[The decentralized training program and the retention of general practitioners in Quebec's Lower St. Lawrence Region].
OBJECTIVE
To assess the effect of decentralized training programs, financial incentives, and physicians' origins on whether general practitioners continue to practise in an area.


DESIGN
Our data were obtained from the physician database maintained by the Bas-Saint-Laurent Regional Department of Health and Social Services and from responses to a mailed questionnaire completed by physicians in the study.


SETTING
The Lower St. Lawrence Region of Quebec.


PARTICIPANTS
General practitioners who practised in the area between 1985 and 2003.


METHOD
We used the Cox proportional hazards model of survival analysis to ascertain which variables were related to retaining physicians in the area.


RESULTS
The adjusted probability of physicians remaining in Bas-Saint-Laurent after being exposed to the area through rural rotations had an odds ratio of 2.12 (P = .15). The probability of remaining in the area climbed to an odds ratio of 4.5 (P < .01) for physicians originally from the Bas-Saint-Laurent region. Financial incentives appeared to make little difference to whether physicians were retained in the area.


CONCLUSION
The most promising strategies for retaining rural general practitioners are recruiting candidates from rural areas and exposing medical students to rural practice through decentralized training.