Alan A. Monavvari
Department of Family and Community Medicine, Canada
Posters & Accepted Abstracts: Quality in Primary Care
In 2012, Canada had 2.44 physicians per 1000 population, well below the Organization for Economic Co-operation and Development (OECD) average of 3.4.1 Canada had also 6.2 medical graduates per 100,000 people, well below the OECD average of 9.9. Historically, International Medical Graduates (IMGs) have played a major role in maintaining Canada��?s medical workforce. Approximately 25% of Ontario doctors are IMGs. In some provinces, such as Saskatchewan or Manitoba, the numbers are higher. However, the contribution of the foreign-trained doctors to the net increase in the number of practicing doctors, between 2000 to 2007, was a modest 8% in Canada compared to 55% in US and 92% in Ireland. In the past, IMGs typically immigrated to Canada under the Skilled Workers program. In most cases, an IMG must complete a postgraduate training program to be licenced in Ontario. Some provinces allow IMGs to start practicing with limited licensure without going through a postgraduate program. The shortage of training positions has meant that many IMGs have been unable to retrain. There are now new players in the game: Over 4,000 Canadian citizens are studying undergraduate medicine abroad. These Canadians Studying Abroad, or CSAs are studying in various medical institutions. The IMG selection process, is expensive and onerous, and based on a literature search done by the authors, has little or no evidence that it is able to select the best candidates. IMG and CSA candidates in the CCFP examinations have a consistently higher failure rate than residents trained at Canadian Medical schools. If the CanMeds roles (Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Professional and Scholar) are the criteria we currently use to define a good physician, the selection process should reflect these criteria.
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