Association of mental health encounters in medical school with physician specialty in Ontario, Canada

Résumé fourni par la source

Mental health concerns among medical students are common and may influence specialty selection and early-career practice patterns. However, their potential impact on physician workforce distribution across specialties is not well understood. We conducted a population-based cohort study of physicians newly registered with the College of Physicians and Surgeons of Ontario (CPSO) between 2008 and 2018. We linked CPSO demographic data with ICES (formerly known as the Institute for Clinical and Evaluative Sciences) health administrative databases using unique encoded identifiers. Mental health encounters were defined as ≥ 1 healthcare encounter for mental health or substance use in the two years prior to medical school graduation. The outcome was the first specialty listed at initial CPSO registration, reflecting physicians’ earliest registered specialty upon entry into practice. We used multivariable logistic regression to examine the association between mental health encounters and specialty (with Family Medicine as the referent group) adjusting for age, sex, language proficiency, medical school, rurality and neighbourhood income quintile at age 16. Among 7105 physicians (median age 26 years, 56% female), 46% entered Family Medicine ( n = 3261). Compared with Family Medicine, physicians with a prior mental health encounter had lower odds of entering acute care specialties including Emergency Medicine/Critical Care (OR 0.48; 95% CI 0.35, 0.67), Surgery (OR 0.63; 95% CI 0.52, 0.77), Anaesthesia (OR 0.67; 95% CI 0.50, 0.91) and Internal Medicine/Neurology (OR 0.68; 95% CI 0.58, 0.80), and higher odds of entering Psychiatry (OR 1.55; 95% CI 1.22, 1.97). Mental health encounters near medical school graduation are associated with early-career specialty registration. These findings may reflect differences in perceived or actual residency support, lifestyle considerations, or training demands across specialties. Not applicable.

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