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New commission needed to address physician employment issues: summit

Establishment of a time-limited commission to address physician employment issues has been supported by the majority of attendees at a two-day summit hosted by the Royal College of Physicians and Surgeons of Canada.

In a statement following the meeting, the Royal College said 130 representatives from medical organizations, governments, medical regulatory authorities, medical educators, researchers, physicians, residents and medical students began a process to develop a multi-stakeholder action plan to aid physician employment and better inform health workforce planning in Canada.

Senior staff from the Canadian Medical Association (CMA) attended, as did four CMA student and resident ambassadors.

The summit follows a similar meeting held a year ago and a panel discussion featured at the CMA’s annual General Council meeting in August.

Presentations at this summit detailed the latest physician employment data in Canada, health system and workforce trends and international case studies.

In opening remarks Royal College President Kevin Imrie noted the “boom-and-bust” cycle Canada has followed with physician workforce planning. “Too often this … approach has been detrimental to new physicians and, even more regrettably, it has been at the expense of patients who need medical care.”

Dr. Justin Hall, one of the CMA ambassadors at the meeting and a resident at the University of Toronto, noted the focus was on identifying a data-driven approach to physician employment. The current system is historical, he said, and doesn’t reflect changing population demographic trends or consider existing workforce demographics and retention/retirement patterns across the country.

One meeting highlight was a presentation by Dr. Des Gorman, a professor and former associate dean in the faculty of medical and health sciences, University of Auckland, and executive chair of Health Workforce New Zealand.

Gorman proposed addressing the physician employment issue in Canada by clearly defining physician workforce numbers and requirements, and by examining lessons from other jurisdictions such as the United Kingdom and New Zealand.

Following a facilitated discussion, most summit participants supported establishing a commission to study the nature and shape of the present health workforce to better understand gaps and shortfalls in meeting patients’ needs and to learn from other comparator jurisdictions. The Royal College will facilitate the formation and launch of this new commission.

CMA Chief Policy Advisor Owen Adams, also in attendance, noted that a similar commission was established in 1992, in which he was involved. Titled the National Coordinating Committee on Postgraduate Medical Training, it had some successes — including agreement on the principle that all Canadian medical graduates should have access to postgraduate training leading to licensure.

Dr. Elizabeth Yorke, a resident at the University of Toronto and another CMA ambassador, said one key takeaway was that several actions can now be taken to help support new medical graduates. These include development of 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. (See Yorke’s full conference summary here)

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