Is There a Doctor in the House? (Increasingly, There Isn’t)

Canadian healthcare is at a crossroads as the number of family doctors can't keep pace with a surging population. What's the solution?

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Canada’s population has grown by 5 million in the past decade, a significant increase driven largely by immigration. However, this growth has not been matched by an adequate increase in medical residencies. Dr. Kathleen Ross, a family doctor in British Columbia and president of the Canadian Medical Association (CMA), highlights the severity of the issue.

“Our health-care system is on its knees. We’re not meeting the needs of the population. Our workers are burning out in droves,” said Ross to CBC news.

In 2014, 3,255 people entered postgraduate medical training in Canada and by 2023, this number had only increased to 3,422, a mere five percent rise in a decade, according to data from the Canadian Resident Matching Service (CaRMS). In contrast, the population growth rate was three times higher during the same period.

The impact of a doctor shortage

The lack of family doctors has direct consequences on Canadians’ health. Without primary care physicians, many people miss out on preventive care, leading to more hospitalizations and premature deaths. Emergency room visits have also spiked, with unscheduled visits jumping from 14 million in 2021-22 to 15.1 million in 2022-23, according to Canadian Institute for Health Information (CIHI) data.

Some provincial governments are taking steps to increase the number of medical residencies. Ontario, for example, has promised to add 449 postgraduate medical training spaces over the next five years. Additionally, new medical schools are set to open, like the University of P.E.I.‘s in 2025 and Simon Fraser University‘s in Surrey, B.C., in 2026.

Dr. Ivy Lynn Bourgeault, a professor at the University of Ottawa and director of the Canada Health Workforce Network, suggests that the raw data on the number of physicians can be misleading. She points out that while there are more family doctors than a decade ago, many are not providing traditional primary care.

“There are a lot of practitioner groups out there that are not being fully utilized. In a time of crisis of access and a crisis of burnout, we really do need to make a remarkable shift in how we utilize all of those different roles,” she said to CBC news.

Current research

A recent paper published in Fam Med Community Health discusses the serious shortage of family physicians in Canada, emphasizing that this issue arises from several challenges, including high expectations placed on family doctors, insufficient support and resources, outdated ways of paying doctors, and high costs of running clinics.

The number of available positions in medical schools and family medicine residency programs are not keeping up with the increasing demand of the growing population. This shortage is especially dire in certain areas, such as the territories, Quebec, and British Columbia.

Research suggests solutions like encouraging medical students to specialize in family medicine, easing the workload and administrative tasks, increasing educational opportunities, and making it more accessible for international medical graduates to work in Canada.

Integrating foreign-trained doctors

Another aspect of the challenge is the integration of international medical graduates (IMGs). Despite Ottawa’s announcement of a new “express entry” stream for health professionals, which aims to bring more foreign doctors to Canada, the reality is that many of these newcomers face significant hurdles in practicing their profession. Last year, only 555 IMGs were placed with a residency, including doctors trained abroad and new Canadian residents or citizens.

Recognizing these challenges, Employment Minister Randy Boissonnault announced an $86 million initiative to integrate 6,600 international health professionals, including doctors, dentists, radiologists, nurses, and others. Boissonnault emphasized the need to remove barriers, stating, “We’ve put up artificial barriers to people accessing the labour market. We can’t afford that anymore.”

Canada’s healthcare system is at a crossroads. The growing population, coupled with a shortage of family doctors, presents a significant challenge that requires a coordinated effort across all levels of government.

Bridging this gap is essential for maintaining the integrity of Canada’s healthcare system and ensuring access to quality healthcare for all Canadians.

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Adam is a passionate advocate for women's and infants' health. With a Master of Science and a current Ph.D. from the University of Toronto's Department of Physiology, he has dedicated his academic and professional career to understanding and improving health outcomes for women and newborns. Adam's research is driven by a deep commitment to empowering women through education and by promoting the incredible advances in women's health care. As a proud Canadian, he is eager to shine a light on the contributions and progress made in his home country, aiming to inspire and contribute to a healthier future for all women and their families.