Earlier this year, the government of Canada released a report called The Canadian Health Workforce Education, Training and Distribution Study. It says that Canada can’t train enough doctors and other health professionals, unless we dramatically change how we do things.
Of the 38 member countries in the Organization for Economic Co-operation and Development (OECD), Canada ranks 35 in numbers of new graduation, with only Japan, Korea and Isreal having fewer graduates per 100,000 people than Canada.
Across the OECD, the average number of new graduates was 14.2 per 100,000 population as of 2023.
Canada was nearly half that with only 7.5 new doctors per 100,000 population.
The country is already 22,823 family physicians short, and with an estimated 1300 new graduates this year, that deficit will never be closed.
This sobering study reinforces the Canadian Medical Association’s (CMA) long-standing advocacy on the shortage of family physicians, the challenges specific to rural care and the disparities of care for Indigenous peoples. These new figures validate the severity of the situation.
Dr. Joss Reimer, president of the Canadian Medical Association (CMA) says the country needs to change tactics. “We endorse the report’s themes about modernizing education, training, and data. Resolving the physician and health provider shortage will require Canada to act more quickly, do more and leverage the expertise already available.”
He proposes a number of solutions, including adopting team-based care as the main model of primary care across the country, eliminating time-consuming and repetitive administrative tasks, embracing new technologies, such as AI to streamline administrative tasks and enhance patient care, connecting all point of care to empower patients with their health information and streamlining inter-connectiveness between providers and supporting and investing in virtual care within the publicly funded system.
Reimer says while the overall number of doctors relative to Canada’s population has grown in the last decade, there are major gaps in getting the right doctors in the right places. “Canada’s overall supply of doctors grew 2.1 percent between 2018 and 2022. That’s the good news,” he says. “But zooming in on the data reveals the increase in family doctors – the ones you see first for most health issues – was lower compared with other specialists and Canada’s population generally.”
Another issue? Doctors aren’t spread out evenly across Canada. 92 percent of Canada’s doctors work in cities, while just eight percent work in rural areas.
Meanwhile, about 16 percent of the Canadian population live in rural areas.
“Many rural and remote communities rely on temporary doctors travelling from other parts of the country to meet their health care needs,” says the CMA. “For example, two-thirds of family doctors in Nunavut are visiting on short-term contracts.”
Mismatches in medical training spots complicate the picture, especially since doctors tend to stay where they trained.
That doesn’t bode well for Tumbler Ridge and other rural communities in BC. The province has the smallest medical school class sizes and fewest family medicine training spots relative to its population – and one of the worst shortages of family doctors, with 17.7 percent of the population not having a family physician.
That’s nothing, though, compared to the territories, where in the Yukon 55 percent of the population doesn’t have a regular family physician, or Nunavut, where that number is 75 percent.
Canada has a below average number of doctors for its population compared to other countries, says the CMA. In a recent comparison of 37 countries, Canada ranked 27th with just 2.8 doctors for every 1,000 people.
That’s just ahead of China, Japan and the United States, but behind Australia, New Zealand, the United Kingdom and the rest of Europe.
A 2023 study in PubMed says that BC only offers five medical school seats per 100,000 provincial residents, though in the last few years with 40 new seats added in the last two years. Despite adding these seats, “BC will still have the least seats per capita among provinces that administer medical education,” says the report.
This year, an additional 65 nurse practitioner training seats were added as well. And, in the last couple of weeks, Simon Fraser University announced it would be building the first new medical school this side of Ontario to be built in decades.
That will add another 48 seats to the province’s health care education system. Classes will begin next year, with the new, permanent facility coming online in 2030. By 2035, they expect to have 120 students graduating each year.
Trent is the publisher of Tumbler RidgeLines.
