Canadian-born, foreign-trained, MDs and residency

[Guest MDHopeful04]

Hi all,

 

I read this article in the Toronto Star:

 

www.thestar.com/NASApp/cs...9583810364

 

Do you think these doctors, who did their medical education in other countries should receive special treatment because they're born and completed their undergrad in Canada? Or do you think they should be considered as foreign-trained doctors?

 

I'm just curious to hear what others have to say.

 

Thanks!

[Guest Kirsteen]

Hi there,

 

As long as there is a shortage of medical professionals here, then I think the place of birth and place of education is irrelevant. As long as it can be accurately demonstrated that the person filling the role can provide the same quality of skills, both medical and personal, i.e., communication, etc., as those trained here, and as long as all immigration policies are met (in this case, I assume that would be irrelevant), then those people should be permitted a shot at Canadian jobs. The biggest problem is accurately demonstrating that skills acquired and honed in a place outside of Canada are the same.

 

Cheers,

Kirsteen

[Guest CTU24]

I'm going to disagree with you Kirsteen that a Dr. shortage requires accepting qualified immigrants.

 

IMO, it is not acceptable for Canada to solve its Dr. shortage by using Drs trained in other, usually 3rd world countries. In essence, we are solving the problems of a developed nation by creating more problems for a developing nation. I think as Canadians, we need to accept our own responsibility for these problems and fix them ourselves, not by making more problems for others.

 

As for giving Canadian/Canadian undergrad students who trained elsewhere special treatment, this is a difficult issue. Residency spots are already low, and simply infusing more helathy bodies w/out first increasing the residency position bottleneck will solve little. So, until residnecy spots are increased, I don't think Canadians at foreign schools should be allowed to match in the first round along with Canadian med school grads as the article suggests...this will just lead to more unmatched candidates, perhaps who will flee to the U.S...losing more Drs.

 

I do think Canadians who train elsewhere should be a given MORE than a fair chance to return to Canada to practice if they want...but not until the #s crunch on the system is addressed.

 

As many have mentioned this is a complex problem (thanks Bob Rae), and simply changing one rule won't do much. We need to get rid of the bottlenecks...then increase production of Drs

 

CTU24

[Guest Gill0927]

I agree with you, CTU, about the problem being the lack of residency positions. I don't see how allowing more qualified candidates into the first round match will solve any Dr. shortage problems here...we will still have the same amount of trained Drs coming out of residency as before...we will, as CTU says, just lose more doctors as more and more Canadians go unmatched.

 

Until the residency problem is fixed (ie we can have more spots available) it won't help the Dr shortage to allow grads from foreign med schools to match, it will just exacerbate the 'brain drain' to the States. Also, until there are more residency spots, there will continue to be a grave Dr. shortage in Canada. IMHO, that's just the way it is.

 

--Gill

[Guest Kirsteen]

Hi there CTU24,

 

Respectfully, I agree with you. However, the question asked was not how we should solve Canada's medical manpower shortage problems, but what we should do with those folks who are trained elsewhere and wish to return to the country to practice. There are numerous interesting approaches for tackling that specific problem, none of which I elaborated on, above. Perhaps I should not have emphasized the "As long as there is a shortage..." part of my thought, by placing it at the front of that sentence. All I meant was that, accepting Canadian candidates with training from other countries could be an option to fill spots, as long as their training could be deemed equivalent, etc.

 

Cheers,

Kirsteen

[Guest CaesarCornelius]

Hey Kirsteen,

 

I agree with you, however, you last sentence of your first post is a HUGH hurdle. Assessing the education that someone received in another country is (IMHO) overly difficult and would be too time(read: money) consuming to be done properly. Thus, although I think it would be great to get canadian's back here, I don't think that it is feasable.

 

On another note, I don't think that the majority of canadian born students who are training internationally are going to 3rd world countries to get their medical education. The article specifically mentions Ireland and Australia, which are not 3rd world.

 

CC

[Guest Kirsteen]

Hi there,

 

I agree with you, however, you last sentence of your first post is a HUGH hurdle. Assessing the education that someone received in another country is (IMHO) overly difficult and would be too time(read: money) consuming to be done properly. Thus, although I think it would be great to get canadian's back here, I don't think that it is feasable.

I agree with you completely. I think that's the biggest reason why these folks haven't had too much success in making too many inroads into Canadian positions, unfortunately.

 

Cheers,

Kirsteen

[Guest aneliz]

Canadian citizens that do medical school in another country are still 'foreign medical graduates'.... they did not attend a Canadian medical school, the school and exams that they have been exposed to are not regulated/approved etc by the Canadian licensing bodies, etc. Their training may be equivalent, it may not be. Just because they are already Canadian citizens does not mean that they are any more qualified to practice medicine here than someone that is not.

 

Now, I am not arguing that the current policy is right. However, consider this:

 

There are a limited number of residency positions in Canada...right now the ratio of CANADIAN med school grads to residency positions is approaching 1:1.... allowing 'foreign grads' (Canadian citizen or not) into the residency match will NOT increase the number of qualified doctors that we have... you can't get more out of the system by increasing the competition to get in. Allowing foreign grads into the first round will only INCREASE the competition between graduates for residency positions... and the net result may be that a Canadian trained MD may not get a residency position.... so, after the Canadian taxpayer has subsidised 4 years of their med school education, that Canadian trained MD will likely go to the states for residency...not a solution if you ask me.

 

What we need are more residency positions....however, given that we have a shortage of physicians and resources...we don't have any more capacity to teach more residents....so you get into a chicken and egg, can't win situation. What we really need are more fully qualified physicians...to teach more residents so that we have more fully qualified physicians...see the problem? I don't know what the solution is but letting extra people into a residency match to compete for a defined number of spots is not going to solve it.

 

As for should they be given special treatment....well, yes and no. It is dumb for someone that has fluent English or French, is familiar with Canadian societey, etc and has a recognised 'first world' MD degree (like from Ireland or Australia) to be lumped in the same category as someone that has significant language/cultural barriers and was trained in Ethiopia (as a random example). There is no way that these two people are equivalent...and they shouldn't be treated as such. However, if they are treated as 'equivalent' and asked to jump the same hoops, the Canadian should perform better and float to the top anyway...

 

However, it becomes a question of where do you draw a line.... is a Canadian citizen that just graduated from med school in Ireland more or less valuable to the Canadian health care system than a fully qualified Australian cardiologist with 15 years experience?

 

Making blanket generalisations on certain country's acceptability is dangerous too...there are schools in the US that are not US med schools (they are carribean with a US campus)...there are UK med schools that are not UK med schools....they are African schools with a UK campus...

 

I think that 'equivalent' foreign trained doctors should be allowed to practice here...what I have a problem with is the potential for 'foreign trained' doctors to compete with Canadian grads for a limited number of training positions. This is counter-productive. So, in that sense, I don't think that they should have advantages....

[Guest Lorae]

Well said aneliz!

 

I think they need to increase both med school seats and residency spots. Then, if they could increase residency spots *above* the current 1.01 spots per student, they could look into letting more foreign trained graduates into the match... maybe one day there could be a "brain drain" where US trained physicians seek residencies here

 

'course increasing spots takes $$

[Guest Kirsteen]

Hi there,

 

A similar question arose during one of my medical school interviews this year, i.e., not what to do with the Canadian, yet foreign-trained medical graduates, but what to do about the attrition of Canadian medical graduates, and fully-licensed practitioners to the US. We had an interesting discussion surrounding this during the interview. One resolution that I mentioned (which the physician seemed to like): find out why the doctors are leaving and target those problems. (The problems could include overwork, inferior technology or resources, etc.) If we don't do this, I think we're going to continue to lose some of our best practitioners, even if we increase medical school and residency seats.

 

Cheers,

Kirsteen

[Guest strider2004]

Assessing the education that someone received in another country is (IMHO) overly difficult and would be too time(read: money) consuming to be done properly

 

I disagree. I've spent time with a veteran pediatrican from Colombia who, after spending 6 months in a pediatrics residency in Canada, was licensed to practice in a smaller town in Ontario. He just needed to be surpervised for a little while which is not hard. It's not that difficult to test someone. See them work for a while (they'll be paid as a resident and providing a service at the same time), let them take the test (CCFP, or FRCPC/S) just like everyone else. The money spent to train one resident would be enough to recertify 10 foreign specialists or 4 foreign family docs.

[Guest moo]

I don't agree with the statement that Canada is "stealing" physicians from other third world countries. First, a lot of these people are in Canada, seeking a better life. If you restrict MDs are you going to restrict nurses, engineers and other professionals from immigrating here? I met an Egyptian trained MD who was working as a nurse's aid and who came here thinking that he would be able to practice medicine. All he said was that Canada was "all lies" and last I heard from him, he was back in Egypt. I've heard other stories of other MDs who've come here seeking a better life, who's headed south instead. If the government would only get in gear and add more residency spots. Of course this is easier said than done but it certainly is one way of addressing this issue. Second, is of course many of the foreign grads are Canadian citizens. It used to be that grads of med schools of these Commonwealth countries (minus Ireland) are considered equivalent to Canadian schools in terms of training. Why the switch all of a sudden? Are Canadians that arrogant in thinking Canadian schools are superior, above all others?

 

Another solution I see would be to allow a Canadian citizen who's done residency in the US to return. Again, easier said than done as the residencies are different length, etc. But at the very least, for primary care residencies, where for example, the US FP residency is 3 years, and the Canadian residency is 2 years, one can see this happening. Again, it's not that Canada is necessarily short specialists but FPs. This would be a great way to allow FPs to come back to Canada, after having passed the requisite exams of course.

[Guest tubbbs]

i totally agree with CTU24 and aneliz. open up more residency spots dammit.