The solution for Canada’s doctor shortage is abroad

Canada isn’t training enough new MDs to close the gap

Canada has fewer doctors per capita than almost every other wealthy nation. And this doctor shortage will worsen in the coming years. Canadian medical schools aren’t producing enough physicians to meet the needs of our growing population.

To ensure that patients receive timely care, government officials must welcome more physicians educated at international medical schools.

The doctor shortage threatens our nation’s public health.

Nearly 16 per cent of citizens aged 12 and older don’t have a primary health care provider, according to the most recent figures from Statistics Canada. In Quebec, over one-quarter of residents lack a primary care provider.

Canada also lacks enough psychiatrists. Ontario, for instance, is short 200 psychiatrists. That gap will grow to 350 by 2030.

The doctor shortage is particularly severe in rural communities. While 18 per cent of the population resides in a rural area, fewer than 10 per cent of the nation’s physicians practice there.

A dearth of doctors makes it difficult for Canadians to obtain care. Only 43 per cent of Canadians can get a same-day or nextday appointment when they’re sick — putting the country dead last in a study of 11 developed countries. One in five Canadians waits more than a week to see a doctor.

The crisis will deepen as Canada’s population grows in the coming years. Within less than two decades, 47 million people could call Canada home, up from about 37 million today.

At the same time, many of the physicians currently practicing in Canada will retire soon. About 40 per cent are 55 or older.

Canadian medical schools aren’t graduating enough young doctors to fill these gaps — especially in high-need fields like primary care. In 2018, about one-third of Canadian medical graduates chose family medicine residencies. That share has been falling for years. More and more graduates are pursuing careers as specialists, in fields like surgery, anesthesiology, and ophthalmology.

If Canada relies solely on homegrown medical talent in the coming years, the supply of physicians will hardly increase at all — growing from 2.74 doctors per thousand Canadians today to just 2.84 in 2030.

To curb its doctor shortage, Canada needs to look beyond its borders. International medical schools are producing thousands of well-trained graduates — many of whom are Canadian citizens.

International medical graduates are disproportionately likely to pursue careers in primary care. Of the 1,500 IMGs who applied for first-year residencies in Canada this year, more than 60 per cent chose a primary-care discipline as their top preference. Nearly three-quarters of Canadian students from the school I work with — St. George’s University in Grenada — selected residencies in family medicine or internal medicine last year.

IMGs also fill gaps in the psychiatry workforce. In the 2018 match cycle, 129 international graduates chose psychiatry as their first-choice discipline — third only to family medicine and internal medicine. A smaller percentage of domestically-educated grads put this field first.

International medical graduates are also more willing to practice in underserved rural areas than their domestically-trained peers, according to a study of family physicians in southeastern Ontario.

Consequently, the Canadian government must do more to recruit doctors educated abroad — particularly those who are Canadian citizens or permanent residents. Officials can start by funding more residencies for international medical graduates, so that they can complete their training in their home country.

Canada is dangerously short on doctors — and isn’t training enough new ones to close the gap. Doctors educated abroad are willing and able to help. Canada must welcome more of them.

Sandra Banner is the consultant for St. George’s University relations in Canada