New research from the Royal College of Physicians and Surgeons of Canada indicates that 16% of the country's new specialists and subspecialists cannot find work, while another 31% are pursuing further training in an attempt to become more employable.
The report, based on surveys of physicians who were certified in 2011 and 2012, says that the unemployment rate for recent fellows is more than twice as high as for Canadians as a whole (7.1%). All survey respondents had at least eight years of undergraduate and specialist training.
"Also of note is the significant number of new specialists and subspecialists - 414 - who chose not to enter the job market but instead pursued further subspecialty or fellowship training because they believed it would make them more employable," the study says. [The reference to 414 physicians involves only doctors who completed the survey. The final total would be higher. - Ed]
Danielle Fréchette, the lead investigator, said the research is the first of its kind in Canada. "After many years of hearing about physician shortages, pockets of evidence have emerged in recent years indicating a growing segment of medical specialists and subspecialists who can't find jobs," she said.
Fréchette said the Royal College launched its investigation in 2011, and the result is the 60-page study, What's really behind Canada's unemployed specialists?, that was released Oct. 10. It concludes that there are three main factors behind the employment problems.
The main one is a lagging economy. Not only has the resulting "weakened stock market" delayed retirement for many physicians, thus depriving new physicians of job openings, but government cuts have resulted in reductions in the availability of operating room time and hospital beds.
"This has directly impacted physician employment," the study says.
The second factor is an evolving health care system, which is resulting in new models of care that rely less on physicians and has also produced a "misalignment" between workforce planning, care delivery models and residency intake quotas.
The final factor involves "mainly personal" issues. For instance, new specialists "are older today than in the past," and because they often have families it is difficult for them to relocate to areas where jobs are available.
The study also notes that a "substantial proportion" of new MDs experiencing employment problems are found in surgical and other "resource-intensive" disciplines.
According to the survey, the five disciplines with the highest proportion of new doctors having trouble finding work are:
- cardiac surgery (all five respondents continued training because they were unable to find a position)
- nuclear medicine (four of seven respondents [57.1%] were unable to find work)
- radiation oncology (14 of 27, 51.9%)
- ophthalmology (13 of 30, 43.3%)
- urology (6/15, 40%)
Dr. Andrew Padmos, the Royal College CEO, said the college favours creation of a "national bureau or think tank" to foster research and develop a national approach to health workforce planning. The CMA has also called for development of a national strategy, as well as more career-planning resources for trainees.
CMA President Louis Hugo Francescutti - a past president of the Royal College - says Canada's vast size and the number of jurisdictions responsible for providing health care make workforce planning difficult.
"I met with our student and resident members during the CMA's annual meeting in August, and there was little doubt then that this is the major issue on their plate. With this new research we now have solid data on the extent of the problem, and can begin to develop a response."
The Royal College says the next step will involve a national summit that it will host next February, where groups such as the CMA will gather to search for "lasting solutions."
The survey used to gather the data was sent to 4,233 specialists who were certified in 2011 and 2012, and the response rate was 32.4%.