Ontario to fund new residency spots with return of service requirements

[medigeek]

https://news.ontario.ca/mohltc/en/2018/04/ontario-funding-additional-residency-positions-for-medical-graduates.html

 

Please don't let this sway your vote...

[JohnGrisham]

The same people that cut 25 spots not long ago

[shikimate]

So they cut residency positions a few years before provincial election, then 2 months before the election create "new" residency positions (no specific # or location mentioned, not to mention ROS contract). Who fall for such tricks? Oh yeah, Ontario voters!

[midi]

Safe to say these are going to be rural FM?

[JohnGrisham]

1 minute ago, midi said:

Safe to say these are going to be rural FM?

Hopefully mostly FM, yes. Maybe some Psych if they're feeling generous, but i'd imagine majority FM.    Not necessarily only rural though, as bigger centres likely have more ability to add capacity of trainees.

[Birdy]

According to one of my school’s reps, the positions will be in more than FM, including possibly EM, IM, paeds and psych. 

 

[quacksflaptogether]

Just now, Birdy said:

According to one of my school’s reps, the positions will be in more than FM, including possibly EM, IM, paeds and psych. 

 

Yeah! Those were the specialties mentioned in the news release.

[Birdy]

Considering how tight the EM match was this year (so I’ve heard from people who applied anyway) I expect there may be some angst around that. 

[la marzocco]

24 minutes ago, shikimate said:

So they cut residency positions a few years before provincial election, then 2 months before the election create "new" residency positions (no specific # or location mentioned, not to mention ROS contract). Who fall for such tricks? Oh yeah, Ontario voters!

Regardless of political stripe, everyone has a vested interest in healthcare. I do not imagine the PC or NDP to roll this back should they come into power - or maybe just naive me   Any governing party post-June 7 would get some serious backlash if they did repeal this.

[JohnGrisham]

Until things are official, i would be cautiously optimistic on specific details and residencies.

[A-Stark]

Seems like quite the shell game to be announcing this now. The unmatched quasi-crisis was an entirely foreseeable problem caused by this very government's shortsighted decisions. What's more, forcing people into ROS under this situation is downright coercive. 

[medigeek]

23 minutes ago, la marzocco said:

Regardless of political stripe, everyone has a vested interest in healthcare. I do not imagine the PC or NDP to roll this back should they come into power - or maybe just naive me   Any governing party post-June 7 would get some serious backlash if they did repeal this.

I could care less about what PCs do when in power. Sad we're at such a low point.

[indefatigable]

1 hour ago, A-Stark said:

Seems like quite the shell game to be announcing this now. The unmatched quasi-crisis was an entirely foreseeable problem caused by this very government's shortsighted decisions. What's more, forcing people into ROS under this situation is downright coercive. 

Agree completely.  What's that saying again... an ounce of prevention is worth a pound of cure?

It's also a cynical short-term tactical pre-emptive move - the bad press regarding unmatched students and also the planned march on Queen's park next Wednesday.  It shows the province is "doing something" and deflects attention away the self-created problem.  

[JohnGrisham]

2 minutes ago, marrakech said:

Agree completely.  What's that saying again... an ounce of prevention is worth a pound of cure?

It's also a short-term tactical pre-emptive move - the bad press regarding unmatched students and also the planned march on Queen's park next Monday.  It shows the province is "doing something" and deflects attention away the self-created problem.  

Great point.

Hopefully this platitude doesnt deter the advocacy. Its currently too vague and no clear terms.

[jfdes]

Funding is $23M for six years... do we know how much the residencies mentioned in the news release cost to fund per spot? Could help provide an estimate for total spots funded

[NutritionRunner]

Even in urban centres (outside of GTA) there is a huge need for family physicians.  When we moved, I was not able to find a family physician for over a year, despite major efforts to secure a family physician.  In the end, it is only because my partner is a member of the Canadian Armed Forces that I was able to find a family physician, through one of their family programs.  This is despite living in an urban centre that is home to a medical school.  There simply aren’t enough family physicians out there for every Canadian.  Especially when you are forced to move every 3-4 years, which is the case if your partner is a member of the CAF (which is why these access programs exist for CAF dependents exist, even if they don’t solve the problem - I know CAF dependents who still don’t have a family physician, despite being on a wait list for 5+ years, simply because there are no family physicians taking new patients in their area).

[NeuroD]

6 hours ago, shikimate said:

So they cut residency positions a few years before provincial election, then 2 months before the election create "new" residency positions (no specific # or location mentioned, not to mention ROS contract). Who fall for such tricks? Oh yeah, Ontario voters!

Perfect scam to try and win some last minute votes.

1. The Liberals create a problem and then solve it to come off as saviors

2. The Liberals take advantage of vulnerable students burdened by social and financial pressures to force people into whatever specialities and locations they want.

[jfdes]

29 minutes ago, PhD2MD said:

Perfect scam to try and win some last minute votes.

1. The Liberals create a problem and then solve it to come off as saviors

2. The Liberals take advantage of vulnerable students burdened by social and financial pressures to force people into whatever specialities and locations they want.

It's actually a brilliant idea, from their perspective.

Cut a lot of spots in urban regions because they cost a lot and there are plenty of doctors there (although as has been pointed out, probably still not enough). Then in a few years when a crisis occurs and people get desperate, bring in ROS spots in areas that you really care about. Boom, you've solved (sort of) your problem of all the med students going to practice in the GTA. Or at least, kicked the problem down the road a bit till after the ROS' are over.

[ralk]

When they cut the original spots, the current situation of unmatched students was entirely predictable - and predicted. If they're making a reversal, that's a good thing, though not something that the Ontario Liberals should be credited for. You don't get to claim you're doing a good thing by fixing your own bone-headed mistake.

I don't find the notion of an ROS problematic in itself, but 2 years likely means we get the same problems with the 5 year ROS for IMGs but worse - communities facing frequent turnover of physicians, particularly in specialties where continuity is extremely helpful (FM, Psych in particular), and few sticking around long-term, because they're only there out of obligation. 

Details are sparse in this statement, so I'm hoping they wind up being favourable. Where and what these residency spots are matters significantly. The selection process also matters, which is completely unspecified - how people get selected for these "additional" spots could be problematic if implemented in a haphazard way.

The cheerleading from the medical schools, and the OMSA, is particularly concerning - even giving the province the benefit of the doubt when it comes to the details and assuming that they'll be reasonable, this announcement is, at best, one step forward after two steps back. This is not behaviour to be celebrated or encouraged by medical student or physician representatives.

[JohnGrisham]

35 minutes ago, ralk said:

When they cut the original spots, the current situation of unmatched students was entirely predictable - and predicted. If they're making a reversal, that's a good thing, though not something that the Ontario Liberals should be credited for. You don't get to claim you're doing a good thing by fixing your own bone-headed mistake.

I don't find the notion of an ROS problematic in itself, but 2 years likely means we get the same problems with the 5 year ROS for IMGs but worse - communities facing frequent turnover of physicians, particularly in specialties where continuity is extremely helpful (FM, Psych in particular), and few sticking around long-term, because they're only there out of obligation. 

Details are sparse in this statement, so I'm hoping they wind up being favourable. Where and what these residency spots are matters significantly. The selection process also matters, which is completely unspecified - how people get selected for these "additional" spots could be problematic if implemented in a haphazard way.

The cheerleading from the medical schools, and the OMSA, is particularly concerning - even giving the province the benefit of the doubt when it comes to the details and assuming that they'll be reasonable, this announcement is, at best, one step forward after two steps back. This is not behaviour to be celebrated or encouraged by medical student or physician representatives.

Here here. OMSA is always patting themselves on the back in social media for their "great work". 

[LittleDaisy]

36 minutes ago, ralk said:

When they cut the original spots, the current situation of unmatched students was entirely predictable - and predicted. If they're making a reversal, that's a good thing, though not something that the Ontario Liberals should be credited for. You don't get to claim you're doing a good thing by fixing your own bone-headed mistake.

I don't find the notion of an ROS problematic in itself, but 2 years likely means we get the same problems with the 5 year ROS for IMGs but worse - communities facing frequent turnover of physicians, particularly in specialties where continuity is extremely helpful (FM, Psych in particular), and few sticking around long-term, because they're only there out of obligation. 

Details are sparse in this statement, so I'm hoping they wind up being favourable. Where and what these residency spots are matters significantly. The selection process also matters, which is completely unspecified - how people get selected for these "additional" spots could be problematic if implemented in a haphazard way.

The cheerleading from the medical schools, and the OMSA, is particularly concerning - even giving the province the benefit of the doubt when it comes to the details and assuming that they'll be reasonable, this announcement is, at best, one step forward after two steps back. This is not behaviour to be celebrated or encouraged by medical student or physician representatives.

I second ralk, the return of service just states that you cannot practice in GTA or Ottawa for 2 years, you could set up a practice in Oakville- and be considered an underserved community. In Family medicine, there are so many jobs+ locum opportunities, the graduating residents that I spoke to have no difficulty staying wherever they want to practice. 

[jfdes]

45 minutes ago, ralk said:

The cheerleading from the medical schools, and the OMSA, is particularly concerning - even giving the province the benefit of the doubt when it comes to the details and assuming that they'll be reasonable, this announcement is, at best, one step forward after two steps back. This is not behaviour to be celebrated or encouraged by medical student or physician representatives.

To be fair to the medical schools and OMSA, it makes sense politically to provide these statements. If you yell at someone for doing something you've been advocating for, they are less likely to do something for you in the future. Need to acknowledge the one step forward (even with the two steps back), because it gives you a better position to lobby privately for more steps forward.

[crysally]

2 minutes ago, jfdes said:

To be fair to the medical schools and OMSA, it makes sense politically to provide these statements. If you yell at someone for doing something you've been advocating for, they are less likely to do something for you in the future. Need to acknowledge the one step forward (even with the two steps back), because it gives you a better position to lobby privately for more steps forward.

Exactly. And give them some credit - AFMC and OMSA have been trying to draw attention to the problem since 2015. Last year Robert Chu literally died because of it and still the ministry was not willing to do something. The ability of these organizations are limited, but they are trying, and positive reinforcement tend to work better than negative ones.

[rmorelan]

21 minutes ago, jfdes said:

To be fair to the medical schools and OMSA, it makes sense politically to provide these statements. If you yell at someone for doing something you've been advocating for, they are less likely to do something for you in the future. Need to acknowledge the one step forward (even with the two steps back), because it gives you a better position to lobby privately for more steps forward.

Plus it is an election year - you don't know who is going to win this thing. There already have been a number of upsets. If you come down publicly hard on the Liberals and they win where does that leave you? If they lose it doesn't matter what you said about them - they are gone and the winning party isn't going to really get mad at you for praising something that obviously is something you would praise. So you have a no win, may lose situation.  

 

[ellorie]

Going to be honest here, I'm a little confused why people feel like the government is inappropriately "taking advantage of medical students" by attaching a ROS.

They are literally paying for extra spots that otherwise would not exist.  Why would they pay for spots that result in more physicians where they aren't needed?  It would be very altruistic of them to do so, but not really in their best interests.

It sucks if you end up having to move to the ass end of nowhere for two years, it really does.  I would be really pissed off if I had to do that.  But when you go to medical school, nobody guarantees that you can practice the specialty of your choice in downtown Toronto.  If the ROS is really not acceptable, the option still exists of going into the first round again next year.  It's not like they waited for people to accept the positions and then sprung an ROS on them out of nowhere.