In light of the physician shortage and long wait lists, Canada's 17 medical schools must increase enrolment and provincial governments must work harder with professional bodies to license more international medical graduates, says Health Minister Ujjal Dosanjh.
Canada has 2.1 physicians per 1000 population, compared to an average of 2.8 among the other member-nations of the Organization for Economic Cooperation and Development. In 2004, there were 60 612 physicians in Canada.
Part of the problem is that there are only 6.5 medical school positions per 100 000 population in Canada; by comparison, the UK has 12.2 openings.
In addition to increasing enrolment, Canada must also boost the number of residency positions, Dosanjh told reporters on Aug. 29.
The CMA, which is setting up a Centre for Health Workforce Research and Planning, advocates 120 residency spots per 100 medical graduates.
Last year, the federal government set aside $75 million over 5 years to offset the expense of training more doctors, but no province has yet accessed that money, said Dosanjh. The funds are available based on the number of additional residency spots created, not on a per capita allocation.
Meanwhile, the shortage is growing. The proportion of FPs accepting new patients declined from 23.7% in 2001 to 20.2% in 2004, states a new report from the Canadian Institute for Health Information. In 2003, 15.8% of Canadians reported difficulty in accessing routine or ongoing care.
“If the shortage gets worse, patient safety will be compromised and wait lists will increase,” said former CMA President Dr. Albert Schumacher. It is bound to get worse, given that 3800 physicians plan to retire this year.
One solution, said Dosanjh, is to lower barriers that prevent international medical graduates (IMGs) from gaining accreditation. One of those barriers is the shortage of re-entry training positions. Last year, 680 IMGs qualified for training but there were only 80 re-entry positions. The CMA General Council recommends a 4-fold increase.
IMGs are part of the short-term solution, but the CMA emphasized the need for physician self-sufficiency. Currently, 24% of Canada's doctors are IMGs. “Wealthy Canadians cannot and must not rely on systematic recruitment of doctors from countries that cannot legitimately afford it,” said former CMA President Peter Barrett.