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Getting the numbers right in postgrad training

The challenge of matching residency positions to meet societal needs was the theme of a special strategic session held at General Council this year.

The session – organized in partnership with Resident Doctors of Canada (RDoC) and the Canadian Federation of Medical Students – also focused on the worrisome rising number of unemployed and underemployed physicians in certain specialties.

“We have some really concerning statistics,” said speaker Dr. Melanie Bechard, a 2015 medical graduate and pediatrics resident, referencing an increased number of unmatched Canadian medical graduates and the inappropriate mix of residents and practice opportunities.

Bechard also noted the disproportionate number of residency positions relative to the number of medical school graduates.

The inadequate availability of career counselling was also documented by Bechard with a recent survey showing almost half of those polled felt they had insufficient information on career options prior to graduating. She said there’s a need for better-quality counselling based on solid data.

Dr. Ashley Miller, vice-president of Resident Doctors of Canada, acknowledged the medical training system in Canada is “incredibly complex” and said it is “profoundly difficult” for educators to advise residents on career decisions because of the lack of data.

“It is a very long game,” she said, noting the time required to fully train a student to become a physician means that physician recruitment training is often reactive.

She said residents feel the cornerstone of how future residency training should be constructed is to ensure the right mix, distribution and number of physicians to meet societal needs.

Both Bechard and Miller stressed the need for a national approach because of the portability of medical licensure in Canada, but Miller noted competition between jurisdictions can hamper national coordination.

Miller presented a series of solutions proposed by RDoC, including:

  • a physician resource planning task force
  • reimagining service delivery, including a team-based approach and physician extenders
  • significant investment in data to inform planning
  • evidence-based evaluation of how residency positions are allocated
In the well-attended session, several medical students and residents stood to express their views on the strategic questions presented —such as the options for providing sufficient capacity in the postgraduate medical system.

 

Dr. Hugh Scully, a former CMA president and chair of two major studies on health human resource planning, reiterated the need for a national health human resources institute to better integrate physician workforce data.

"I urge the CMA to support their young members because, frankly, we need it," said Connor Sommerfeld, a 4th year medical student at the University of Manitoba, pointing to recent cuts in postgraduate positions in Ontario.

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