Fewer doctors trained abroad

TheGlobeandMail.com – Life – Fewer doctors trained abroad: Percentage of foreign-trained doctors in Canada down by 10 per cent
Aug. 21, 2009.   CARLY WEEKS



The proportion of foreign-trained doctors working in Canada has declined more than 10 per cent in the past 35 years, a new report reveals.

In 1972, about 33 per cent of Canada’s physician work force consisted of those who had received their medical degrees in other countries, according to a report released yesterday by the Canadian Institute for Health Information. By 2007, that number had slipped to slightly more than 22 per cent.

“We are becoming increasingly self-sufficient in educating our own physicians and not relying on physicians from outside the country,” said Geoff Ballinger, manager of health human resources at CIHI.

Not all the foreign-trained doctors were raised in other countries. Nearly 30 per cent of them are Canadians who travelled to other countries to obtain their medical degrees. That trend has been increasing in recent years as bottlenecks have made it more difficult to get into Canadian medical schools, said Ivy Bourgeault, research chair in health human resource policy, a position funded by the Canadian Institutes of Health Research and Health Canada.

The report also found major shifts in the countries foreign-trained doctors are arriving from. In 1972, a major portion came from Britain and Ireland. In 2007, South Africa and India were the top sources. Many of those physicians work in rural areas once they arrive in Canada, likely because provinces often offer provisional licences to those who agree to work in more remote regions.

Of all new physicians in rural areas in 2007, more than half were foreign-trained, the report found. Only in Ontario and Quebec are the only provinces where there are more new foreign-trained doctors in urban rather than rural areas.

But no matter where they are now, that doesn’t mean they’ll stay there. The report found that many new foreign-trained doctors move or leave Canada after 10 years. While the trend is not new, CIHI noted that those who began working in Canada in the 1990s were more likely to move provinces or leave the physician work force altogether than those who started in the 1970s.

One of the major reasons the number of foreign-trained doctors has slipped relative to the overall physician work force is that many doctors who came from Britain or Ireland are aging or have retired, Mr. Ballinger said. At the same time, slightly fewer numbers of international medical graduates are setting up practices in Canada, the report found.

Part of that may be because many foreign-trained doctors face significant challenges when seeking work here, such as slow professional evaluation processes.

While some improvements are being made, the answer to Canada’s doctor shortage doesn’t lie with more foreign-trained physicians, said Ian Bowmer, executive director of the Medical Council of Canada. Instead, teams of health-care workers, including doctors, nurse practitioners and specialists, should work together to deliver the various aspects of health care that patients may need, he said. Such a system could take some pressure off family doctors and help distribute care more evenly.

Indeed, as the overall proportion of foreign-trained doctors has slipped in recent years, the number of Canadian-educated medical graduates has jumped to more than 70 per cent of the country’s physician work force from about 25 per cent in 1972, according to the report.

While Canada has traditionally relied on medical graduates from other countries to ease physician shortages, more Canadian medical schools have opened and more spots for medical residents have been created, Dr. Bourgeault explained.

It’s an important change that may help reduce the incidence of foreign-trained doctors leaving developing countries that need their services, she said. “We’ll always have immigration and we’ll always want to utilize the skills of people who come to Canada, but at the same time, we shouldn’t be actively recruiting or even passively recruiting,” said Dr. Bourgeault, who is also a professor in the health sciences department at the University of Ottawa.

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