The family doctor shortage in Kawartha Lakes, and the rest of the country, might not be so bad today if the previous provincial Liberal government had done things differently in 2015.
In Ontario, after a medical student graduates, they don’t immediately start a practice. First, they must complete a residency where they train with established physicians for at least two years and up to four years depending on the discipline.
The number of spots open to Canadian Medical Graduates in Ontario is determined by the Ministry of Health and Long Term Care in consultation with medical schools. The government funds the positions and in 2015, the Liberal government under then Premier Kathleen Wynne broke out the scalpel and cut 50 residency spots.
At the time they defended the move by saying the reductions could come from specialty residencies like neurology or cardiac surgery, not family medicine. However, in April 2018, just weeks before the provincial election, they did an about face and pledged to spend up to $23 million over six years to open more residency positions for medical school graduates who have completed their undergraduate training at an Ontario medical school.
Graduates who occupy these additional residency spots would have been required to provide service for two years in underserviced communities across the province.
So, does part of the doctor shortage relate to a shortage of residency positions? The Association of Faculties of Medicine of Canada thinks so.
Says Dr. Geneviève Moineau, President and CEO of AFMC, “Until governments ensure that we have more residency positions than graduates, we will not be able to fully optimize the match results.”
The “match results” she refers to come from a questionnaire med students complete in their final year through the Canadian Resident Matching Service, (CaRMS). This national organization surveys them on the types of medicine they would like to practice, and matches those results to the opportunities that exist for training. There are two rounds of offers in the process and applicants can revise their application if they are unsuccessful in the first iteration.
This year, 31 grads remained unmatched after the second round. Including 36 students who withdrew after being unmatched in the first round, and 31 prior year graduates who are unmatched, a total of 98 competent graduates wait for matches.
Unsuccessful matches arise when too many grads apply to limited opportunities (which the Liberal decision created), or when there is no interest in very specialized residencies. That being said, overall, matches were found for 97.7% of the applicants.
Kawartha Lakes Underserviced
In the 15 years since the creation of the Kawartha Lakes Health Care Initiative, the volunteer committee has successfully recruited 37 family physicians.
That statistic is revealing in two ways.
First, despite that, the Kawarthas are still under-serviced. That is how bad the doctor shortage is here. In fact, the recruiters would like to attract at least five, and preferably seven, new family physicians to the area.
That is to service people currently without a doctor. This does not factor in people who have a local doctor, but will need one if their MD is one of the five who are expected to partially or fully retire in the near future.
And that also doesn’t account the unknown number of individuals who have moved here from the GTA and still use their doctor in Whitby or wherever because they haven’t found a local health care professional.
In the 15 years since the creation of the Kawartha Lakes Health Care Initiative, the volunteer committee has successfully recruited 37 family physicians. Cyndi Snider, head of Recruitment and Retention, says that they would like to attract at least 5, and preferably 7, new family physicians to the area. To make this happen, perhaps the Wynne government changes should be re-examined.
The doctor shortage is not unique to the Kawarthas and nor is it unique to Ontario. In fact, the whole country is thin on physicians, in part because of the cuts to residency positions.
AFMC continues to advocate to provincial governments for 110 positions for each 100 graduates. Currently, 1.02 residencies exist for each qualified graduate. Across the country as a whole, there are 52 unfilled residencies: 12 in the western provinces, 10 in Ontario, 1 in the East, and 29 in Quebec. The language barrier in la belle province prevents most Canadian grads from applying there, making international applicants more important.
In 2019, only 391 out of 2,302 IMG applicants began post graduate training in this country. Another 22 (of 54 applicants) came from the United States. Canadian medical graduates numbered 2,871.