Thousands of Canadian-born doctors are working abroad at a time when the country is facing an acute shortage of physicians — and there’s little prospect of them practising here because of barriers that block foreign-trained professionals from launching a career at home.
While it’s difficult to establish just how many Canadian doctors are working overseas, a CBC News analysis of publicly available data suggests they number in the tens of thousands.
Since the early 1990s, the number of Canadian international graduates who aren’t matched with residencies has grown significantly. Medical schools, which run the system, privilege their own Canadian-educated students over home-grown doctors trained abroad for the limited number spots that are available each year.
In 2022, for example, only 439 foreign-trained Canadian doctors out of a pool of 1,661 applicants were actually matched with residencies — post-graduate training that is required in order to be licensed. That’s a 26.6 per cent match rate.
That means 1,222 would-be doctors were cut loose and forced to find work elsewhere, according to data from the Canadian Resident Matching Service (CaRMS).
And these are not foreigners — you must be a Canadian citizen or permanent resident to even apply for a residency in Canada.
The number of CaRMS applicants doesn’t tell the whole story.
An untold number of Canadians go to school in countries like Australia, Ireland, the United Kingdom and the U.S. They tend not to apply for residencies at home because they know how unlikely it is they’ll be matched.
Dr. Steve Brennan was one of those students.
Rejected by Canada, he’s now a pediatric pulmonologist and the associate director of the rare lung disease centre at Washington University in St. Louis, Missouri.
Dr. Steve Brennan, born in St. Albert, Alta., works as a pediatric pulmonologist in St. Louis, Missouri. There’s a critical shortage of pulmonologists that work with children. (Submitted to CBC News)
He’s the kind of specialist Canada needs. The American Thoracic Society has said there’s a “critical shortage” of these doctors; fewer than 1,000 of them are actually practising in the U.S. They’re even more scarce north of the border.
Born in St. Albert, Alta., Brennan did his undergraduate degree in social work in Canada. Growing up in a family of nurses, Brennan ultimately decided medicine was his true calling. He applied to a number of Canadian medical schools but wasn’t accepted.
He’s not alone. Few medical school spots are available in Canada — the acceptance rate was just 5.5 per cent last year, according to university data.
Twenty years ago, there were 2,044 first-year medical school positions available at 16 universities nationwide. In 2020-21, there were about 2,800 positions available at 17 schools. Canada has added some eight million people to its population over the same time period.
Brennan went to the University of Queensland in Australia and graduated in 2013 with 100 other Canadian students. He said six of his closest Canadian friends in that graduating class also skipped out on a Canadian residency altogether.
‘Why bother?’
“I didn’t even try to come home. I just knew how hard it would be,” Brennan told CBC News.
“We had someone from the B.C. residency program come to Australia and they basically said, ‘Don’t come back.’ The statistically low match rate means even some of the top students don’t get through. So I said, ‘Why bother?’
“It’s really sad because I went to medical school thinking I’d just come back to Canada. I think that’s what all of us thought. Going to school in Australia — it’s a way to be a doctor, but it’s not actually a way to be a doctor in Canada.”
While he was reluctant to leave Canada, his mum and sister in Vancouver and his dad in Calgary, Brennan turned to the U.S., where international medical graduates are more than twice as likely to land a residency.
“They have enough spots to accommodate every single American student and a ton of internationals,” he said. “They’ve got it figured out.”
Brennan has made a career in St. Louis studying and treating children with asthma, cystic fibrosis and genetic disorders like primary ciliary dyskinesia. He’s married with kids and lives near his in-laws.
Canada is short nearly 17,000 physicians
But he can’t help but think the Canadian system is “a bit cruel” because it keeps Canadian doctors like him away from their own country — and the family and friends they left behind.
Brennan said there’s a reason why the number of internationally trained applicants for Canadian 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.
“In Canada, the system is just not really set up to take international graduates,” he said. “Word gets out.
“And that’s a problem because the health-care system cannot rely solely on Canadian doctors. That’s clearly not working. You have to alter the system somehow if you really want to train people in Canada.”
After years of restrained spending by federal and provincial governments and a generation of protectionist policies that restrict access to residency, Canada’s health-care system is short nearly 17,000 physicians, according to recent data compiled by the Royal Bank of Canada.
A nurse works with a patient in the intensive care unit at the Halifax Infirmary in Halifax on Feb. 25, 2022. Canada is facing a shortage of health-care professionals while thousands of Canadian-born, foreign-trained doctors are working abroad. (Andrew Vaughan/The Canadian Press)
The problem is expected to get worse.
In less than a decade, as the baby boomer cohort retires en masse and the population grows by some 500,000 people a year, Canada will be short an estimated 43,900 physicians — including more than 30,000 family doctors and general practitioners, the bank reported.
Dr. Kate Stewart wanted to help Canada fill the gap. Born and raised in St. Catharines, Ont., Stewart did an undergraduate degree and got her master’s at the University of Guelph.
She’s now a practising obstetrician-gynecologist in the Melbourne area.
Dr. Kate Stewart (right) is a Canadian-born doctor living near Melbourne, Australia, with her husband Dr. Chamath De Silva (left). Stewart wanted to come home after her medical training but there are significant roadblocks that make it difficult for Canadian doctors trained abroad to return. (Submitted to CBC News)
Stewart was another Canadian who didn’t bother with the CaARMS residency match process after she graduated in 2012.
She knew the chances of getting a position were slim — there were only three ob-gyn residency positions in all of Ontario open to international graduates that year.
She also didn’t want to be separated from her Australian husband, who is an anesthesiologist.
Stewart thought that after she completed her residency and specialist training in Australia, she could come home and live near her parents in Ontario’s Niagara region.
But after doing a deep dive on the process, she realized it was difficult to get the Royal College of Physicians and Surgeons, which oversees the accreditation of specialists in Canada, to recognize her Australian credentials.
While the Royal College has a streamlined process for trained specialists coming from select Commonwealth and other western countries, Stewart would still be forced to sit for an exam — a test that requires at least 20 to 30 hours of study per week for a year.
Stewart said she can’t juggle that with her obligations as a doctor and as a parent to two young girls.
“It’s really not something I’m interested in doing again. I’ve been there and I’ve done that,” she told CBC News.
She’d also be out $8,000 — there’s a fee to assess her “exam eligibility” and a separate fee for the exam itself. The test can’t be done remotely — she’d have to come to Canada.
“I could pick up the phone tomorrow and ring the U.K. or New Zealand and I’d be able to apply for a job there without restrictions. It doesn’t make sense to me why I couldn’t do the same with Canada,” she said.
“I’ve practised and worked and learned in a Western, English-speaking country with similar cultures and values. People coming from countries like New Zealand, Australia, the U.K., they have the capacity to integrate into the Canadian system as good workers, easily.”
Her Australian husband, Dr. Chamath De Silva, was willing to move to Canada — but he also found the process daunting, time-consuming and expensive.
It’s a shame, Stewart said, because the Niagara region desperately needs anesthesiologists like De Silva. Last month, a hospital in Welland, Ont. had to cancel surgeries because there wasn’t one available.
With Canada experiencing such an acute shortage of doctors, Stewart said the roadblocks thrown up by provinces and regulatory bodies are puzzling.
“The country should be grateful that these Canadians are willing to come back and be completely overworked and underpaid,” she said. “And you didn’t even have to pay to educate them.”
TORONTO – Will Taylor Swift bring chaos or do we all need to calm down?
It’s a question many Torontonians are asking this week as the city braces for the arrival of Swifties, the massive fan base of one of the world’s biggest pop stars.
Hundreds of thousands are expected to descend on the downtown core for the singer’s six concerts which kick off Thursday at the Rogers Centre and run until Nov. 23.
And while their arrival will be a boon to tourism dollars — the city estimates more than $282 million in economic impact — some worry it could worsen Toronto’s gridlock by clogging streets that already come to a standstill during rush hour.
Swift’s shows are set to collide with sports events at the nearby Scotiabank Arena, including a Raptors game on Friday and a Leafs game on Saturday.
Some residents and local businesses have already adjusted their plans to avoid the area and its planned road closures.
Aahil Dayani says he and some friends intended to throw a birthday bash for one of their pals until they realized it would overlap with the concerts.
“Something as simple as getting together and having dinner is now thrown out the window,” he said.
Dayani says the group rescheduled the gathering for after Swift leaves town. In the meantime, he plans to hunker down at his Toronto residence.
“Her coming into town has kind of changed up my social life,” he added.
“We’re pretty much just not doing anything.”
Max Sinclair, chief executive and founder of A.I. technology firm Ecomtent, suggested his employees avoid the company’s downtown offices on concert days, saying he doesn’t see the point in forcing people to endure potential traffic jams.
“It’s going to be less productive for us, and it’s going to be just a pain for everyone, so it’s easier to avoid it,” Sinclair said.
“We’re a hybrid company, so we can be flexible. It just makes sense.”
Swift’s concerts are the latest pop culture moment to draw attention to Toronto’s notoriously disastrous daily commute.
In June, One Direction singer Niall Horan uploaded a social media video of himself walking through traffic to reach the venue for his concert.
“Traffic’s too bad in Toronto, so we’re walking to the venue,” he wrote in the post.
Toronto Transit Commission spokesperson Stuart Green says the public agency has been working for more than a year on plans to ease the pressure of so many Swifties in one confined area.
“We are preparing for something that would be akin to maybe the Beatles coming in the ‘60s,” he said.
Dozens of buses and streetcars have been added to transit routes around the stadium, and the TTC has consulted the city on potential emergency scenarios.
Green will be part of a command centre operated by the City of Toronto and staffed by Toronto police leaders, emergency services and others who have handled massive gatherings including the Raptors’ NBA championship parade in 2019.
“There may be some who will say we’re over-preparing, and that’s fair,” Green said.
“But we know based on what’s happened in other places, better to be over-prepared than under-prepared.”
Metrolinx, the agency for Ontario’s GO Transit system, has also added extra trips and extended hours in some regions to accommodate fans looking to travel home.
A day before Swift’s first performance, the city began clearing out tents belonging to homeless people near the venue. The city said two people were offered space in a shelter.
“As the area around Rogers Centre is expected to receive a high volume of foot traffic in the coming days, this area has been prioritized for outreach work to ensure the safety of individuals in encampments, other residents, businesses and visitors — as is standard for large-scale events,” city spokesperson Russell Baker said in a statement.
Homeless advocate Diana Chan McNally questioned whether money and optics were behind the measure.
“People (in the area) are already in close proximity to concerts, sports games, and other events that generate massive amounts of traffic — that’s nothing new,” she said in a statement.
“If people were offered and willingly accepted a shelter space, free of coercion, I support that fully — that’s how it should happen.”
This report by The Canadian Press was first published Nov. 13, 2024.
TORONTO – Hundreds of Taylor Swift fans lined up outside the gates of Toronto’s Rogers Centre Wednesday, with hopes of snagging some of the pop star’s merchandise on the eve of the first of her six sold-out shows in the city.
Swift is slated to perform at the venue from Thursday to Saturday, and the following week from Nov. 21 to Nov. 23, with concert merchandise available for sale on some non-show days.
Swifties were all smiles as they left the merch shop, their arms full of sweaters and posters bearing pictures of the star and her Eras Tour logo.
Among them was Zoe Haronitis, 22, who said she waited in line for about two hours to get $300 worth of merchandise, including some apparel for her friends.
Haronitis endured the autumn cold and the hefty price tag even though she hasn’t secured a concert ticket. She said she’s hunting down a resale ticket and plans to spend up to $600.
“I haven’t really budgeted anything,” Haronitis said. “I don’t care how much money I spent. That was kind of my mindset.”
The megastar’s merchandise costs up to $115 for a sweater, and $30 for tote bags and other accessories.
Rachel Renwick, 28, also waited a couple of hours in line for merchandise, but only spent about $70 after learning that a coveted blue sweater and a crewneck had been snatched up by other eager fans before she got to the shop. She had been prepared to spend much more, she said.
“The two prized items sold out. I think a lot more damage would have been done,” Renwick said, adding she’s still determined to buy a sweater at a later date.
Renwick estimated she’s spent about $500 in total on “all-things Eras Tour,” including her concert outfit and merchandise.
The long queue for Swift merch is just a snapshot of what the city will see in the coming days. It’s estimated that up to 500,000 visitors from outside Toronto will be in town during the concert period.
Tens of thousands more are also expected to attend Taylgate’24, an unofficial Swiftie fan event scheduled to be held at the nearby Metro Toronto Convention Centre.
Meanwhile, Destination Toronto has said it anticipates the economic impact of the Eras Tour could grow to $282 million as the money continues to circulate.
But for fans like Haronitis, the experience in Toronto comes down to the Swiftie community. Knowing that Swift is going to be in the city for six shows and seeing hundreds gather just for merchandise is “awesome,” she said.
Even though Haronitis hasn’t officially bought her ticket yet, she said she’s excited to see the megastar.
“It’s literally incredible.”
This report by The Canadian Press was first published Nov. 13, 2024.
OTTAWA – Via Rail is asking for a judicial review on the reasons why Canadian National Railway Co. has imposed speed restrictions on its new passenger trains.
The Crown corporation says it is seeking the review from the Federal Court after many attempts at dialogue with the company did not yield valid reasoning for the change.
It says the restrictions imposed last month are causing daily delays on Via Rail’s Québec City-Windsor corridor, affecting thousands of passengers and damaging Via Rail’s reputation with travellers.
CN says in a statement that it imposed the restrictions at rail crossings given the industry’s experience and known risks associated with similar trains.
The company says Via has asked the courts to weigh in even though Via has agreed to buy the equipment needed to permanently fix the issues.
Via said in October that no incidents at level crossings have been reported in the two years since it put 16 Siemens Venture trains into operation.
This report by The Canadian Press was first published Nov. 13, 2024.
