Canadian grads should get first shot at residency
Re Haunting epitaph: ‘What good is a doctor who cannot practise?,’ June 17 The story of Robert Chu is such a heart-wrenching tragedy. Nothing crushes the human spirit more than a sense of futility. And how could this young man not be overwhelmed by such a feeling, after spending $100,000 and pursuing his goal diligently for probably one-third of his young life, only to be tossed aside?
Speaking of her son, his mother reveals the very qualities that would be found in a good doctor. Tenacity, a quality I would hope to see in a doctor searching for a diagnosis. And who wouldn’t want a doctor with broad knowledge and intellectual curiosity, rather than just a narrowly focused technician?
Chu was successful in medical school; he should have been given a chance to practise. Medical school enrolment should match residency positions. Health Minister Eric Hoskins, please fix this. Linda Genova, Toronto
Re Residency for every M.D., June 20 Your editorial fails to address an even more troubling situation. Currently, Ontario residents and Canadian citizens graduating from non-Canadian medical schools, known as International Medical Graduates (IMG), are even more discriminated against and have much less chance to get a residency.
The Canadian Resident Match Service (CRMS), which runs the matching program for the Ontario government, is controlled by the medical elite (universities, doctors and medical student associations) and is seriously conflicted and self-serving. CRMS runs the matching process in two steps, the first for Canadian medical graduates only and then for IMGs, who compete for the remaining 5 to 10 per cent of the total available positions.
Thus, IMGs who are Ontario residents, and in many cases have had their undergraduate and graduate education funded by the Ontario government, do not have an equal opportunity to apply for all resident positions.
This is not acceptable and the Ontario government must take action to ensure that all Ontario residents and Canadian citizens are treated fairly and equally. Bill Fearn, Toronto It is heartbreaking to read that preventable problems with the Canadian Resident Matching Service contributed to the suicide of 25-year-old Robert Chu.
Entry to a Canadian medical school like McMaster University is extremely competitive, and many high-achievers miss out. Each year, about 100 of them choose to study in Australia as a full-fee-paying student instead. At my alma mater, The University of Sydney, these students pay $300,000 (plus living costs) for a Doctor of Medicine, with no guarantee of a residency in either Australia or Canada at the end — without which they can never practise medicine and serve society as a doctor. The stress must be enormous, especially for students who incur a mortgage-sized debt in the process.
It is fashionable for medical schools and hospitals to speak about individual-level factors like “resilience” training to improve doctors’ mental health, but systemic factors like medical school fees, inadequate workforce planning and unrealistic workload pressures for residents are the biggest and most urgent issues to address.
Robert’s suicide is unacceptable, and the least his family deserves is for the medical profession and governments to act immediately to prevent more such avoidable suicides. Dr. Benjamin Veness, past-president of the Australian Medical Students’ Association, Melbourne, Australia
Robert Chu was correct in his criticism of our system. Several years ago, doctors qualified in other countries were complaining that, due to the inability to obtain resident positions, they were often unable to continue in the medical profession. The Canadian medical community responded compassionately by reserving some residency positions for such doctors.
However, it appears that such opportunity has been abused. Students who failed to meet the standards of our medical schools have received foreign degrees and then obtained residency through the back door. The Canadian medical degree is devalued if those who were not admitted to a Canadian school can obtain residency ahead of Canadian graduates.
Priority must be given to those trained in Canada. Then we can consider foreign doctors with at least five years’ post-grad practice. Only after that should new graduates from foreign universities be considered. Paul D. Mack, Oshawa
“Robert Chu’s suicide is unacceptable, and the least his family deserves is for the medical profession and governments to act immediately to prevent more such avoidable suicides.” DR. BENJAMIN VENESS MELBOURNE, AUSTRALIA
What kind of province do we live in where a bright, young, promising medical student cannot obtain a residency to complete his training as a much-needed doctor? Yet this same province has extended credit to presumably addicted gamblers to the tune of $10 million that is unrecoverable.
I am shocked and outraged that our government is more interested in fuelling gambling addictions than ensuring we have enough residency places for aspiring doctors.
We live in a rural community where many residents do not have a family doctor and are languishing on waiting lists that get longer every day. This unacceptable situation must be addressed and I challenge our legislators to ensure our hard-earned tax dollars are spent in a more responsible way. Kim Stamp, Haliburton, Ont.
The Canadian Resident Matching Service should be ashamed of stopping Dr. Robert Chu from succeeding in the profession he had planned and worked for throughout his stellar education.
This service needs to provide residency opportunities for Canadian medical school graduates first and foremost, because these graduates are Canada’s top students who competed academically to gain coveted entrance to Canadian medical schools.
Students who choose medical training abroad, where admission is easy for a huge cost, should not be eligible for Canadian residency placements until all Canadian medical school graduates have been accommodated. And more residency places must be created in Canadian hospitals to serve the growing demand for doctors. Sammy Smith, Whitby
Re Grad’s suicide a message medicine cannot ignore, Opinion, June 20 I think Dr. Franklin Warsh’s column slips into the tunnel vision problem of medical treatment. He wants to atone for the tragedy of Robert Chu’s suicide but ignores the bigger problem of why Chu’s suicidal tendency wasn’t identified before the tragedy.
Florida State University psychology researcher Jessica Ribeiro, in her paper “Predicting Risk of Suicide Attempts over Time through Machine Learning,” has developed a method that can identify suicide risks with 80- to 90-per-cent accuracy up to two years in advance. Why don’t medical schools (and other high stress environments) develop and implement such tools?
The medical profession has become proactive instead of reactive, such as recommending healthy diets and exercise to prevent cardiovascular disease. So why does it drag its feet on mental-health issues such as suicide prevention? Moses Shuldiner, Toronto