CaRMS 2024 Data (Snapshot) and Final Unfilled Positions Now Available

[MedicineLCS]

https://www.carms.ca/news/2024-r-1-match-data-snapshot/?utm_source=Facebook&utm_medium=social&utm_campaign=R1_Match

https://www.carms.ca/pdfs/6lgf4255tuL_R1_2_OverviewByUniversity_EN.pdf

No major changes year to year except that there's one EM IMG seat that didn't fill (will probably fill in the post-processes or not at all if they really dislike candidates). Also Cardiac Surgery did not have a great year. Very few English FM spots left. 

[shikimate]

FM is still in free fall. If anybody is paying attention, AB government just released their NP compensation structure. Basically NP can earn more in AB than FM in most other provinces lol. Why do FM when you can just do NP school?

If I were looking for a residency spot I'd take that Neuropathology or Medical Microbiology spot over any of the FM spots. At least as a pathologist or microbiologist you can get a salaried position with 400K salary and benefits rather than slaving away as FM earning 200K lol.

[1D7]

Most students would still rather do FM even if it is their 3rd or 4th choice discipline, than go unmatched (or do a lab based specialty).

I wonder if the previous push to make FM 3 years was somehow rooted in the idea that by making FM less desirable, there may be a true reduction in FM physician supply and increase in negotiation power.

 

[indefatigable]

It's a surprise to see cardiac surgery have two unfilled spots after the second round.  I'm not sure if there are more issues within the discipline - e.g. turf vs cardiology or whether it was just a very poorly planned CaRMS selection process.

I don't think the CFPC is practical enough to think about negotiating power - in any case, the true power resides in provincial governments which keep increasing the number of FM residency positions despite lagging demand from CMGs.  In response, FM programs are basically backfilling their positions with more and more IMGs - 

"But when second-round results were released on Thursday, all but two spots reserved for military doctors were filled in Ontario, the majority of them with graduates of international medical schools.  Many of those students are Canadians returning home after completing a medical degree abroad, Dr. Green said. CaRMS matched more international graduates to residency spaces this year than ever before: 671, up from 555 last year and 439 in 2022."

It's also true that the trends will likely continue unless more provinces decide to prioritize FM.  Instead, as mentioned by shikimate, it looks like AB decided to give NPs what looks like to be a better contract than most FPs nationwide.  In other words, FM is really no longer becoming a value proposition.

 https://www.theglobeandmail.com/canada/article-family-medicine-resident-graduates/

https://open.alberta.ca/dataset/00a02c21-141b-46be-af2c-528ef6ee29a6/resource/1fc45515-397e-4984-9b23-5f1ca6c76754/download/hlth-nurse-practitioner-primary-care-program-guide-2024-04.pdf

[Bambi]

Meanwhile, Ontario is opening new medical schools. The Canadian healthcare system is out of whack. 

[MedicineLCS]

11 hours ago, 1D7 said:

Most students would still rather do FM even if it is their 3rd or 4th choice discipline, than go unmatched (or do a lab based specialty).

I wonder if the previous push to make FM 3 years was somehow rooted in the idea that by making FM less desirable, there may be a true reduction in FM physician supply and increase in negotiation power.

 

From reading the materials and talking with people in FM leadership it's academic nonsense unfortunately. They genuinely seem to think that making training longer will somehow increase generalism by making people "feel prepared" as if somehow taking away another year of staff income when you are already financially constrained makes this more comforting. Out of dozens of future FMs I've worked with I've met ONE who actually believed this. 

[Andrew]

On 4/25/2024 at 6:23 PM, shikimate said:

FM is still in free fall. If anybody is paying attention, AB government just released their NP compensation structure. Basically NP can earn more in AB than FM in most other provinces lol. Why do FM when you can just do NP school?

If I were looking for a residency spot I'd take that Neuropathology or Medical Microbiology spot over any of the FM spots. At least as a pathologist or microbiologist you can get a salaried position with 400K salary and benefits rather than slaving away as FM earning 200K lol.

Do pathologists and lab medicine really make 400K salary? seems like a lot. I'm assuming that's roughly 9-5pm 40 hours/week, no call?

 

Those NP fees are an absolute joke. Paying NP $246K to see 2 patients per hour + patient panel 1000?

Meanwhile I see 4 patients per hour and have a panel of 1600 and growing. 

 

Who in the hell thinks there is value/efficiency in paying NP's to see that few patients. Ya the future of FM in Canada is dead.

[ChemPetE]

Probably sparse call with group practice. But yeah path IV I think is around there/just above 400s in my province. Not crazy at all especially in high inflation environment and in comparison to other specialists. If you can stomach the work, it can be a great gig for sure.

[shikimate]

pathologist salaries are public on most job postings. AB advertise 380-410. ON about 375. BC 380, and so on so forth. 400K is about right with some additional $ coming from call stipend, etc. Of course there are people who make multiples of this average IYKYK. Definitely not as high as other visual pattern recognition specialties like DR and derm.

In case you are wondering what I mean by visual pattern recognition, the mental algorithm for path, derm and DR are somewhat of a convergent evolution. 1) you look at something and recognize pertinent features 2) you quickly come up with a pattern categorization and ddx (eg. inflammatory vs neoplastic, if neoplastic, then benign vs malignant, if malignant, SCC vs adeno vs other etc). 3) you look for other features to refute or support your ddx 4) you do additional studies and note additional findings on a case by case basis.

This way of thinking is different than specialties that are muscular memory based (eg. neurology, surgery), numerical pattern recognition based (IM, anesthesia), and interpersonal relationship/verbal based (FM, psych). Med students should assess where their skills lie and choose specialties based on their strength and weakness. For example, if you are not a stoic listener, don't choose psych, even if you think "you can get along with people fine". Choose something that has brief, short patient interactions. Let's say you also like high acuity cases with some hands on work, then ER or anesthesia would work well. 

[zoxy]

On 4/25/2024 at 9:45 PM, indefatigable said:

It's a surprise to see cardiac surgery have two unfilled spots after the second round.  I'm not sure if there are more issues within the discipline - e.g. turf vs cardiology or whether it was just a very poorly planned CaRMS selection process.

Combination of both. Cardiac had 9 CMG spots last year vs 13 this year. They usually average 10 -11 spots a year. UofA had 2 spots this year and they filled 1 spot in the first round and didn't open up to IMGs in the second round to fill its last spot. Winnipeg filled its empty spot in the second iteration, and Dal has the lowest operative volume of any training site in English Canada so not surprised it went unmatched in the second round as well. Additionally, Cardiac is not a service-heavy specialty, especially at sites with closed ICUs. They don't need residents for the Cardiac surgery service to run.  If they can't find a good trainee, they won't take one. Unlike say IM, Peds, Neurology, Gen Surg, or Obs.

As for issues within the discipline, there are many. There are 175ish Cardiac surgeons in Canada and they take 10-11 new residents a year. You don't need a math degree to figure out something is off with those numbers. The lack of jobs has led to an arms race among trainees for grad degrees and fellowships. A master's and a fellowship are a must for any job, even in a non-academic site. You can look at any training program and see despite Cardiac being a 6-year residency, they have 9-10 residents since many are taking multiple research years.

And this job market is with the current operative volumes that are fairly decent with boomers being in prime cardiac surgery age. But looking more closely at the data shows age-adjusted CABG volumes are decreasing. Mainly due to better medical therapy rather than PCI encroachment. SAVR volumes are heavily down with TAVI being approved in low-risk patients. Mitral volume is steady or even increasing, as are ascending aneurysms, and so is transplant and mechanical circularity support. But isolated CABG and isolated SAVR are the two most common cardiac surgeries and both are declining as I said above.

Cardiac surgery will not die off completely and there will always be a need for CABG with multivessel disease, left main disease, or SAVR for prosthesis patient mismatch or a root enlargement. Not to mention the infective endocarditis disasters, transplants, ECMO, Type As, and ascending aneurysms(for now) that are solely surgical pathology.

It won't die but the overall volume of cases and the job market will decline well into the future. An American job, while possible, isn't as easy as other specialties since Canadian training does not make you board-eligible in the US.

[GH0ST]

Public health and preventive medicine interest continue to wane ... 

The UofA spot that's still up really says something. Can't say I'm too surprised. 

- G 

[innocentius]

It is criminal that increasing numbers of IMGs are matching when CMGs are going unmatched. I don't have as much of a problem with current year IMG grads, who are more likely Canadians returning after having to do med school abroad..But previous year IMGs matching at the expense of CMGs is a different story. I fucking hate how FM is being brigaded by these full-blown IMGs from other countries, which is resulting in erosion of any negotiating power and allowing the government to keep wages low.

[1D7]

11 hours ago, innocentius said:

It is criminal that increasing numbers of IMGs are matching when CMGs are going unmatched. I don't have as much of a problem with current year IMG grads, who are more likely Canadians returning after having to do med school abroad..But previous year IMGs matching at the expense of CMGs is a different story. I fucking hate how FM is being brigaded by these full-blown IMGs from other countries, which is resulting in erosion of any negotiating power and allowing the government to keep wages low.

There's no need to be angry at IMGs for the current situation in FM.

There is no direct supply-demand correlation in our country. Even if the supply of family docs practicing FM continues to erode, there would still need to be the additional step of the public becoming motivated to pressure the government into politically changes. Currently people are still willing to say "at least it's free, not like the American system".

Also, in other fields, when people are made aware of their colleagues earning more, they try to negotiate for more (hence why companies don't like salary transparency). In medicine, physicians will see high earners and instead of arguing that the floor should be increased, they will argue to decrease other physician's earnings.

[DrOtter]

 

11 hours ago, innocentius said:

It is criminal that increasing numbers of IMGs are matching when CMGs are going unmatched. I don't have as much of a problem with current year IMG grads, who are more likely Canadians returning after having to do med school abroad..But previous year IMGs matching at the expense of CMGs is a different story. I fucking hate how FM is being brigaded by these full-blown IMGs from other countries, which is resulting in erosion of any negotiating power and allowing the government to keep wages low.

That's honestly the sad reality of primary care in Canada rn...Aside from BC, working condition and pay disparity have only worsened for FM docs in the past decade and even people who enter FM don't want to do primary care care when they graduate - and instead of improving things and ensuring high quality of care, gov prefers to fill the gap with NPs and IMGs (although I do hope residency programs still maintain a high standard when matching IMGs). This is classic exploitative capitalism - "oh this work is too hard for you? We'll find someone else who will be willing to do it" kind of mentality; except in this case, everyone (workers, gov, patients) will eventually lose...

As for CMGs going Unmatched, I still think the vast majority of those are due to the fact that they don't want FM/Path/Psych and prefer to do a gap year to re-match the next cycle. Unless someone has serious red flags, no reason a CMG would otherwise go unmatched after the 2nd iteration.

[Bobthebuilder]

On 4/25/2024 at 11:45 PM, indefatigable said:

It's a surprise to see cardiac surgery have two unfilled spots after the second round.  I'm not sure if there are more issues within the discipline - e.g. turf vs cardiology or whether it was just a very poorly planned CaRMS selection process.

I don't think the CFPC is practical enough to think about negotiating power - in any case, the true power resides in provincial governments which keep increasing the number of FM residency positions despite lagging demand from CMGs.  In response, FM programs are basically backfilling their positions with more and more IMGs - 

"But when second-round results were released on Thursday, all but two spots reserved for military doctors were filled in Ontario, the majority of them with graduates of international medical schools.  Many of those students are Canadians returning home after completing a medical degree abroad, Dr. Green said. CaRMS matched more international graduates to residency spaces this year than ever before: 671, up from 555 last year and 439 in 2022."

It's also true that the trends will likely continue unless more provinces decide to prioritize FM.  Instead, as mentioned by shikimate, it looks like AB decided to give NPs what looks like to be a better contract than most FPs nationwide.  In other words, FM is really no longer becoming a value proposition.

 https://www.theglobeandmail.com/canada/article-family-medicine-resident-graduates/

https://open.alberta.ca/dataset/00a02c21-141b-46be-af2c-528ef6ee29a6/resource/1fc45515-397e-4984-9b23-5f1ca6c76754/download/hlth-nurse-practitioner-primary-care-program-guide-2024-04.pdf

 

I've always been an advocate of NPs. I still am but I dont understand where the different provincial governements are going with this. Now, in Québec, NPs can practice indepedently and soon they will ask for the same salary as NPs in Alberta. At this point, an NP is essentially the same on paper as an FP but with increased costs. 

On an administrative standpoint I can understand the appeal. I mean these are salaried positions that you can control a bit more than a small-medium entreprise family physician. 

I am not fundamenttaly opposed to an alternative pathway to become a primary care provider or family physician. It happened in other fields in healthcare. However, I am fairly sure the training is not equivalent and down the road it is gonna be an issue. If we are going this way there needs to be a higher level of training for NPs.

I guess the only thing missing right now is data showing NPs care is associated with adverse outcomes for mortality / morbidity because I believe it has been established there is increased costs (imaging, lab test, etc.).

My 0,02$ but I am really interested to see where this is going. 

[MedicineLCS]

The one issue is that a lot of research is observational and there are still physicians around - for a true 1:1 you'd need NPs alone because it would be difficult to control for the true level of supervision/curbsiding (I've had to chuckle at the multiple times in MS4 the NPs were trying to curbside ME even after telling them I was the med student with the service...) The AMA has actually shown increased mortality in "severe cases" in a study where NPs were essentially alone:

https://www.ama-assn.org/practice-management/scope-practice/3-year-study-nps-ed-worse-outcomes-higher-costs

In contrast they'd trott out a study like this (https://journals.lww.com/ccmjournal/abstract/2017/02000/a_comparison_of_usage_and_outcomes_between_nurse.38.aspx) which has this wonderful line:

"The NPs were under the direct supervision of board-certified medical intensivists and could also consult at any time with critical care fellows."

You could probably demonstrate a rock is non-inferior in this setup, you'd just have a very grouchy critical care fellow and staff doing everything. Nevermind the evidence that NPs get given easier cases, in this study they even note that it was the staff or fellow making admission decisions and my experience has been NP/Hospitalist services get more typical presentations whereas the main teaching service gets the interesting/more out of the box/complicated admissions. 

Now, I think it's inevitable we end up with NPs simply due to a lack of MD interest in primary care. This can probably work in a supervised setting but paying NPs FMD money knowing full well NPs order more investigations/referrals seems like a fast way to dig a system further in the whole. 

[Andrew]

On 5/2/2024 at 4:14 AM, Bobthebuilder said:

 

I've always been an advocate of NPs. I still am but I dont understand where the different provincial governements are going with this. Now, in Québec, NPs can practice indepedently and soon they will ask for the same salary as NPs in Alberta. At this point, an NP is essentially the same on paper as an FP but with increased costs. 

On an administrative standpoint I can understand the appeal. I mean these are salaried positions that you can control a bit more than a small-medium entreprise family physician. 

I am not fundamenttaly opposed to an alternative pathway to become a primary care provider or family physician. It happened in other fields in healthcare. However, I am fairly sure the training is not equivalent and down the road it is gonna be an issue. If we are going this way there needs to be a higher level of training for NPs.

I guess the only thing missing right now is data showing NPs care is associated with adverse outcomes for mortality / morbidity because I believe it has been established there is increased costs (imaging, lab test, etc.).

My 0,02$ but I am really interested to see where this is going. 

NP's are literally doing HALF THE WORK, as in literally seeing half the patients (2 patients per hour), managing half-sized patient panel (1000 vs 2000), vs a GP whilst being paid 80-100% the same "salary" (whether through contract/salary/fee-for-service/overhead allowance). 

We don't even need to begin to debate the acuity of the cases, the quality of an NP's work, or patient outcomes or whether unnecessary tests/referrals are being made (therefore costing the medical system more).

To be honest, under the current system, I would rather actually take an Alberta NP contract (give me 40 hour work weeks, 200K+ base salary, 85K overhead allowance, however many weeks paid vacation, a pension plan and so on). I'll see 2 patients per hour, I can spend 10 minutes doing an actual visit and 20 minutes chatting with my patients about their golf game or they leave early and I surf the Internet and twiddle my thumbs.

This is in my opinion, the beginning of death of FM in Canada for CMG's, and hearing about this new Alberta contract makes my recommendation to any Canadian medical students to not match in FM (literally do anything else). If I graduated today I would even choose pathology or lab medicine according to the above posts/salaries. We are likely looking at a future of FM only staffed by IMG's / NP's and basically any CMG's that couldn't match outside of FM and were forced into FM.

I am personally not interested to "see where this is going", because there is already a pattern of Governments trying to decrease spending (on GP visits specifically) short-term, by utilizing measures such as giving Pharmacists prescribing powers and authority to perform clinical visits (and get paid) for lists of "basic problems" such as UTIs. Legislation legitimizing pseudo-science practitioners such as Naturopaths to act as "primary caregivers" and authority to order government-paid tests like certain lab tests, prescriptions etc.

It wouldn't surprise me if these policies came from a table of non-healthcare idiots in Government who just sat around and said, "oh look GP visits are the largest % spending in Healthcare (ignoring that there are many more GP's than specialists), wouldn't it be great if we could reduce this expenditure by X%, imagine how much money we would save!"

From a Government perspective, the only thing they can see is that they reduce GP fee-for-service visits (therefore saving paying GP's!). What they cannot see is that they still have to payout NP's, Pharmacists (not Naturopaths because they have to be paid by extended health care so those visits are completely saved costs!). At the rate they are paying NP's and Pharmacists to "substitute" for GP visits, they aren't even saving that much money per visit. And in the case of NP's some Government beancouter has overlooked that they are paying 80% for a nurse to see 2 patients where a GP would see 4, in effect costing the medical system 60% more per patient seen

As a consequence, 5-10 years from now we will start dealing with fallout from missed diagnoses (and probably increased ER visits or increased costs from unnecessary ordered tests) that will end up costing the medical system more. By then, current Government will have won the next immediate election (the only thing they care about), or be long out of power and they don't care about kicking the can down the road.

[Bambi]

It's sad! 

The healthcare system is in terrible shape. The politicians are only interested in appearances to the public as their interest is in gaining votes, not in really improving the system for the betterment of our population. And Trudeau on the heels of an election is pushing free dental care and providing a tiny band aid for the lack of affordable rental housing and the unaffordable price of homes. In all the above, the governments are doing too little, too late and going in the wrong directions.

Short term solutions are no solutions at all,, rather they make things worse.    

[shikimate]

Well judging by the # of FM grads who do +1, they know that niche areas are where the $ is, not longitudinal care. In my cities there are FM who bill 150K and who bill 700K. One thing I know for sure is the ones billing150K don't do more lucrative things like inpatient, ER, etc.

[Synth1]

Saskatchewan, Manitoba and Nova Scotia have also released new payment models that at least from a $ perspective are essentially equivalent to BC. I'm not sure there is much gap between other "niche" things in those provinces anymore. In BC, for example, they are having a harder time staffing things like hospitalist positions because longitudinal primary care actually pays more. 

 

[Findanus]

There should be significant concern over the assertion that foreign medical graduates can take over the spots that Canadian medical graduates do not want. This places significant downward pressure on both quality and remuneration. A Liberal Minister is on record saying that foreign medical graduates will be used as replacements. This should be very concerning for everyone in medicine, not just family doctors or prospective ones.

This is a significant problem in the field of pathology. Unpopular programs are pressured by administration to fill their ranks with whoever applies, in order to secure funding for the research labs associated with academic pathology departments. This results in low quality fmgs occupying too many spots, which places downward pressure on incomes and reduces the quality of medical care provided. Low quality applicants are anecdotally less likely to advocate for their own specialty once in practice, further reducing quality and remuneration.

[Artier]

On 5/3/2024 at 4:04 PM, Andrew said:

NP's are literally doing HALF THE WORK, as in literally seeing half the patients (2 patients per hour), managing half-sized patient panel (1000 vs 2000), vs a GP whilst being paid 80-100% the same "salary" (whether through contract/salary/fee-for-service/overhead allowance). 

We don't even need to begin to debate the acuity of the cases, the quality of an NP's work, or patient outcomes or whether unnecessary tests/referrals are being made (therefore costing the medical system more).

To be honest, under the current system, I would rather actually take an Alberta NP contract (give me 40 hour work weeks, 200K+ base salary, 85K overhead allowance, however many weeks paid vacation, a pension plan and so on). I'll see 2 patients per hour, I can spend 10 minutes doing an actual visit and 20 minutes chatting with my patients about their golf game or they leave early and I surf the Internet and twiddle my thumbs.

This is in my opinion, the beginning of death of FM in Canada for CMG's, and hearing about this new Alberta contract makes my recommendation to any Canadian medical students to not match in FM (literally do anything else). If I graduated today I would even choose pathology or lab medicine according to the above posts/salaries. We are likely looking at a future of FM only staffed by IMG's / NP's and basically any CMG's that couldn't match outside of FM and were forced into FM.

I am personally not interested to "see where this is going", because there is already a pattern of Governments trying to decrease spending (on GP visits specifically) short-term, by utilizing measures such as giving Pharmacists prescribing powers and authority to perform clinical visits (and get paid) for lists of "basic problems" such as UTIs. Legislation legitimizing pseudo-science practitioners such as Naturopaths to act as "primary caregivers" and authority to order government-paid tests like certain lab tests, prescriptions etc.

It wouldn't surprise me if these policies came from a table of non-healthcare idiots in Government who just sat around and said, "oh look GP visits are the largest % spending in Healthcare (ignoring that there are many more GP's than specialists), wouldn't it be great if we could reduce this expenditure by X%, imagine how much money we would save!"

From a Government perspective, the only thing they can see is that they reduce GP fee-for-service visits (therefore saving paying GP's!). What they cannot see is that they still have to payout NP's, Pharmacists (not Naturopaths because they have to be paid by extended health care so those visits are completely saved costs!). At the rate they are paying NP's and Pharmacists to "substitute" for GP visits, they aren't even saving that much money per visit. And in the case of NP's some Government beancouter has overlooked that they are paying 80% for a nurse to see 2 patients where a GP would see 4, in effect costing the medical system 60% more per patient seen

As a consequence, 5-10 years from now we will start dealing with fallout from missed diagnoses (and probably increased ER visits or increased costs from unnecessary ordered tests) that will end up costing the medical system more. By then, current Government will have won the next immediate election (the only thing they care about), or be long out of power and they don't care about kicking the can down the road.

I realize this thread is starting to veer off topic but interesting discussion nonetheless. Out of curiosity, does anyone know what kind of possible repercussions there are for NP's with regard to incompetent decision making (e.g. inappropriate assessments/plans, missed diagnoses, etc.)? For physicians, these cases are adjudicated by other MDs through the provincial college, but how is it handled for NPs working effectively independently? By other nurses? Or are they held to the same standard required of MDs? Do they get some alternate form of CMPA coverage?

[1D7]

1 hour ago, Artier said:

I realize this thread is starting to veer off topic but interesting discussion nonetheless. Out of curiosity, does anyone know what kind of possible repercussions there are for NP's with regard to incompetent decision making (e.g. inappropriate assessments/plans, missed diagnoses, etc.)? For physicians, these cases are adjudicated by other MDs through the provincial college, but how is it handled for NPs working effectively independently? By other nurses? Or are they held to the same standard required of MDs? Do they get some alternate form of CMPA coverage?

Nursing complaints, including those for NPs, are handled by the provincial nursing college. For malpractice, they are protected by the CNPS (nursing version of CMPA).

I don't really know the details but I doubt MDs are involved at any step of the process.

[zoxy]

3 hours ago, Findanus said:

A Liberal Minister is on record saying that foreign medical graduates will be used as replacements.

I saw that interview too. She shrugged off the interviewer's questions about Canadian physicians being unhappy with the tax changes and said we've spent money on expediting credentialing for foreign doctors.

That got me curious and I looked it up and saw that she is indeed right. The Royal College in 2024 had 443 applications to receive equivalency and determined 432 of them to be eligible! That's more doctors than Alberta and Saskatchewan's three medical schools combined train in a year. This is a marked increase from the 99 applications in 2022 when only 69 were found to be eligible. Source below.

Canada will soon resemble the UK where enterprising domestic trainees will leave for greener pastures (US for us, Australia and NZ for the Brits) and those who remain behind will find their compensation and work conditions regressing. With the Royal College essentially folding in the face of federal government pressure, there's an endless supply of British and South African trainees who would be willing to move here and suppress what little negotiating power we held in the face of the government's monopsony.

https://www.royalcollege.ca/en/newsroom/posts/recruitment--retention-and-collaboration--addressing-canada-s-sh.html

[Findanus]

1 hour ago, zoxy said:

I saw that interview too. She shrugged off the interviewer's questions about Canadian physicians being unhappy with the tax changes and said we've spent money on expediting credentialing for foreign doctors.

That got me curious and I looked it up and saw that she is indeed right. The Royal College in 2024 had 443 applications to receive equivalency and determined 432 of them to be eligible! That's more doctors than Alberta and Saskatchewan's three medical schools combined train in a year. This is a marked increase from the 99 applications in 2022 when only 69 were found to be eligible. Source below.

Canada will soon resemble the UK where enterprising domestic trainees will leave for greener pastures (US for us, Australia and NZ for the Brits) and those who remain behind will find their compensation and work conditions regressing. With the Royal College essentially folding in the face of federal government pressure, there's an endless supply of British and South African trainees who would be willing to move here and suppress what little negotiating power we held in the face of the government's monopsony.

https://www.royalcollege.ca/en/newsroom/posts/recruitment--retention-and-collaboration--addressing-canada-s-sh.html

I am aghast that the Royal College is acting as an arm of the government. Physician maldistribution is primarily an economic concern, one that is entirely the purview of the government. Lowering standards to help the government save money should not be the role of the RC.