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Canada urged to integrate foreign-trained MDs

Hundreds of them can't get the retraining they need to practise here, task force says

By WALLACE IMMEN
Wednesday, February 18, 2004 - Page A6

At least 600 foreign-trained doctors who have passed provincial medical exams in Canada were unable to find space last year in medical schools and teaching hospitals to get the retraining they need to practise here, a federal task force says.

Hundreds more who have education equivalent to degrees from Canadian medical schools can't get the training needed to take the exams -- and to help ease the growing shortage of physicians across the country, it says in a draft report.

"We've got people saying, 'Let's bring in more doctors,' but we've got these people already in Canada who may very well be able do the job," said Dale Dauphinee, executive director of the Medical Council of Canada, who co-chaired the task force of representatives of federal and provincial government agencies and medical licensing boards.

Canada is not training enough doctors to replace those who emigrate, retire or leave practice each year, the study confirmed. Ontario alone is facing a shortage of up to 1,500 physicians, a coalition of politicians and doctors told the Ontario Medical Association last month.

But if the system worked the way it should, foreign-trained doctors could be practising within two years, compared with the 10 years it takes to graduate a new doctor in Canada from first-year medical school right through an internship, the task force says.

Many foreign-trained doctors are well qualified but have gaps in their training, or they may need to improve their knowledge of diagnostic techniques, technology or language skills to work in Canada, Dr. Dauphinee said.

"We've lost flexibility. During the 1990s, capacity in medical schools was reduced because of a mentality that there were too many doctors, and that is driving up the costs of health care."

At a meeting in Calgary on Feb. 29, the task force will make two key recommendations: to expand assessment and training, and to develop national standards for testing and licensing.

Dr. Dauphinee says the plan could serve as a model for other federal task forces that plan to report later in the year on strategies to help foreign-trained nurses and engineers enter the work force.

New funding will be required for the prime recommendation, "ensuring there is adequate capacity and funding for their assessment and training," the task force said.

It did not estimate the costs. Provinces will be responsible for expanding training facilities and "the resources are not infinite," commented Mary Anne Chambers, Ontario's Minister of Training, Colleges and Universities. But she said the province agrees with the recommendations.

"We are going to pull out all the stops to make this a success," she said in an interview. "There is far too much skill and education out there to not use it."

Professional regulatory groups in the province have already indicated they will support the effort to expedite the accreditation process, Ms. Chambers said. "But there is absolutely no interest anywhere in lowering standards."

Ontario, Quebec and British Columbia are already expanding medical school programs this year.The Ontario College of Physicians and Surgeons has been approached by 1,300 people from 92 countries in recent years who are waiting to practise in the province, Ms. Chambers said.

Provincial programs to assist and train immigrant doctors are being amalgamated this month into an Ontario International Medical Graduates Clearinghouse, which held a meeting in Toronto last night and will have another public meeting this evening in Hamilton.

Health Canada and three other federal ministries have pledged money to help implement the task force's other recommendations -- on licensing, verification of credentials and testing for competency and language proficiency. The funds come from $90-million allocated in the federal budget last year for health and human resources priority issues, said Robert Shearer, Health Canada's director of human resources strategies.

"We went across the country and what we found is there are a lot of disconnects," Dr. Dauphinee said. The 10 provinces and three territories each have their own medical systems and professional requirements for licensing, and doctors who want to emigrate to Canada must try to sort though the discrepancies.

The number of doctors in Canada peaked in 1993, a time when efforts to cut health care and education budgets led to a 10-per-cent reduction in the number of positions in Canadian medical schools, and it has fallen by 5 per cent in the past decade, according to a report by the non-profit Canadian Institute for Health Information.

Until the 1970s, if you were trained as a doctor you got points that facilitated your application for immigration. But that priority was removed in the 1980s. "At the time a lot of us [in the medical profession] wrote articles saying this was shortsighted. Look ahead, there will come a point where that big increase in doctors in the '60s and '70s will come to retirement age."

That time, Dr. Dauphinee says, has come.

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Its too bad us Canadians are left with such little options. I feel really sorry for all those foreign-trained doctors trying each year to get a residency, it really isn't fair.



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