6.5 million Canadians lack a family doctor. The solution is already here

Posted on October 15, 2024 in Health Policy Context

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TheStar.com – Opinion/Contributors
Oct. 15, 2024.   By Makini McGuire-Brown, Contributor

As almost every Canadian knows, healthcare is in crisis. Though the list of problems is long, the lack of family physicians is among the most pressing. A staggering 6.5 million Canadians currently don’t have a family doctor.

It was thus refreshing to see a proposed solution to that problem from three of Canada’s senators, Ratna Omidvar, Stan Kutcher and Mohamed-Iqbal Ravalia. In a report released this month, they suggest the following: accelerate a pathway for the many internationally trained doctors who are currently unable to practise in Canada.

Though healthcare is often complicated, the proposal has one key takeaway: the federal government can help in the form of funding. Funding these proposed measures would make a significant difference in how Canadians access healthcare. Getting more trained doctors practising is a key part of that solution.

A crucial finding of the senators’ report is that internationally-trained physicians (ITPs) have dismal match rates of residency spots (39 per cent) compared to Canadian Medical Graduates (CMGs) (92 per cent). Residencies are training programs that lead to independent practice as a physician in a chosen specialty. Hundreds of ITPs currently compete for each residency spot available to them, a situation which is clearly untenable.

Considering that both groups hold Canadian Citizenship or Permanent Residency status, it is also worth asking whether discrimination against a group of Canadians is a factor. These concerns are only furthered when, as cited in the report, ITPs from European and Australian schooling have preferential match rates to those from Africa, Asia, the Caribbean, and South America.

What is most unfortunate about the thousands of qualified doctors who are unable to practise is that their idleness represents a loss to all of Canada. Not only is it intensely psychologically straining for the ITP, but Canada misses out on the 3 to 7 years of clinical experience that ITPs bring. These physicians also have experience in hospital and community settings, in settings with constrained resources and experience that spans family medicine and numerous specialties. Additionally, ITPs are a diverse workforce who are multilingual and have high cultural awareness, obvious assets to the current needs of the health workforce.

There is a pathway to addressing that situation in the form of what is called a Practice Ready Assessment or PRA. PRAs consists of a 3-month assessment of a doctor’s competency to practise, assessed by licensed doctors in Canada while they see patients, usually in a rural or remote setting. Currently, PRA programs do not have the capacity to onboard the large numbers of experienced ITPs that are available. The senators make a clear proposal to expand PRA capacity.

The challenges that ITPs face are complex. More can be said about the difficulty of staying in clinical practice — which could be solved through a National Clinical Assistant program that lets trained doctors transition into becoming licensed — or the need for a review of eligibility criteria for licensure pathways that fail to capture ITP strengths. Equally, there is more to the healthcare crisis than only the failure to utilize ITPs. However, what remains true is that getting more competent doctors into the system quickly is a crucial part of the solution.

Ultimately, though, even the best intentions still must be met with funding. Training a resident costs money. Assessing a PRA candidate costs money. Running a program costs money and expanding a program costs more. Adjusting a program to better capture the strengths of internationally-trained doctors also costs money. For ITP advocacy to effect the change that is required — that is, to get more doctors to work helping Canadians — funding is essential. It’s now up to the federal government to fill that need.

Dr. Makini McGuire-Brown is an ITP from Trinidad & Tobago, an MBA, PhD Candidate in Administration and Chair of the Board at Internationally Trained Physicians of Ontario.

https://www.thestar.com/opinion/contributors/6-5-million-canadians-lack-a-family-doctor-the-solution-is-already-here/article_337b59ea-858c-11ef-bbad-2fb66c4fc2e3.html?source=newsletter&utm_content=a08&utm_source=ts_nl&utm_medium=email&utm_email=0C810E7AE4E7C3CEB3816076F6F9881B&utm_campaign=top_3877

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