Medical schools can solve rural doctor shortage

Sandra Banner’s op-ed for the 100 Mile Free Press

Timely medical care is all too rare for many Canadians.

Fewer than half can get a same-day or next-day appointment with their family doctor, according to a recent report from the Canadian Institute of Health Information. Fifty-six percent of Canadians have to wait more than a month to see a specialist.

These statistics are a bracing reminder of the nation’s growing shortage of physicians, especially primary care doctors. More than 4.5 million Canadians lack a regular doctor. That’s nearly 15 percent of the population.

Canada’s leaders must act to reverse these shortages. Doing so will require an aggressive effort by medical schools and governments to encourage more young people to consider careers in family medicine — careers that have an outsized impact on the health of Canadians.

Canada is short primary care doctors in part because graduates of Canadian medical schools are growing more reluctant to pursue careers in family medicine. Just one-third of Canadian medical graduates go into primary care.

These shortages take a toll on Canadians’ health. Patients with no regular doctor are less likely to get annual exams or other preventive care. And the evidence shows that there’s a strong correlation between a population with access to effective primary care providers and positive health outcomes.

The primary care shortage has hit Canada’s rural communities hardest. One hospital in Preeceville in rural Saskatchewan, which serves 60,000 locals, recently began suspending emergency room services on a regular basis.

On Prince Edward Island, 4,000 patients are without a primary care doctor. According to the Nova Scotia Health Authority, over 25,000 residents are currently waiting to see a family doctor throughout the province — up from only 6,000 last fall. More than 200,000 residents of British Columbia have no family doctor.

Last summer, the Canadian Association of Emergency Physicians, the Royal College of Physicians and Surgeons, and the College of Family Physicians of Canada recommended a dramatic increase in the number of emergency room residency slots. They say that the current shortfall of nearly 500 ER doctors could triple by 2025.

Since 2004, medical schools have been opening campuses all across the country. These are meant to encourage students from rural communities to enroll in medical school — and hopefully return to practice in smaller communities.

Despite all these changes, millions of Canadians still cannot find a family doctor. Perhaps it’s time to look outside our borders.

Institutions outside Canada can make a difference, just as they have in the United States. One-quarter of our southern neighbour’s doctors are graduates of international medical schools. And among doctors practicing in the United States, half of those educated at med schools in the Caribbean are working in primary care.

St. George’s University, a school on the Caribbean island of Grenada for which I serve as a consultant, has trained more than 1,200 Canadian doctors. Two-thirds of those grads are in primary care — twice the share of graduates of Canadian medical schools.

Over 600 of our current students hail from Canada. Many are eager to train and practice in their own communities. That’s why St. George’s has partnered with the University of Saskatchewan Hospital and the Vancouver General Hospital — to arrange clinical rotations for these doctors-in-training.

It’s time to end Canada’s doctor shortage. Provincial governments could fund more training positions for family medicine. Medical schools inside and outside Canada have a role to play, too — by graduating and training more family physicians, and steering them to the underserved communities that need them most.

Sandra Banner is the consultant for St. George’s University relations in Canada.

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