The country's medical schools turn away more than 1,000 Canadian doctors trained abroad annually, even though the country is facing a physician shortage. But they still manage to find residency spots for foreign nationals who are much less likely to stay and help chip away at the physician deficit.
I think the article falls short in its reasoning. Yes, I agree that Canadian IMGs should have priority over foreign IMGs, but where’s the root of the problem? Why do we have so many Canadian international medical graduates in the first place?
The issue here is not so much with how residency programs rank candidates, and I’d very much like to see a source for Pawliuk’s claim of IMGs paying for residencies, because CaRMS doesn’t work like that, but more because of the lack of Canadian graduates in the first place. Canadian medical schools are extremely exclusive and use outdated evaluation practices to limit their intake to a number that has not increased much at all in the past decade, at least at my local university.
This exclusivity leads to Canadians who want to be doctors to seek medical training elsewhere, as the article mentions. This then makes them an IMG, and the system doesn’t often distinguish between a Canadian or foreign IMG. It’d be up to the residency program itself to prioritize Canadians, but then you’d have to convince the ranking committee to select based on nationality rather than aptitude.
The question we should be asking is not, “why are there so many foreigners in Canadian residencies?” but rather, “why don’t we have more Canadian graduates to fill our own residencies?”
The title is convoluted. It’s more like “residency programs train doctors who move abroad rather than doctors who stay in Canada”. Here’s the relevant bits:
medical schools that run residency programs still find room for foreign nationals from countries like Oman, Kuwait and Saudi Arabia — people who frequently have no intention of staying here to work over the long term.
All of this is done with Ottawa’s blessing. The federal government has exempted medical schools from immigration laws that require Canadians get priority for a job.
Critics maintain that dismantling the foreign “visa trainee” program — which gives several hundred residency spots to non-Canadians — would free up positions so more homegrown doctors can work here in Canada and help chip away at the physician deficit.
And here’s some context:
Federal data suggest Canada will be short some 44,000 doctors, including more than 30,000 family doctors and general practitioners, by 2028.
And here’s the smoking gun:
These foreign nationals have benefactors that pay much more for medical residencies than the sums offered by provincial governments for Canadian residents.
That explains why the current system continues, Pawliuk said: foreign trainees are a cash cow for the medical schools that administer the residency program.
Sorry if I missed this in the article. But what is the reason we can’t just expand the number of residents? It seems like the issue isn’t foreign intrest taking the slot, but that there isn’t enough slots to meet demand. Wich seems like a thing we should be able to fix.
Apparently training doctors in residency programs takes time from existing doctors. Meaning we don’t have enough doctors to train new doctors and maintain our current level of services.
Ah that makes sense. I was just reading about that same kind of issue affecting commercial pilots. Both jobs have extreamly high training/education cost then leave students in low paying jobs for a long stretch of their early careers. Both jobs also have foreign countries paying way better then what we are offering. (The documentary was about the US but I assume we are not better off)
The answer is money. These foreign grads come from countries that are flush with oil money and their governments pay Canadian hospitals to train them, and get more for doing so then the government pays for domestic residents. The result is a win-win for hospitals here. They get labour of extra residents and make a profit. These residents typically go back to their home countries afterwards.
At the same time, they do use training capacity that could be used for domestic grads. However the government is reluctant to fund additional spots because they cost money. The government would also have to open more med school spots which also costs money. The losers are Canadian grads and the public since we train less doctors that stay in the country.
You need Canadian med students to fill Canadian residencies, so medical schools need the resources to expand their intake, which relies both on convincing many conservative provincial governments to provide more funding to keep the already exorbitant tuition at a similar level, and having more people willing to teach in med school, which often means giving up some of their practice.
In my opinion, there is a vast supply of people who want to become doctors, but the very limited spots that med schools have lead them to create extremely obtrusive barriers to entry to limit their intake to who they think are the best, the succes of which is questionable at best.
It’s fairly clear that standardized tests aren’t an indicator of success in a profession, even grades at the undergraduate level can arguably be said to be an indication of how well one is at test writing. Intake, at least at the university near me, is also based on an in-person interview with poor scoring metrics, often conducted by later year med students or residents rather than practicing doctors.
I don’t think the issue is a multitude of rich foreigners essentially paying for residency spots. The system is so dysfunctional they wouldn’t even know where to send the money. Look to where the journey of becoming a doctor starts, and you’ll find universities with limited resources using outdated intake practices to artificially limit the ones they accept into medical school, creating a bottleneck right at the very start of the process. There aren’t a lot of Canadian graduates going unmatched to residencies, there are a lot of residencies open to foreign grads because we don’t produce enough Canadian grads to fill them.
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