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.”
Montreal Alouettes wide receiver Tyson Philpot has announced he will be out for the rest of the CFL season.
The Delta, B.C., native posted the news on his Instagram page Thursday.
“To Be Continued. Shoutout my team, the fans of the CFL and the whole city of Montreal! I can’t wait to be back healthy and write this next chapter in 2025,” the statement read.
Philpot, 24, injured his foot in a 33-23 win over the Hamilton Tiger-Cats on Aug. 10 and was placed on the six-game injured list the next week.
The six-foot-one, 195-pound receiver had 58 receptions, 779 yards and five touchdowns in nine games for the league-leading Alouettes in his third season.
Philpot scored the game-winning touchdown in Montreal’s Grey Cup win last season to punctuate a six-reception, 63-yard performance.
This report by The Canadian Press was first published Sept. 12, 2024.
MIAMI GARDENS, Fla. (AP) — Miami Dolphins quarterback Tua Tagovailoa sustained a concussion for the third time in his NFL career, leaving his team’s game Thursday night against Buffalo after running into defensive back Damar Hamlin and hitting the back of his head against the turf.
Tagovailoa remained down for about two minutes before getting to his feet and walking to the sideline after the play in the third quarter. He made his way to the tunnel not long afterward, looking into the stands before smiling and departing toward the locker room.
The Dolphins needed almost no time before announcing it was a concussion. The team said he had two during the 2022 season, and Tagovailoa was diagnosed with another concussion when he was a college player at Alabama.
Dolphins coach Mike McDaniel said Tagovailoa would get “proper procedural evaluation” and “appropriate care” on Friday.
“The furthest thing from my mind is, ‘What is the timeline?’ We just need to evaluate and just worry about my teammate, like the rest of the guys are,” McDaniel said. “We’ll get more information tomorrow and take it day by day from here.”
Some players saw Tagovailoa in the locker room after the game and said they were encouraged. Tagovailoa spoke with some players and then went home after the game, McDaniel said.
“I have a lot of love for Tua, built a great relationship with him,” said quarterback Skylar Thompson, who replaced Tagovailoa after the injury. “You care about the person more than the player and everybody in the organization would say the same thing. Just really praying for Tua and hopefully everything will come out all right.”
Tagovailoa signed a four-year, $212 million extension before this season — a deal that makes him one of the highest-paid players in the NFL — and was the NFL’s leading passer in Week 1 this season. Tagovailoa left with the Dolphins trailing 31-10, and that was the final score.
“If you know Tua outside of football, you can’t help but feel for him,” Bills quarterback Josh Allen said on Amazon following the game. “He’s a great football player but he’s an even greater human being. He’s one of the best humans on the planet. I’ve got a lot of love for him and I’m just praying for him and his family, hoping everything’s OK. But it’s tough, man. This game of football that we play, it’s got its highs and it’s got its lows — and this is one of the lows.”
Tagovailoa’s college years and first three NFL seasons were marred by injury, though he positioned himself for a big pay bump with an injury-free and productive 2023 as he led the Dolphins into the playoffs. He threw for 29 touchdowns and a league-best 4,624 yards last year.
When, or if, he can come back this season is anyone’s guess. Tagovailoa said in April 2023 that the concussions he had in the 2022 season left him contemplating his playing future. “I think I considered it for a time,” he said then, when asked if he considered stepping away from the game to protect himself.
McDaniel said it’s not his place to say if Tagovailoa should return to football. “He’ll be evaluated and we’ll have conversations and progress as appropriate,” McDaniel said.
Tagovailoa was hurt Thursday on a fourth-down keeper with about 4:30 left in the third. He went straight ahead into Hamlin and did not slide, leading with his right shoulder instead.
Hamlin was the player who suffered a cardiac arrest after making a tackle during a Monday night game in January 2023 at Cincinnati, causing the NFL to suspend a pivotal game that quickly lost significance in the aftermath of a scary scene that unfolded in front of a national television audience.
Tagovailoa wound up on his back, both his hands in the air and Bills players immediately pointed at him as if to suggest there was an injury. Dolphins center Aaron Brewer quickly did the same, waving to the sideline.
Tagovailoa appeared to be making a fist with his right hand as he lay on the ground. It was movement consistent with something that is referred to as the “fencing response,” which can be common after a traumatic brain injury.
Tagovailoa eventually got to his feet. McDaniel grabbed the side of his quarterback’s head and gave him a kiss on the cheek as Tagovailoa departed. Thompson came into the game to take Tagovailoa’s spot.
“I love Tua on and off the football field,” Bills edge Von Miller said. “I’m a huge fan of him. I can empathize and sympathize with him because I’ve been there. I wish him the best.”
Tagovailoa’s history with concussions — and how he has since worked to avoid them — is a huge part of the story of his career, and now comes to the forefront once again.
He had at least two concussions during the 2022 season. He was hurt in a Week 3 game against Buffalo and cleared concussion protocol, though he appeared disoriented on that play but returned to the game.
The NFL later changed its concussion protocol to mandate that if a player shows possible concussion symptoms — including a lack of balance or stability — he must sit out the rest of the game.
Less than a week later, in a Thursday night game at Cincinnati, Tagovailoa was concussed on a scary hit that briefly knocked him unconscious and led to him being taken off the field on a stretcher.
His second known concussion of that season came in a December game against Green Bay, and he didn’t play for the rest of the 2022 season. After that, Tagovailoa began studying ways where he may be able to fall more safely and protect himself against further injury — including studying jiu-jitsu.
“I’m not worried about anything that’s out of my hands,” McDaniel said. “I’m just worried about the human being.”
NEW YORK (AP) — When her husband turns on the television to hear news about the upcoming presidential election, that’s often a signal for Lori Johnson Malveaux to leave the room.
It can get to be too much. Often, she’ll go to a TV in another room to watch a movie on the Hallmark Channel or BET. She craves something comforting and entertaining. And in that, she has company.
While about half of Americans say they are following political news “extremely” or “very” closely, about 6 in 10 say they need to limit how much information they consume about the government and politics to avoid feeling overloaded or fatigued, according to a new survey from the Associated Press-NORC Center for Public Affairs Research and USAFacts.
Make no mistake: Malveaux plans to vote. She always does. “I just get to the point where I don’t want to hear the rhetoric,” she said.
The 54-year-old Democrat said she’s most bothered when she hears people on the news telling her that something she saw with her own eyes — like the Jan. 6, 2021, attack on the U.S. Capitol — didn’t really happen.
“I feel like I’m being gaslit. That’s the way to put it,” she said.
Sometimes it feels like ‘a bombardment’
Caleb Pack, 23, a Republican from Ardmore, Oklahoma, who works in IT, tries to keep informed through the news feeds on his phone, which is stocked with a variety of sources, including CNN, Fox News, The Wall Street Journal and The Associated Press.
Yet sometimes, Pack says, it seems like a bombardment.
“It’s good to know what’s going on, but both sides are pulling a little bit extreme,” he said. “It just feels like it’s a conversation piece everywhere, and it’s hard to escape it.”
Media fatigue isn’t a new phenomenon. A Pew Research Center survey conducted in late 2019 found roughly two in three Americans felt worn out by the amount of news there is, about the same as in a poll taken in early 2018. During the 2016 presidential campaign, about 6 in 10 people felt overloaded by campaign news.
But it can be particularly acute with news related to politics. The AP-NORC/USAFacts poll found that half of Americans feel a need to limit their consumption of information related to crime or overseas conflicts, while only about 4 in 10 are limiting news about the economy and jobs.
It’s easy to understand, with television outlets like CNN, Fox News Channel and MSNBC full of political talk and a wide array of political news online, sometimes complicated by disinformation.
“There’s a glut of information,” said Richard Coffin, director of research and advocacy for USAFacts, “and people are having a hard time figuring out what is true or not.”
Women are more likely to feel they need to limit media
In the AP-NORC poll, about 6 in 10 men said they follow news about elections and politics at least “very” closely, compared to about half of women. For all types of news, not just politics, women are more likely than men to report the need to limit their media consumption, the survey found.
White adults are also more likely than Black or Hispanic adults to say they need to limit media consumption on politics, the poll found.
Kaleb Aravzo, 19, a Democrat, gets a baseline of news by listening to National Public Radio in the morning at home in Logan, Utah. Too much politics, particularly when he’s on social media sites like TikTok and Instagram, can trigger anxiety and depression.
“If it pops up on my page when I’m on social media,” he said, “I’ll just scroll past it.”
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Sanders reported from Washington. David Bauder writes about media for the AP. Follow him at http://x.com/dbauder.
The AP poll of 1,019 adults was conducted July 29-August 8, 2024, using a sample drawn from NORC’s probability-based AmeriSpeak Panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 4.0 percentage points.
