As we continue through a health-care system in crisis, anticipation around the annual results from the Canadian Residency Matching Service (CaRMS) is no longer just for medical graduates waiting to hear where they will study, work and live for their chosen specialty. They’ve also become a bellwether for the future of access to health care. Vacancies in family medicine, particularly in Quebec, made headlines earlier this spring.
CaRMS is an important window on workforce trends and pressures, but it can only tell us how many spots are filled – not whether they’re the right spots in the right places across the country.
Although CaRMS is a centralized tool for matching residents, determining how many doctors we should train and where they should work is still siloed by jurisdiction. Provincial and territorial Ministries of Health provide funding to hospitals and universities for a specific number of residents each year, often without a long-term view of workforce requirements.
Because Canada does not have national data or a blueprint for the health workforce, planning is based on a patchwork of jurisdictional information, neglecting changing professional lifespans, demographics and population needs, as well as the shift to different models of care delivery.
Without a national approach, we can’t plan for the challenges we see on the horizon:
- The population of adults over 65 years old has tripled in the last 40 years and is expected to grow by 68 per cent over the next two decades. The number of doctors who can manage older adults’ complex care needs isn’t keeping pace.
- We continue to hear stories about family physicians closing their practices due to burnout and other stressors. This is especially concerning in rural and remote communities, where patients may depend on just one doctor. In northern Ontario, half of the physicians are expected to retire in the next five years. If there’s no one to fill the gap, entire communities will suffer.
- We are lacking consultant specialists. From 2022 to 2031, new job openings for specialist physicians are estimated to total 29,800 compared with 24,000 new job seekers, including through immigration and relocation. The wait time to see a specialist depends on numerous factors – type of specialist, location, urgency – but according to a 2023 survey, physicians reported a median wait time of 27.7 weeks between a referral from a general practitioner and receipt of treatment.
- Canadians already struggle to access mental health services. An ongoing shortage of psychiatrists will be exacerbated by coming retirements.
The Canadian Medical Association (CMA) believes national health workforce data and integrated long-term planning are essential to support a thriving health workforce and ensure residents are training in areas where they can have the biggest impact. Last fall, the CMA convened a health workforce summit with more than 40 health-care organizations to look at future needs.
There have been other steps in the right direction. Following calls to action by the CMA and partners across the health sector, a commitment to collect and share health data was baked into the recent funding agreements between Ottawa and provincial and territorial health ministers. The federal government is also funding an independent organization, Health Workforce Canada, to advance data-informed policy.
More can be done at all levels of government. In partnership with the Canadian Nurses Association (CNA) and the College of Family Physicians of Canada (CFPC), the CMA has developed eight recommendations to help alleviate the workforce crisis.
Most provinces and territories have hired more health workers and committed to retention incentives. According to the CMA’s latest progress update, however, only a few jurisdictions have comprehensive health human resources strategies or targeted recruitment plans.
When premiers gather for the summer meeting of the Council of the Federation, it’s an opportunity to discuss tangible action to address the health care crisis. Collaborating on long-term workforce planning to meet Canadians’ needs in the decades to come should be a priority.
Medical residents are a critical part of the health system. Together, we can plan for a future where they and their patients are set up for long-term success.
Dr. Kathleen Ross is a family physician in Coquitlam and New Westminster, B.C. and is president of the Canadian Medical Association.
This article was originally published on healthydebate.ca.