Aug. 19, 2004. 01:00 AM
What doctor shortage?
Canada already has a hidden reserve of foreign-trained MDs eager to begin medical practice, says Michael Urbanski
There is a lot of talk about the need to boost the training and retention of Canada's medical workforce.
But the country already has a hidden reserve of foreign-trained doctors who are eager and ready to begin medical practice.
The Canadian Medical Association has called for a $1 billion investment to increase medical school spots and help to fast-track doctors from other countries to practise in Canada. This is the CMA's proposed solution to ending the doctor shortage.
However, what's crucial to understanding the issue of doctor shortage in Ontario is that while the Liberal government is planning to go "poaching" for other countries' doctors, there are an estimated 4,000 internationally trained doctors right here in Ontario working at low-wage jobs.
They are well-trained foreign professionals, often with many years' medical experience abroad and many have virtually no hope of practising in Canada.
Why? Because the accrediting institutions, like the Ontario College of Physicians and Surgeons of Ontario, lack the resources to inform, assess and provide additional training to help move them into practice.
And physicians characterize the existing programs or those being developed as a "drop in a bucket." This year, for example, out of hundreds of qualified applicants who already live in Ontario, the accrediting institutions will handpick just 200 internationally trained Canadian doctors to practice.
That's compared to 150 doctors last year, 75 the year before, 50 in 2001, and 24 five years ago.
A drop in a bucket, indeed.
What's more, the disillusioned Ontario IMGs (International Medical Graduates) have to struggle with the lack of clarity regarding assessment criteria, lack of feedback from licensing officials, and the expensive and time-consuming process, at the end of which getting into residency is still a lottery.
So the problem isn't a shortage of physicians, but rather a "licensing bottleneck" as the Association of International Physicians and Surgeons of Ontario puts it.
That is to say, we need to improve fast-tracking of doctors who are already here rather than spending $1 billion to lure international doctors into our system and away from the communities they are currently serving.
And even if the doctor crisis has already arrived — as of today, Ontario is 2,000 doctors short and 136 communities are designated as under-serviced — we need to ensure that the health-care system we create adheres to the principles of fairness, responsibility and accessibility.
Yet, the current shortage of physicians is hardly a new development; a long history of bureaucratic "erring on the side of caution" precedes it.
In the 1980s, the political wisdom of the day predicted a hefty surplus of physicians, scaring the licensing institutions into tightening the entry criteria.
In the '90s, the NDP government, propelled by the same fear, reduced the number of medical school and residency places.
And now, despite the worst physician shortage in decades — Canada reported the lowest number of physicians per capita among the top 10 most developed countries and the second lowest among the top 20, according to a recent U.N. report — the government isn't willing to invest in evaluation and licensing of the immigrant doctors who are already here.
If the Liberal government goes through with its knee-jerk plan to "lure-and-poach" other countries' doctors, the international community will once again condemn Canada for unethical behaviour.
And internationally trained Ontario doctors will continue driving our taxis and delivering pizza.
But at least the U.N.'s Human Development Report will yet again establish Canada as having the most highly educated workforce on the planet.
Michael Urbanski is an Ottawa -based journalist who specializes in health care and immigration