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Green M et al. – The authors found significant differences in the practice patterns of third–year program (PGY3) graduates and those of core program graduates. Graduates of PGY3 programs are more likely to provide care in nonoffice settings, but by far most core program graduates also participate in out–of–office care; only 13.8% initially and less than 20% after 6 years have "office–only" practices. Concerns about substantial diversion into specialized niche practices are largely unfounded, as only a very small number of recent graduates are classified as "quasi–specialists." Participation in PGY3 training is strongly associated with increased participation in care outside the office. Access to additional training might be one way to ensure that comprehensive family medicine continues to be a vital component of our health care system.


Exclusive Author Commentary
Michael Green, 09/18/09

For years there as been debate about the impact of extra training in particular areas of interest within family medicine on how graduates practice after completion of training. This is the first comprehensive examination of this issue in Ontario, Canada. We used admiinstrative billing data from our provincial health plan to see what types of work was billed by physicians whose training was either the standard 2 year program and those who undertook extra training in a number of areas. There were signficant differences between the groups, with higher rates of participation in out of office care in the extra training groups.

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