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The review synthesizes peer-reviewed evidence published from January 1, 2000 to March 30, 2025 using Whittemore and Knafl’s five-stage approach and a five-domain coding framework (personal, family, community, professional, structural/systemic). Results show structural and professional barriers as key deterrents and identify community ties, spousal support, team-based practice, and continuing professional development as facilitators, informing seven physician personas and multi-level recommendations.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/to-stay-or-leave-an-integrative-review-of-factors-personas-and-recommendations-for-retaining-family-physicians-in-canada/455861/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/to-stay-or-leave-an-integrative-review-of-factors-personas-and-recommendations-for-retaining-family-physicians-in-canada/455861.png","ImageObject",300,407,{"name":92,"@type":93},"Damian","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-10","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the main purpose of the review?","Question",{"text":113,"@type":114},"The review synthesizes literature to identify key drivers of family physician retention in Canada and to provide evidence-based recommendations to support sustained comprehensive practice.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which factors most strongly influence retention, according to the results?",{"text":118,"@type":114},"Structural and professional barriers—such as licensure restrictions, administrative burden, and limited autonomy—emerged as the most consistent deterrents across the five domains.",{"name":120,"@type":111,"acceptedAnswer":121},"What recommendations are highlighted to improve retention?",{"text":122,"@type":114},"Recommendations include reforming licensure and payment models, enhancing mentorship and continuing medical education access, supporting spousal integration, and fostering culturally safe, community-rooted team-based practice models.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},455861,1791468898,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":26,"preview_page_count":4},137451208677,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Okpalauwaekwe etal. BMC Primary Care (2026) 27:6  \n[https://doi.org/10.1186/s12875-025-03128-x](https://doi.org/10.1186/s12875-025-03128-x)  \nBMC Primary Care  \nRESEARCH Open Access  \nTo stay or leave: an integrative review offactors, personas, and recommendations for retaining family physicians in Canada  \nUdoka Okpalauwaekwe 1*, Brian K. MacPhee2, Lindsay Balezantis2, Vivian R. Ramsden3 and Angela Baerwald4  \nAbstract  \nIntroduction Family physicians are the cornerstone of primary health care in Canada. Yet, retention remains a growing concern. Challenges in retaining family physicians poses serious implications for healthcare accessibility, continuity, and equity across all practice contexts in Canada, including (but not limited to) rural, remote, urban, and underserved communities. Currently, 25% of Canadians do not have a primary care provider. While much attention has been given to recruitment, less is known about the multifaceted and intersecting factors that influence whether practicing family physicians and family medicine trainees (including Canadian Medical Graduates (CMGs) and International Medical Graduates (IMGs)), remain in sustained comprehensive practice in Canada. This review synthesizes the literature to identify key drivers of family physician retention and offers evidence-based recommendations.  \nMethods We conducted an integrative review of peer-reviewed literature published between January 1, 2000, and March 30, 2025, following Whittemore and Knafl’s five-stage methodology. A systematic search was carried out across five electronic databases. Included studies were assessed for quality and thematically analyzed using a fivedomain coding framework: personal, family, community, professional, and structural/systemic. Composite personas were developed to illustrate recurring physician retention trajectories and evidence-based recommendations were thematized across our five-domain coding framework.  \nResults Of the 1,613 records screened, 23 studies met inclusion criteria. Factors influencing retention were identified across all five domains. Structural and professional barriers, including licensure restrictions, administrative burden, and limited autonomy, emerged as the most consistent deterrents. Facilitators included strong community ties, spousal support, team-based practice environments, and access to continuing professional development. We identified and developed seven physician personas to create a portrait of the diverse experiences of family physicians in Canada. Key recommendations included reforming licensure and payment models, enhancing mentorship and CME access, supporting spousal integration, and fostering culturally safe, community-rooted team-based practice models. Conclusion Retaining family physicians in Canada is a relational challenge that requires collaborative, multi-level change. Tailored, context-specific retention strategies co-designed with physicians and communities can enhance sustainability and health equity especially in rural, remote and underserved communities.  \n*Correspondence:  \nUdoka Okpalauwaekwe [udokaokpala.uo@usask.ca](udokaokpala.uo@usask.ca)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly fr","cbCainxkvwNLpV8E","https://ap.wps.com/l/cbCainxkvwNLpV8E","pdf",2920683,24,"English","# Abstract\n# Introduction\n# Methods\n# Results\n# Conclusion\n# Keywords","[{\"question\":\"What is the main purpose of the review?\",\"answer\":\"The review synthesizes literature to identify key drivers of family physician retention in Canada and to provide evidence-based recommendations to support sustained comprehensive practice.\"},{\"question\":\"Which factors most strongly influence retention, according to the results?\",\"answer\":\"Structural and professional barriers—such as licensure restrictions, administrative burden, and limited autonomy—emerged as the most consistent deterrents across the five domains.\"},{\"question\":\"What recommendations are highlighted to improve retention?\",\"answer\":\"Recommendations include reforming licensure and payment models, enhancing mentorship and continuing medical education access, supporting spousal integration, and fostering culturally safe, community-rooted team-based practice models.\"}]","To stay or leave - an integrative review of factors, personas, and recommendations for retaining family physicians in Canada | PDF",1790744518]