Compelling evidence of a pan-Canadian physician supply shortage triggered a massive increase in domestic medical education capacity a decade ago. At about the same time steps were taken to facilitate practice entry for many International Medical Graduates (IMGs) already residing in Canada. Policy changes also enabled a growing cohort of Canadians studying [medicine] abroad (CSAs) to return to Canada for residency training.
In concert, these three decisions have yielded a very substantial growth in physician supply which has exceeded population growth. Although persistent physician supply deficiencies remain in some disciplines and in some communities, the crisis of physician short-supply has largely been solved.
Many thoughtful observers are expressing opinions that we are approaching or have achieved a reasonable physician-population ratio across Canada. Indeed in some surgical disciplines we are now witnessing physician under-employment or outright unemployment.
The prospect of potential unemployment in selected disciplines is causing understandable anxiety among residents in those disciplines. Our 17 medical schools are being challenged to adjust their residency capacity allocations to align with projected future market demands.
The focus in Medical Human Resource management (MHR) is now shifting to the challenge of aligning optimal physician workforce distribution with community needs. There is a growing awareness that the public interest is not well served by an unfettered discretion by each physician to practice where and/or how he/she prefers.
In some provinces, Ministries of Health have implemented programs and policies designed to steer new graduates to practice in high need areas. The New Graduate Entry Program (NGEP) in Ontario is the most recent example of such a workforce management strategy.
In Nova Scotia, the provincial Regional Health Authority has announced a policy prohibiting new family physician practice entrants from practicing at walk-in clinics with the goal of assuring better public access to full scope family physicians.
Some provinces are striving to avoid the use of such blunt workforce management polices by engaging all stakeholders in more pro-active joint planning. In Saskatchewan, the Ministry of Health has just released aPlanning Tool for Physician Resources in Saskatchewan, which will serve as a guide to agencies like saskdocs.
As the CEO of saskdocs, I’m pleased that this medical workforce planning tool has been created to guide our future collaborative work with our medical school, RHAs, the Cancer Agency, Northern medical Services, the Saskatchewan Medical Association, and individual medical clinics.
The need to align our medical workforce with community needs is no less compelling in Saskatchewan than it is elsewhere across Canada. The failure of all stakeholders to work collaboratively in pursuit of that goal may yet necessitate the implementation of more intrusive policies we see emerging elsewhere in Canada. We are truly appreciative of this window of opportunity for collaborative action focused on public interest goals. We must not squander this opportunity.