Doctor Shortage in Canada

Doctors' walkouts in British Columbia and discontent among physicians across Canada point to critical problems that will lead to a severe doctors' shortage if current trends continue, medical officials say. According to the Canadian Medical Association, we have fewer physicians per capita in Canada than almost any other industrialized country. There are fewer doctors now partly because of a 10 per cent reduction in medical school enrollment that was imposed across the country in 1993.

According to the Association of Canadian Medical Colleges, there were 1,599 medical school graduates last year, down from a peak of 1,835 in 1985. Although Canada has traditionally attracted doctors from South Africa, Britain and Australia, more of them are going to the United States for better pay and working conditions.

The national shortage of doctors is especially worrisome for rural communities, which must deal with one-third less family doctors per capita than urban areas.

Workloads of family doctors in rural Ontario are double that of some metropolitan centres. Already 26% of the rural population has difficulty finding a family doctor, significantly higher than the rates in urban centres. This can only get worse as more doctors burnout from the steadily increasing workload and leave. With no one to replace them health care for rural Ontarians will deteriorate. Currently, rural Ontarians make up about 15% of the population of the province, but are serviced by only about 5% of the physicians.

But other factors also account for the lack of physicians. They include federal government barriers that have prevented foreign-trained doctors from practicing in Canada and an exodus of Canadian doctors to the United States.

Doctors who arrive in Canada as immigrants or refugees are generally discouraged from seeking a medical licence. Those who still wish to pursue a career in medicine must negotiate a complicated and costly series of evaluating and licensing examinations, without government assistance for language or academic upgrading. For those who pass the examinations, there are still barriers. In both Canada and the United States, foreign-trained doctors are required to perform up to two years in a hospital resident program. However, they have generally been systemically excluded from the resident programs, creating a maddening Catch-22 As immigrants with little in the way of financial resources, these doctors are also expected to pay for their examination fees and other academic costs with no government help.

However, foreign-trained doctors will find it easier to work in Manitoba, thanks to a new provincial licensing program.

The Medical Licensure Program for International Medical Graduates (MLPIMG) will assist foreign trained physicians to obtain medical licensure to practise as primary care physicians in Manitoba. International Medical Graduates may apply to the Faculty of Medicine, University of Manitoba for an assessment to determine if they have the medical knowledge and skills required for licensure in Manitoba. The process includes written and oral examinations as well as a clinical assessment using the Clinicians Assessment and Professional Enhancement (CAPE) process. They will have up to 5 years to complete the Medical Council of Canada Qualifying Examinations. During that period the International Medical Graduate will practise in an underserviced area of the province (as declared by the Minister of Health for the Province of Manitoba) with a medical practice advisor who will provide support and guidance to the individual.

Other provinces, such as Ontario, also have International Medical Graduate programs in place.

For more information about obtaining a license to practice as a doctor in Canada, you may order the RWH Occupation Information and Forms.