area of practice
Place of birth Northern NB Southern NB Outside NB
Northern NB 36 32 17
Southern NB 8 48 19
Outisde NB 3 7 8
χ2 test = 25.55 p<.0001
• Among doctors practicing in
southern NB, 64% are working for
Vitalité and 36% for Horizon
• CFMNB-trained doctors originally
from northern NB are 7 times
more likely to return to that area
to set up their practice compared
to those from southern NB
• 73.3% of NB graduates are
practicing in urban areas
(pop.>10,000), while 26.7% are
located in rural areas

22. Results
• Completing medical program in NB increases the
likelihood of graduates practicing in NB
• Family physicians are generally more likely to
practice in NB than specialists
• Zone 1 tends to retain graduates who are from
this zone originally and to attract many from
other zones (notably zones 4, 5 and 6)

23. So we know:
• Training in the province vs no exposure
– Family physicians 6 times more chance of returning
– Specialists about 3.2 times more likely to return
• Our francophone family medicine training program
retention rate of 85% to 90%
• If originating from northern NB, 7 times more
likely to return to practice in the same area

24. So we know:
• Specialists trained in Québec with no
exposure to NB = 40% return
• Those who complete their undergrad in NB
show higher rates of return initially but this
rate falls to 50-55% in recent years
– What is influencing this and what can we do?

25. So what can we do?
• Train more students from the province?
• Influence where our students come from?
• Have more specialty training in the province?
• Find ways to create stronger relationships
with those studying a specialty?

26. MD PROGRAM
OR UNDERGRAD
(4 years)
Pre-med Program
(80%)
(2 years)
University degree(s)
(20%)
(4+ years)
24 students at the
CFMNB
3 Université Laval
3 Université de Montreal
CaRMS
POSTDOCTORAL OR RESIDENCY
TRAINING
Family
medicine
(2 years)
Psychiatry
(5 years)
Speciality
training
(4 to 6 years)
PRACTICING PHYSICIANS
(minimum 8 years of University)
And minimum 6 years in medical program
UMF – Dieppe
16-18
positions/annually
Admission requirements :
Academic mark « Cote Z » :
Université de Moncton or other
MEMFI-Atlantique
U of S / CFMNB / U de M
Steps to become a physician*
Must be a New Brunswick resident to be eligible for CFMNB
Admission process
All in New
Brunswick
Moncton
2 positions/annually

27. Use of the data bank
• Types of questions:
Would you be able to provide me the overall retention rate for CFMNB, and the
breakdown for family medicine and specialties? If possible, by the end of the
day? And could we get the average distribution between family medicine and
specialties?
How about: total average since 2006 for all graduates, family medicine and
specialties; and last two years for same, all graduates, family physicians and
specialists?
Thank you.

28. Questions