Canada’s health care system needs physicians to fill important gaps, but it has also set up barriers for international graduates to practise here instead of the U.S., Britain and Australia
With nearly 300 Canadian students enrolled in its programs, the Royal College of Surgeons in Ireland feels a lot like a medical school in Canada, just separated by 3,340 kilometres of Atlantic Ocean.
Even the curriculum is geared toward a career in medicine in North America – with an academic calendar built around the writing periods for Canadian and U.S. medical exams. 17 medical schools – where roughly nine out of 10 applicants are rejected, often despite impeccable grades and qualifications, since demand far outstrips supply.
A B.C. physician demonstrates at the We Need Doctors Now rally outside the provincial legislature in Victoria this past October.Between its domestic and international graduates, and thousands more immigrant physicians who live here but don’t work in their field, Canada has more than enough doctors to help the country fill shortages in family medicine, clinics and hospitals.
“The messaging for so long has been that it’s nearly impossible to get a bloody residency in Canada if you’re an international graduate,” said Peter Nealon, the California-based CEO of the Atlantic Bridge Program, the admissions organization for North Americans who want to attend medical school in Ireland. “These people are the cream of the crop, and they’re simply going elsewhere, because they’re in demand. You tell people to go away long enough, and eventually, they go away.
The head of CaRMS says the organization is watching the decline in international applications and acknowledges there’s a worry Canada could be losing good physicians to other countries. Part of the reason is that international medical graduates are increasingly being lured away by other countries facing their own physician shortages, said John Gallinger, CEO of the national matching service.
“Some of my classmates would love to do family medicine, and even rural medicine. But they can’t get in at home, so they go internationally, pay a ton more money, and are losing spots to people back in Canada who are really trying to do other specialties,” said Mr. Macciaccheras, who became interested in medicine after a sports injury and is now president of the Canadian Irish Medical Students Association.
Jessica Langevin is among those Canadians studying at RCSI who hope to return home to practise family medicine. “I think every international student in my program has that same concern. We all just want to come home to be able to practise.” In 1988, Canada took in nearly twice as many international medical graduates for residency programs as it did in 2019. The number of international grads being given other forms of postgraduate training here, such as internships, also began to drop in the 1990s.provincial leaders in 2022 who want to address the health care challenges are running head-first into an entrenched system of roadblocks that prevents easy fixes.
“The Americans now have first dibs on Canadians training overseas. They’re only too happy to take these people,” said Dr. Desmond Leddin, a Halifax-based professor of internal medicine who has taught and practised in both Canada and Ireland. “And the reality is, people often end up staying where they were trained.”
At St. George’s University in Grenada, which now produces more first-year residents each year for North American teaching hospitals than any other medical school in the world, 92 per cent of Canadian students end up getting a residency position in the United States. Since the school opened in 1981, more than 2,100 Canadians have received their medical degrees from here – and 1,796 of them have gone to postgraduate residencies at U.S. hospitals.
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