National Summit on Physician Employment — a medical trainee’s perspective
The 2015 National Summit on Physician Employment, hosted by the Royal College of Physicians and Surgeons of Canada, opened with welcoming remarks from Royal College President Kevin Imrie and CEO Andrew Padmos. They outlined the importance of data collection and sharing to better understand the healthcare needs of Canadians, in order to better align and plan the healthcare workforce.
Over two days, speakers outlined the current landscape of physician resources in Canada, citing some important areas for planning in the coming years. For example, Dr. Eric Schneider, senior vice-president for policy and research for the Commonwealth Fund, noted the majority of Canadians believe health care requires fundamental change.
In addition, Canada is not faring well on the international stage, ranking at 10 of 11 OCED countries when healthcare services and outcomes are compared. This country scores especially badly on wait-lists for specialist services and emergency room wait times.
The resident perspective was presented by Dr. Matt Strickland, senior surgical resident at the University of Toronto, who spoke of current frustrations for residents trying to find jobs, with many having to do more training to try to become marketable.
For those who find employment, he said, the jobs found are often considered “underemployment”— for example, as “on-call-ogists’ who do call without OR time.
Dr. Natasha Snelgrove, from Resident Doctors of Canada (RDoC), outlined several actions that can be taken immediately to help facilitate new-to-practice doctors finding employment. These include: developing a national database for job postings (most new jobs are now found through departmental connections and never posted), establishing a mentorship program to help develop career skills throughout residency and into early practice, and a program to connect new physicians with those transitioning out in order to provide continuity of care for patients and develop career opportunities.
Several regional and international examples of health resource planning were presented. Physician recruitment and planning efforts in New Brunswick – as well as in New Zealand –focused on educating medical students early about job opportunities after residency, in both specific specialties and availability by region. The meeting was told these initiatives have helped students make more informed choices about career selection.
One outcome from the summit was the call for establishment of a commission (based on the New Zealand model) to collect and gathering data from the individual provinces.
Such a commission would develop national guidelines to advise provinces and territories on how to plan for future physician employment.
Key takeaway messages
- Physician employment is complex: there are 14 different health care systems in Canada, and each has its own strategy for health human resource planning.
- The key players for planning physician supply include provincial and territorial governments, the deans of university residency and medical school programs, resident and physician organizations and general and subspecialty medical colleges.
- Several actions can be taken now to help support new medical graduates, including a national employment database, early career counselling and mentoring for medical trainees and early career physicians, and a transition program for early and late career physicians. The Canadian Medical Association (CMA) and Resident Doctors of Canada are taking steps to act on these ideas.
- Medical trainees can prepare by seeking out employment data from their region and specialty. Career opportunities for upcoming graduates are posted on cma.ca , the CMA website.
Dr. Elisabeth Yorke
PGY-1 Pediatrics, University of Toronto