News
Canada is short of doctors — and it’s turning away hundreds of home-grown physicians each year
|
|
The country’s health-care system is suffering from an acute shortage of doctors — even as hundreds of qualified Canadian physicians trained abroad are turned away each year because of a tangle of red-tape and bias, experts say.
Canada is passing up a chance to add hundreds of these Canadian doctors to a strained system because, critics say, tight-fisted provincial governments have restricted the number of residency spots — and because the system explicitly privileges students who went to Canadian medical schools.
According to census data, there’s no shortage of doctors in Canada. What we have is a shortage of licensed doctors.
While estimates vary, there may be as many as 13,000 medical doctors in Canada who are not practising because they haven’t completed a two-year residency position — a requirement for licensing.
Critics of the system say discrimination is pervasive.
“There is a ‘don’t come home attitude’ in Canada,” said Rosemary Pawliuk, president of the Society for Canadians Studying Medicine Abroad.
“They have cute slogans like, ‘You’re wanted and welcome in Canada,’ but when you look at the barriers, it’s very clear that you should not come home. Their message is essentially, ‘Go away.’ And so they do.”
Under Canadian regulations, medical schools themselves decide who gets a residency. Critics say those schools have a vested interest in seeing Canadian-educated students get as many of those positions as possible — leaving those Canadians trained at reputable schools abroad at a serious disadvantage.
Critics say the system is designed to ensure that every graduate of a Canadian medical school — no matter how competent they are — is licensed to practice medicine. Only a relatively small number of underperformers are weeded out each year.
The same cannot be said for Canadians who attend medical school overseas.
A bias built into the system
“The physicians running these departments want the best — but that’s not allowed. They’re not allowed to pick from the full pool of qualified applicants,” said Pawliuk.
About 90 per cent of all residencies are set aside each year for Canadian medical graduates. Internationally trained doctors get the rest.
In some provinces, domestic medical school graduates and those educated abroad can’t compete against one another — there are two separate pools, and the one reserved for international medical graduates is much smaller.
According to data from the Canadian Resident Matching Service (CaRMS), 1,661 international medical graduates (IMGs) applied for residency positions in Canada last year. Just 439 were matched with the necessary post-graduate training. That’s a “match rate” of just 26 per cent.
And these are not foreigners — you must be a Canadian citizen or permanent resident to even apply for a residency in Canada.
“The Canadian public should be entitled to the best qualified Canadian applicant. Whether they’ve graduated from a Canadian school or an international school, whether they’re a Canadian by birth or if they’re an immigrant, they should be competing on individual merit,” Pawliuk said.
The way the residency system works has consequences. For example, 115 residencies nationwide — mostly in family medicine — went unfilled last year because Canadian medical school graduates weren’t interested in them, according to CaRMS data.
These Canadians trained abroad also face a series of other hurdles.
Unlike Canadian medical graduates, for example, international medical graduates have to sit for the “MCCQE Part 1” exam administered by the Medical Council of Canada before they can apply for a residency.
Canadian medical graduates can do it after they’ve already secured a spot and, each year, about 5 per cent of them fail the exam but continue with their residency anyway, according to data from Pawliuk.
A shortage of space in med schools
Canada’s residency placement rate compares poorly to what’s been reported in other countries.
In the U.S., for example, 61.6 per cent of American-born or naturalized citizens who go to school abroad are matched with a residency position, according to data from the U.S. National Resident Matching Program.
Many medical students go abroad to train because there are very few medical school spots available in Canada.
Tens of thousands of pre-med students are competing for just 2,800 first-year openings at the country’s 17 medical schools. Their acceptance rate is only about 5.5 per cent, according to university data.
Every year, about 1,000 would-be Canadian doctors go to school in countries like Australia and Ireland, where first-year spots are more plentiful.
Toronto-born Jake Portnoff is one of those students.
A pre-med graduate of Queen’s University, Portnoff wasn’t accepted at his Canadian medical school of choice — in part because there was a flood of applications after years of COVID-related deferrals.
He’s now at the University of Queensland with about 100 other Canadian students who were also shut out of what he calls a “very competitive and daunting” Canadian medical school selection process.
Portnoff said most of the Canadian students there want to return home — they’re just worried about a residency process that looks like an uphill battle.
“There are so many qualified and educated medical students who I believe really should be given a chance. The amount of residency seats available right now is just such a barrier. It’s certainly hard to hear that many qualified Canadians are being turned aside in the face of what we’re experiencing,” he told CBC News.
“Increasing the amount of residency spots would be a huge benefit to Canadians, especially when the system there is in a crisis.”
With some emergency departments closing due to staff shortages and a dearth of family doctors nationwide, Portnoff said it’s obvious Canada needs to increase the number of residency spots on offer.
“We do all we can to promote the best health-care outcomes for our patients. That doesn’t change, whether I’m in Australia or Canada. I’d take all my skills and clinical acumen home and all apply them in the Canadian system,” he said.
Number of international residency applicants dwindling
Beyond adding more residency positions, Portnoff called for other creative solutions — such as an international exchange program so that students in Australia can go home to Canada to gain experience before diving into the cutthroat residency matching process.
Portnoff co-founded the Canadian-American-Australian Medical Student Association, an advocacy group designed to help students make the transition at time when word has gotten out that it’s difficult to come back to Canada.
The number of international applicants to residency positions has fallen steadily from 2,219 in 2013 to 1,661 in 2022 — a drop of 25 per cent in just a decade.
Some foreign-trained doctors are giving up on Canada because the process is so difficult, Pawliuk said.
“If you tell people to stay away long enough, they will,” she said.
That’s an issue because Canada depends in part on foreign-trained doctors to fill the ranks of departing doctors.
Foreign-trained physicians historically account for about 25 per cent of all doctors, according to data from the Canadian Institute for Health Information.
In family medicine, nearly a third of all doctors have international medical degrees.
This week, the federal Liberal government announced an offer to the provinces of about $46 billion in new health-care spending.
In exchange for that cash, critics say Ottawa should demand that the provinces do more to streamline foreign-credential recognition.
As part of his health-care plan, Conservative Leader Pierre Poilievre has pitched working the provinces to fast-track the process.
“It’s outrageous that my little girl has to sit in the emergency room with a migraine for six hours because there’s not enough doctors and nurses,” he told reporters Wednesday after Trudeau unveiled his health-care plan.
“I think we should team up with the provinces to come up with a simple system that gives a ‘yes’ or a ‘no.’ It should happen within sixty days, not six or seven years.”
The Royal College of Physicians and Surgeons of Canada oversees the accreditation of medical resident training in Canada for specialists.
In a statement, the Royal College said it considers residents who completed medical school outside of Canada to be “important contributors to a robust education environment and future health workforce,” and it is currently considering some “alternate pathways” to streamline the system.
“I think five years from now, internationally trained physicians would be getting into the system within one or two years, regardless of their medical specialty, as opposed to five to seven years,” said Glen Bandiera, executive director of standards and assessment at the Royal College.
Toddlers ran through aisles filled with snacks and candies. Adults slumped in chairs. Multiple cellphones were plugged into a single wall socket. Backpacks and suitcases were scattered among the two rows of tables in a corner of this small-town bus stop and gas station.
After they were turned away at the Canadian border and spent three days in detention, the roughly 15 asylum seekers at the Mountain Mart No. 109 in the town of Plattsburgh, N.Y., south of Montreal, on Tuesday afternoon were trying to figure out what to do.
They had tried to get into the country at the popular unofficial crossing on Roxham Road in the hours after a new border deal between Canada and the U.S. came into effect late last week.
Alan Rivas, a Peruvian man who was hoping to reunite with his girlfriend who’s been living in Montreal for two years, said he’d spent $4,000 on making it this far.
“I’m trying to think about what to do now.”
A sense of solidarity emerged as people recognized each other from various parts of their time stuck on the border, along with a sense of resignation and deep disappointment.
“Disappointing and heartbreaking,” said a man from Central Africa, whom CBC agreed not to identify because he fears it could affect his asylum claim process in the United States.
He had shared a cab ride with a man from Chad, who fled to the U.S. after the government of his country led a violent crackdown on opponents last fall.
“It’s unfair. We are not home and we suffer. We’re looking for a better life,” the man from Central Africa said.
The man from Chad looked up and said: “No, looking for protection is not having a better life. I had a life.”
The Chadian was not let into Canada despite his wife and child being Canadian citizens, he said. Having a family member with legal status in Canada is one of the few exemptions to the strict new rules that make it nearly impossible to claim asylum at the Canada-U.S. border. His wife and child fled to a nearby country after the crackdown in Chad, but he explained that his wife’s family is still in Canada.
Other exemptions include being an unaccompanied minor and having a work permit or other official document allowing a person to be in Canada.
“They made me sign a paper without giving me time to read it. They didn’t explain anything,” said the man, whom CBC also agreed not to name because he fears for his family’s safety in an African country near Chad.
The Canada-U.S. deal was implemented swiftly before the weekend, leaving local governments and organizations little time to respond and turned-away asylum seekers struggling to find food, shelter and rides.
The man from Central Africa was trying to round up enough money to pay for a $200 bus ticket to Houston, where he would stay with a friend. The man from Chad gave him the $40 he was missing.
The Central African said he had spent his savings on coming to Canada. His hope was to live here until obtaining residency, and then arranging for his family to come to meet him.
“I know a guy in Houston who hasn’t seen his family in 10 years. He still doesn’t have status,” he said.
A young Haitian mother cradled her baby as her toddler made friends with another child. Her family had paid an acquaintance in New Jersey $300 per adult to get to Roxham Road before midnight Friday, but the driver got lost and they arrived at 12:03 a.m.
Steven, a 24-year-old Venezuelan who attempted to cross into Canada at Roxham early Saturday morning, mingled with the people he’d met in detention. Then he tried to call his mom.
“She doesn’t know,” said Steven, who didn’t want his last name used in this story because of fears it could affect his U.S. asylum claim. “I know I seem happy but I am sad.”
Carmen Salazar, 45, also from Venezuela, watched him from another table.
“It’s hard, really hard,” she said.
The group of asylum seekers at the Mountain Mart had found comfort in finding each other. They all boarded a bus leaving Plattsburgh at 7:45 p.m. Tuesday. Its main destination was New York City.
Others haven’t been so lucky finding a way out of Plattsburgh.
The night before, a woman who was seen at Roxham Road early Saturday, sat alone at the bus stop crying.
3 nights in a motel and no plan
Across the street, in a small motel, a 34-year-old Haitian man and his pregnant girlfriend had one night left out of three that had been paid for by local emergency housing services. But they had no plan and only $41 to their name.
“We’re here. I don’t know what’s going to happen, but we’re going to look for ways to be able to live. What I’m looking for — nothing more — is a place to rest and a place to work. Nothing else,” said the man, sitting in the lobby of the motel. CBC is not naming him because of fears it could affect his American asylum claim.
The couple had intended to stay in the U.S. after crossing the Mexican border, but the woman became pregnant and developed constant pains. In the U.S., they had to stay with separate family members far from each other and the man worried about his wife and being able to afford medical bills, so they decided to try to get to Canada, having heard it was easier to find work and that health-care was more affordable, he said.
In an interview with Radio-Canada Monday, a man from another Central African country struggled to hold back tears.
He said the confusion after being taken in at Roxham Road by RCMP officers was hurtful because it wasn’t clear if he’d be accepted into Canada or not. When they called his name, he was filled with hope, only to be told he was being sent to U.S. Border Patrol.
“I don’t know, I don’t know, I don’t know where to go. I don’t have anyone who will take me in,” he said.
The response from U.S. Border Patrol appears to be uneven. Some asylum seekers CBC spoke with had taxis called for them, having to pay another $70 to get to the Mountain Mart. One woman was found on the side of the service road by the border and given a ride by a social science researcher and documentary photographer met by CBC.
The man interviewed by Radio-Canada was part of a group who were given a ride to the gas station by a Greyhound bus heading back to New York from Montreal.
CBC reached out to U.S. Customs and Border Protection on Monday, asking what happens to asylum seekers rejected by Canada, but did not receive a response.
Although in favour of some kind of change to reduce traffic at Roxham Road, one local official wants help from the federal governments to deal with the fallout.
Michael Cashman, supervisor for the Town of Plattsburgh, says Canada and the U.S. to come up with a response to help asylum seekers get to where they want to go in the U.S.
He isn’t against the move to restrict access to Canada at Roxham Road.
“There had to be a change,” he said, noting residents had been asking for one, but compared the way it was done to turning off a light switch before entering a room: “You’re going to bump into some furniture.”
The area is rural and has its share of struggles with transportation and housing, Cashman said.
“There isn’t a robust infrastructure to be able to take on this humanitarian crisis as it develops.”
On Monday and Tuesday, buses coming from New York carried only a few asylum seekers hoping to cross the border. Most knew about the new rules, believing their cases would fit some of the exemptions. Others still did not know.
By Tuesday, cab drivers were no longer ferrying people to Roxham Road, taking them to the official border crossing at Champlain, N.Y., and Lacolle, Que., instead.
|
|
Canada’s economy might be recovering from the pandemic, but many Canadians are still struggling with the cost of living, thanks, in part, to the impacts of global inflation.
To help offset rising living expenses, the Government of Canada has built some benefit increases and fee reductions into its 2023 budget. Among these measures is a new grocery rebate in the form of a one-time payment for middle- and low-income Canadians that is designed to offset food inflation.
“Our more vulnerable friends and neighbours are still suffering from higher prices,” Minister of Finance Chrystia Freeland said after tabling the budget on March 28. “That’s why our budget contains targeted, temporary relief from the effects of inflation for those who need it.”
Here’s what we know about the rebate.
HOW WILL THE GROCERY REBATE WORK?
According to the budget, the benefit will be rolled out through the GST/HST rebate system, once a bill implementing it passes in the House of Commons. This move essentially re-ups and re-brands the recent GST rebate boost.
While no specific date for the payments has been announced, upcoming GST/HST credit payment dates for 2023 include April 5, July 5 and Oct. 5. Because the rebate is automatically rolled into the GST/HST credit, eligible Canadians shouldn’t need to do anything besides file their tax return in order to receive the payment.
WHO GETS THE GROCERY REBATE IN CANADA?
The Grocery Rebate is earmarked for 11 million low- to modest-income Canadians. It will provide eligible couples with two children with up to $467, single Canadians without children with up to $234 and seniors with $225 on average.
The budget doesn’t pinpoint any eligibility brackets based on income, but outlines hypothetical scenarios where a couple earning $38,000 per year and an individual earning $32,000 both received the maximum rebate.
Since the rebate will be rolled into the GST/HST credit, the eligibility criteria for that credit might offer some insight into who will be eligible for the maximum Grocery Rebate amounts.
The GST benefit is reduced as income rises. It’s phased out entirely once income reaches just over $49,000 for a single person, $50,000 for a couple without children and more than $60,000 for a couple with four children.
HOW MUCH DOES IT COST TO FEED A FAMILY OF 4 IN CANADA?
The average family of four will spend up to $16,288.41 on food this year, according to the latest Canada’s Food Price Report, published by the Agri-Food Analytics Lab at Dalhousie University.
“For a family of four, their food bill will increase by about $1,100 this year,” the lab’s director, Sylvain Charlebois, told CTV News Calgary on Tuesday.
The cost of staple grocery items based on March 2023 prices listed on Fortinos.ca. (CTV’s Your Morning)
The most substantial increases will be in the cost of vegetables, dairy and meat, according to the report. Food inflation has softened somewhat in recent weeks, Charlebois said, but even with that softening and the extra cash in their pockets from the grocery rebate, Canadians aren’t out of the woods yet.
“We are expecting things to be a little more manageable for households probably in the summer, (but) not before then,” he said. “We are expecting to finish the year with a food inflation rate of about four to five per cent. It’s still high, but it’s better than 10 per cent.”
HOW CAN I SAVE MONEY ON GROCERIES IN CANADA?
As finance commentator Pattie Lovett-Reid pointed out during an interview on CTV’s Your Morning on Tuesday, a maximum grocery rebate of $467 for a family of four doesn’t even offset half of the additional $1,100 families can expect to spend on groceries in 2023.
“It’s a small amount that will help a family of four,” she said. “But, is it enough? No, it’s not, we’ve got to get inflation down.”
With their spending power significantly weakened, a growing number of consumers are looking for new ways to save on their grocery bills.
According to a March 22 report published by the Agri-Food Analytics Lab, in partnership with Angus Reid, some of the methods Canadians are using to save money at the grocery store include reading weekly flyers, using coupons, taking advantage of volume discounting and using food rescue apps such as Too Good To Go and the Second Harvest Food Rescue App.
– With files from Senior Digital Parliamentary Reporter Rachel Aiello
|
|
D HOWELL
Drops
“MAN DEM”
By way of Spanish Town
Toronto, On – International selling Pop/ Reggae artist, D Howell drops his new single, “Man Dem “available now, on all major music platforms. The release featuring Ding Dong & Nicky B follows a long list of hit music from the talented pop-reggae artist. Howell’s single, ’Wine Bounce” with Jamaican born reggae artist Dominant ft. Nick B was picked up by Universal Music, solidifying Howell’s career with the likes of Sean Paul, Elephant Man and Sarani. The artist contributes his Jamaican roots to the success of his brand. Keeping his early beginnings in Spanish Town, Jamacia close to his heart, “Man Dem” (meaning multiple men) was created. The single is inspired by the multicultural people of Toronto with special consideration to the immigrants from Jamaica. Their specific style of talking is heard on every street corner in Toronto. The new generation have made it their own, a way of bringing and keeping their heritage alive. Howell’s music speaks to that, making the heritage & the music one. The highly anticipated release of “Man Dem” will take you home to Spanish Town.
DJ, producer and artist, D Howell knows what it takes to make hit singles. It’s not just talent that makes a single a hit, but the chemistry & respect for your fellow artists. Knowing what works and what doesn’t between artists is key. Mixing different instruments, sounds and styles to create his always evolving pop reggae sound has made Howell an in-demand producer and artist. From the super hit ‘Jumanji’ to a lineup of multi-selling collaborations featuring his unique reggae influence, Howell makes it work. Collaborations with Karl Wolf (“Fall in Love”), Danny Fernandes (“Party”) and the man himself, Sean Paul (“Time to Party”). Howell writes for and brings together a wide range of artists from different genres into his studio to create a combination of sounds that works on the music charts today. D Howell brings the love, nurture & music of his early beginnings to his seat at the industry table. “Man Dem” takes you on that journey…
Listen to Man Dem”
https://open.spotify.com/album/7nW1yToUEz2I2OUdZ9jVso?si=DxAcnCwbTNOwkQvwhaFvUA
Follow D Howell:
https://soundcloud.com/realdhowell/nicky-b-man-dem-clean
https://www.instagram.com/realdhowell/
https://www.youtube.com/@diamienrecords
https://twitter.com/realdhowell
Media Inquiries:
Sasha Stoltz Publicity:
Sasha Stoltz | Sasha@sashastoltzpublicity.com | 416.579.4804
https://www.sashastoltzpublicity.com
How To Choose The Perfect Type Of Fundraiser For Your Cause
Pierre Poilievre is neither for nor against the Liberals' industrial strategy. Quite the opposite – The Globe and Mail
As Canadians miss out on benefits, Ottawa promises automatic tax filing is on the way – BNN Bloomberg
-
Business17 hours ago
Bank of Canada ‘ready to act’ if financial turmoil spreads
-
Media17 hours ago
2023 Media Layoff Tracker: Rough Year For Journalism Marked By Increasing Layoffs
-
News18 hours ago
What is the grocery rebate in federal budget 2023? Key questions, answered
-
Health18 hours agoWHO Experts Say Healthy Kids, Teens May Not Need More COVID Shots
-
Investment19 hours ago
2X Receives Strategic Growth Equity Investment from Recognize
-
Business19 hours ago
Musk, other tech experts urge halt to further AI developments
-
Art8 hours ago
Art collector Myriam Ullens killed outside her home in Belgium, allegedly by her stepson – Art Newspaper
-
Sports17 hours ago
Toronto Maple Leafs vs. Florida Panthers – Game #74 Preview, Projected Lines & TV Info
