Foreign-trained Doctors

[Guest IRNBRUD]

I just finished looking at the Executive Summary of the Romanow Report and found this particular passage from Chapter 11 puzzling:

 

"Reduce our reliance on the recruitment of health care professionals from developing countries.

Visit a small rural community and chances are good you will meet a doctor from a developing country who has come to Canada to practice. Canada has made extensive use of

foreign-trained medical graduates, particularly in communities that have had trouble attracting Canadian doctors. While Canada has a long-standing policy of welcoming immigrants from around the world, we have an obligation to help protect health care systems in developing countries. We must learn to solve our problems domestically rather than rely on luring physicians away from developing countries where their services are desperately needed."

 

I found myself wondering "Could this possibly be a thinly veiled attempt to legitimize and perpetuate the long and often arduous process that foreign-trained doctors must undergo in order to be able to practice here in Canada?"

I was under the impression that there was a move to speed up this process in order to alleviate our doctor shortage and to make good use of the highly educated and skilled immigrant labour force that currently makes up our service industry in this country.

 

Any thoughts?

 

IB

[Guest bj]

Hi IB,

 

Just to give a counter-argument, the recruitment of foreign-trained physicians can be seen as an issue of social justice. By "allowing" that physician to practice in Canada, are we facilitating the loss of professionals from their country of origin? Are we just enabling a brain-drain from the poorest and least developed countries of the world? Now, of course, this must be balanced by the idea of freedom of movement and the right of each individual to choose to pursue what they deem to be the best chance at a good life for their families. The sad corollary is that developing countries may be spending scarce resources on educating their brightest, only to have these professionals leave the country. It's not an easy or quick situation as it deals with rights and justice at both the individual and national levels.

 

BJ

 

(Just my thoughts. Feel free to disagree!)

[Guest IRNBRUD]

I do agree with what you are saying and admit that this is likely the intent of Mr. Romanow's directive. For the sake of discussion I will continue my devil's advocate stance. :evil

I found myself wondering how actively we "recruit" these professionals and thus whether we:

1. actually are "enabling" the depletion of the resources of developing countries or

2. are merely benefitting from the choice of these people to move to Canada.

If case 2 is more accurate then would this directive not discriminate against those professionals?

 

IB

[Guest nubar89]

The excerpt from the Romanow report that IB quoted left me feeling a little uneasy. To me, it felt like there was a hint of xenophobia to the minister's tone, and I agree that it was a thinly veiled attempt at saying something...

 

There is nothing wrong with supporting and endorsing Canadian medical students by giving them first choice on residency placements (in fact I think it would be unacceptable to do otherwise), but there is something definitely wrong with implementing reforms that are designed to hinder doctors from foreign countries from practicing in Canada. The fact is that there is a doctor shortage in this great country (especially in rural communities), and residency positions are at a premium. Instead of restricting immigrant doctors from practicing in Canada, Mr. Romanow should look at investing in more dollars residency positions.

 

Like it or not, this country is becoming more multicultural every day. Instead of discouraging highly trained professionals from immigrating to Canada, we should be welcoming them as long as they meet the Royal College's standards.

 

Great question IB!

 

NBR

[Guest nonce]

From a completely practical point of view, our gov't, and our population should actually feel obligated to 'actively' seek out physicians from any country, whether it be a developing one or not. We vote our gov't into office to assume the responsibility of Canada first, and then play its role in other countries. If there is a physician shortage, then yes, practically speaking, they should do anything in their direct control to alleviate that problem.

 

With that being said, however, we must look at the issue from a moral standpoint, as our public health care system is built on the such, not from a practical point of view. In this light, it is wrong to seek out help from countries who need it themselves. We are essentially removing the few valuable assets they may have.

 

My solution is that, for every doc we take from a 'underdeveloped country' we give a certain amount of assistance in another way (i.e. wells, nurses, medical equip, vaccinations etc.) until we can find a way to replace what we have taken.

 

I know, its a simplified answer, but i think it holds a least some merit. A physician may not be the most important thing in an area where running water cant be found in less then a few hour walk, or vaccinations (which do not need docs to be administered) could help save a 100 children a day.

 

What do i know though, just my 2 cents:b

[Guest Ian Wong]

"Reduce our reliance on the recruitment of health care professionals from developing countries.

Visit a small rural community and chances are good you will meet a doctor from a developing country who has come to Canada to practice. Canada has made extensive use of

foreign-trained medical graduates, particularly in communities that have had trouble attracting Canadian doctors. While Canada has a long-standing policy of welcoming immigrants from around the world, we have an obligation to help protect health care systems in developing countries. We must learn to solve our problems domestically rather than rely on luring physicians away from developing countries where their services are desperately needed."

To me, this doesn't sound like a call to recruit foreign physicians. Rather, it sounds like a message to government that Canadian medical schools need to have their enrollment increased dramatically, and that the only secure way to guarantee a supply of doctors in Canada is to train them ourselves instead of stealing them from other countries.

 

Physicians are a resource like anything else. They require a long-term investment in all sorts of ways, and the payback is a long-term one that is averaged over the several decades of a physician's career. The only way to ensure that physician supply is adequate is to train and retain an adequate number in Canada. Otherwise, we will continue to poach physicians fom other countries to meet our demands, and this is a much less sustainable mechanism than training our own.

 

Ian

[Guest MayFlower1]

nubar, Ian,

 

Instead of restricting immigrant doctors from practicing in Canada, Mr. Romanow should look at investing in more dollars residency positions.

 

To me, this doesn't sound like a call to recruit foreign physicians. Rather, it sounds like a message to government that Canadian medical schools need to have their enrollment increased dramatically, and that the only secure way to guarantee a supply of doctors in Canada is to train them ourselves instead of stealing them from other countries.

 

Physicians are a resource like anything else. They require a long-term investment in all sorts of ways, and the payback is a long-term one that is averaged over the several decades of a physician's career. The only way to ensure that physician supply is adequate is to train and retain an adequate number in Canada. Otherwise, we will continue to poach physicians fom other countries to meet our demands, and this is a much less sustainable mechanism than training our own.

 

I also interpreted this part of the Romanow report similarly. "Stealing" foreign-trained doctors is, in my opinion, a "quick fix". Should we continue welcoming immigrants into this country...absolutely...should foreign-trained docs be welcomed to practice in our country...again, ABSOLUTELY, assuming they meet standard.

 

However, with a long-term view...you guys are right...the government needs to invest in growing the local workforce...we need significantly more seats in medical schools and lots of residency positions for when they're done. We also need more nurses and all the other professions associated with medicine. Developing these skills locally and then rewarding them for staying in Canada will likely help fill the shortage better than recruiting from abroad.

 

Peter

[Guest IRNBRUD]

I too would like to think that this is a message to improve funding for training local doctors, but wonder if it is actually the case. The OMA certainly doesn't see it that way :

OMA press release

 

Just to clarify my question:

How would a policy directive like this one impact people who were NOT "recruited" but have immigrated to Canada and just happen to be Doctors? Is it discriminatory? :hat

 

Just trying to distract myself from the horrible news we woke up to this morning...

 

IB

[Guest habra]

Hi, IB

I recall to have watched a program where the government of SASK was actively recruiting physicians from South Africa

[Guest habra]

and the government of south Africa was pleading with the Canadian authorities not to recruit their physicians at a time when they are faced with numerous public health crises such as AIDS etc. The South African Health Minister was furious with the Government of SASK. She was suggesting that Canada should recruit from other "English" speaking countries such as India etc.

So yes this phenomenon is a problem for some developing countries.

H

[Guest UWOMED2005]

And to be perfectly honest, at the moment physicians can make a much greater impact on people's lives (at least as measured by increases in life expectancy) in the developing world than they could in Canada. Here, the majority of serious illnesses that can cause significant morbidity and mortality are either age, lifestyle (ie smoking, fitness) or genetic induced, at least relative to the developing world where malnutrition and infectious diseases are much more prevalent. With proper supplies, physicians could be extremely effective at treating infectious diseases and malnutrition in the developing world. It's much more difficult to make an impact in a society where the majority of the population is already vaccinated and has access to

 

The counter argument is that in this day and age of globalization, workers in all fields seem to be able to go anywhere they want. Why should medicine be different?