Doc­tors ed­u­cated abroad can cure Canada's health­care woes

Prairie Post (East Edition) - - Viewpoints - BY SAN­DRA BAN­NER

Canada has fewer doc­tors per capita than al­most ev­ery other wealthy na­tion. 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 per­cent of cit­i­zens aged 12 and older don't have a pri­mary health­care 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 per­cent of the pop­u­la­tion re­sides in a ru­ral area, fewer than 10 per­cent of the na­tion's physi­cians prac­tice there.

A dearth of doc­tors makes it dif­fi­cult for Cana­di­ans to ob­tain care. Only 43 per­cent of Cana­di­ans can get a same­day or next-day 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. 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 prac­tis­ing in Canada will re­tire soon. About 40 per­cent are 55 or older.

Cana­dian med­i­cal schools aren't grad­u­at­ing enough doc­tors to fill these gaps -- es­pe­cially in 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 per­cent 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.

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