Demographics

Medical Resident Demographics	PDF
(FM) Please indicate your current status.	PDF
(SP) Please indicate your current status.	PDF
(SP) Are you in your final year of your residency?	PDF

A. About you.

Q1: Age.	PDF
Q2: Sex.	PDF
Q3: How many years of POST-SECONDARY education did you complete before beginning medical school?	PDF
Q4: Beyond secondary school, what degrees/ diplomas did you complete prior to entering medical school?	PDF
Q5a: What year were you awarded your M.D. degree?	PDF
Q5b: At which university were you awarded your M.D. degree?	PDF
Q6a: At which university are you currently registered for your residency medical training?	PDF
Q6b: Please indicate where your residency training is located.	PDF
Q6c: Please indicate the number of weeks you have received training as a medical resident in the following settings.	PDF
Q7: Are you studying at a regional or satellite medical campus? If yes, please specify:	PDF
Q8: What led you to select a career in medicine?	PDF

B. Training.

(SP) Please indicate the training program you are in.	PDF
Q9: Please indicate your overall satisfaction with your residency training program.	PDF
Q10: Please indicate your satisfaction with the following at your medical school:	PDF
Q11 (FM): For the following experiences within your residency training, please indicate if the specific category of training is/was available.	PDF
Q11 (FM): For the following experiences within your residency training, please indicate you intend to provide the following in your medical practice.	PDF
Q11a (All): Please indicate if the specific category of training is/was available within your residency training.	PDF
Q11a (FM): Please indicate if the specific category of training is/was available within your residency training.	PDF
Q11a (SP): Please indicate if the specific category of training is/was available within your residency training.	PDF
Q11b (FM): Please indicate if specific training on providing care to the following demographic groups was available as part of your residency training and if you intend to provide care for those demographic groups as part of your practice.	PDF
Q11b (SP): Please indicate if specific training on providing care to the following demographic groups was available as part of your residency training and if you intend to provide care for those demographic groups as part of your practice.	PDF
Q12a (SP): Considering the domain of your discipline, please describe the main focus of your intended practice.	PDF
Q12b (SP): Do you feel that your residency training will prepare you for the kind of practice you are planning to undertake?	PDF
Q12 (FM): Do you feel that your residency training will provide you with the knowledge and skill required to care for the following?	PDF
Q13: To what extent would you agree or disagree with this statement: "the academic and the clinical service components of your residency program are balanced"?	PDF

C. Future Practice.

Q14a: Once you complete your medicine residency training, do you plan to continue beyond your residency by undertaking a fellowship position?	PDF
Q14a (FM): Once you complete your family medicine residency training, do you plan to continue your residency by undertaking a third year training poistion? Which programs have you applied / been accepted to?	PDF
Q14bi (FM): Once you complete your family medicine residency training, do you plan to practice as a family physician (general practitioner)?	PDF
Q14bii (FM): Once you complete your family medicine residency training, do you plan to specialize within an area of family medicine?	PDF
Q14b (SP): Once you complete your medical residency training, do you plan to sub-specialize within an area of your current specialty?	PDF
Q14c: Once you complete your medical residency training, do you plan to join or set up a practice? If yes, what type of practice would you prefer?	PDF
Q14d: Once you complete your medical residency training, do you plan to have call responsibilities?	PDF
Q14e: Once you complete your medical residency training, do you plan to practice as a locum?	PDF
Q14f: Once you complete medical residency training, do you plan to practice in a hospital setting?	PDF
Q14g: Once you complete your medical residency training, do you plan to seek an administrative (non-patient care) position?	PDF
Q14h: Once you complete your medical residency training, do you plan to apply for (a) hospital appointment(s)?	PDF
Q14i: Once you complete your medical residency training, do you plan to apply for (a) faculty appointment(s)?	PDF
Q14j: Once you complete your medical residency training, do you plan to practice within the same province in which you are currently training?	PDF
Q14k: Once you complete your medical residency training, do you plan to practice in another province or territory in Canada? If so, which ones?	PDF
Q14l: Once you complete your medical residency training, do you plan to leave Canada to practice in another country? If yes, which country?	PDF
Q15: Are you being actively recruited for a practice location? If yes, where are you being recruited to?	PDF
Q16a: What language(s) can you speak with your patients?	PDF
Q16b (FM): Please describe the population PRIMARILY served by the practice you intend to undertake after completion of residency.	PDF
Q17 (SP): Please indicate the types of health care providers with whom you regularly interact:	PDF
Q17 (FM): Please indicate the types of health care providers with whom you regularly interact.	PDF
Q18a: What do you think will be factors in having a satisfying and successful medical practice?	PDF
Q18b: Please indicate which of the factors in 18a. is the one most important factor for you to have a satisfying and successful medical practice.	PDF

D. Time Allocation

Q19: Please indicate in which of the following areas you intend to spend time or participate upon completion of your residency training.

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E. Information Technology

Q20: Have you used or been exposed to electronic medical records to enter/retrieve patient clinical notes during your clinical training? If yes, in which setting(s)?	PDF
Q21: Would you expect to use electronic medical records to enter/retrieve patient clinical notes instead of paper when you enter into practice?	PDF
Q22: What websites do you use for access to research or clinical information?	PDF

F. Professional Income.

Q23: How would you prefer to be paid for your services as a physician?

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G. Finances.

Q24a-d: Please indicate how much education-related debt you incurred during each of the following timeframes, and how much debt you estimate you will have after the completion of your residency.	PDF
Q24e: If you indicated debt incurred during medical school, did your debt influence your choice of medical specialty in any of the ways listed below?	PDF
Q24f: If you expect to have debt upon completion of residency, do you intend to do any of the following to pay off the debts you have accumulated in your pre-medical and medical training?	PDF
Q25: Have you received scholarships or other financial support that does not require repayment for your post-secondary education? If yes, how much?	PDF
Q26: Is there a return of service agreement associated with your postgraduate medical education?	PDF
Q27: To what extent do you believe that the amount of financial assistance available to you through grants and loans from either the government or university institutions, meets your actual financial need?	PDF
Q28: What proportion of your financial debt is through personal loans, bank loans, and government loans?	PDF

H. Demographics.

Q29a: Where were you born?	PDF
Q29b: Please indicate your status in Canada.	PDF
Q30: Where did you grow up prior to going to university?	PDF
Q31: Select the ONE statement which best describes the environment in which you grew up prior to university.	PDF
Q32: Current marital status.	PDF
Q33: Do you have children (including stepchildren)?	PDF