87 Big shoes to fill: Realities of Rural Pediatricians in British Columbia
Bibliographic record
Abstract
Abstract Background Recruitment and retention of paediatricians remains a challenge in rural settings across Canada. In British Columbia, paediatricians are specialty physicians who provide consultation for children and neonates who are acutely unwell or with complex medical conditions. Little is known about the state of rural paediatrics in British Columbia (BC) and the reality of the province's rural paediatricians. Objectives Using a survey, this study aimed to understand rural paediatrics in BC, in terms of physician workload and burnout, recruitment, and participation in medical education. Design/Methods For the purposes of this survey, those communities with a rural practice subsidiary agreement (RSA) were considered rural. There are 12 RSA communities with paediatricians in BC, served by 32 paediatricians. Surveys were sent to the 28 paediatricians with available contact information and responses were received from 96% (27/28) of those paediatricians. Results Only one community has more than 5 paediatricians, and 11/12 communities are supported by a single or pair of paediatricians. Sixty-three percent of respondents have been in practice for 10 or more years, and all of the solo paediatricians have been in practice for more than 10 years. This data supports previous studies, which have identified aging of paediatricians, fewer new graduates choosing to practice in rural settings, and difficulty retaining those currently practicing as key factors contributing to the challenges in providing rural paediatric care. Over 75% of respondents reported some degree of burnout, and no respondents were looking to increase their workload. The workload challenges did not seem to be affected by the number of paediatricians in a community. Recruitment was a significant concern for over 80% of respondents, and only 7% felt their community had effective recruitment strategies. When asked what recruitment strategies have previously been effective, mentoring by local paediatricians was a frequent response, indicating that physicians are taking it upon themselves to actively recruit others. Approximately 80% of respondents reported participating in the education of medical students or residents, which has been shown to increase job satisfaction when balanced with workload. Conclusion This survey will contribute to the understanding of the current state of rural paediatrics in BC, a will form the basis for the development of new initiatives, and allow for their evaluation as they are implemented.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".