Social Policy in Ontario

The Royal College of Physicians and Surgeons, which released the report on Thursday, is warning the crisis may lead to another round of brain drain — the exodus of talented young doctors from Canada — and a more recent phenomenon called “brain waste,” that describes what happens when new specialists work several part-time jobs, none of which allows them to practice the full spectrum of skills they are trained to perform.

“This is a sad situation,” said Danielle Fréchette, the study’s principal investigator. “Not only for the dedicated physicians and surgeons who spent more than a decade training to serve Canadians, but also for Canadians who desperately need timely access.”

The college surveyed newly certified specialists and subspecialists across Canada over a two-year period. Sixteen per cent of nearly 1,400 respondents said they could not get a job in their field. Thirty-one per cent said they were pursuing additional training to become more employable. Nearly one quarter of the new graduates reported working multiple part-time jobs and 40 per cent of them said they were unhappy.

The problem, Fréchette said, boils down to a bad economy, frozen hospital budgets, a disorganized health-care system and poor workforce planning by provinces and territories.

The solution lies in creating a national think-tank to collect and analyze human resources data nationwide, she said.

A place where something as simple as job postings could be centralized, she said.

“Different jurisdictions, hospitals, health-care organizations post the information in different places,” she said.

The think-tank proposal will be raised during a national summit the college is organizing in Ottawa in February to discuss the employment crisis with government officials, medical regulators and representatives from various arms of the health-care sector.

Some physicians groups have been actively trying to match graduates with jobs for more than a decade, but it’s an inexact science, says Dr. Ross Halperin, president of the Canadian Association of Radiation Oncology.

“It’s disappointing, without question, that we haven’t been able to do a better job of avoiding these mismatches,” Halperin said by phone from Kelowna, B.C., where he is interim vice-president of radiation therapy for the province.

“The graduates are coming out and they’re not finding positions.”

More than half of the new radiation oncologists who responded to the Royal College study were unemployed.

When Dr. Hugh Scully became president of the Canadian Medical Association in the late 1990s, the Toronto-based cardiac surgeon identified staffing shortages as a priority. The country was in the grip of a massive brain drain.

Nearly 15 years later, the issue is back on Scully’s plate. He sits on the Royal College’s health policy advisory committee. He said the fee-for-service system is out of step with team-based care, an increasingly popular model.

“The concern in the fee-for-service system is if you bring somebody in for mentoring, then who is billing for what? If you have a contract or a salary arrangement, which pays well, there is room to bring people in.”

The Star reached Scully in Washington on Wednesday, where he is attending the annual general meeting of the American College of Surgeons. He is one of the group’s governors and the only non-American to serve on its health policy and advocacy group.

A major discussion topic was the country’s looming need for specialists, he said.

The Americans are scrambling to plan for a shortage of between 20,000 and 30,000 specialists by the end of this decade.

“And Canada has always been a favourite target.”

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