News
Meet the Canadian-born doctors who can’t work in Canada
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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.
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.
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.
Rejected by Canadian medical schools, Stewart set out for the University of Queensland, which ranks among the top schools in the world.
She’s now a practising obstetrician-gynecologist in the Melbourne area.
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.”
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.
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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
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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
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