Canadian Medical Association

Canada’s physicians are facing increasing challenges of how to practise in a modern health care system. Within the current licensing system, physicians are limited in their ability to fill locum positions across provinces, serve rural and remote populations, and provide virtual care to patients.

To gauge member interest in exploring the concept of a pan-Canadian approach to licensure, the CMA conducted a survey through its e-Panel (N=3,444) in November 2018 to gain insight into the challenges physicians face in obtaining medical licenses, the current licensure system and possible solutions. Close to 40% of those surveyed responded.

Completed:
November 2018

Distributed to:
3,444 e-Panel members

Responses:
1,307

Response rate:
38%

Want to share your perspective? Visit the CMA Member Voice e-Panel page for more information on how to participate in future surveys.

Been hoping for a national system for a long time! This would greatly help with locum recruitment and facilitate physicians moving their practices. It makes good common sense to have. So many other countries already do this, Canada should be no exception.

- CMA Member Voice e-Panel respondent

What members said

Challenges with medical licensing in multiple jurisdictions

Of the respondents who had an active medical license, 10% indicated they had two or more medical licenses across Canadian jurisdictions.

Of the respondents who had only one active license currently (90%), more than half (53%) had applied for a license to practise medicine in another region. Their reasons to seek a license in another province/territory:

  • Relocating to practise (49%)
  • Practising as a locum physician (32%)
  • For training or elective courses (8%)
  • To practise in a border town (6%)
  • To provide virtual care (1%)

Respondents who had sought a license in another province/territory indicated that they encountered challenges when they were seeking to:

  • Practise as a locum (39%)
  • Relocate their practice (34%)
  • Practise in a border town (21%)
  • Provide virtual care (9%)

Respondents who indicated experiencing challenges when seeking to practise in other provinces or territories were asked what obstacles were most significant. Obstacles they indicated as somewhat or very significant were:

  • Process complexity (90%)
  • Length of the process (84%)
  • Costs (79%)
  • Credential verifications for International Medical Graduates (IMGs) (64%)
  • Credential verifications for/from the provincial/territorial regulatory authority (60%)

I have obtained licensure in three provinces, BC, AB and ON. The process in all three was onerous (numerous documents needed to be photocopied and submitted, long forms). The cost was reasonable, but what was irritating was how similar the applications were. The licence requirements between the three were so similar, I can’t understand the value of going through it three different times. I can’t help but think there is a more effective way Colleges can conduct this process, that would allow them to better regulate the profession.

- CMA Member Voice e-Panel respondent

Supporting a national license framework

When asked about support of various national practice license frameworks:

  • 93% of respondents were supportive of creating a national license permitting them to practise in all provinces/territories.
  • 92% of respondents supported their provincial/territorial licenses being recognized across jurisdictions without additional requirements.
  • 29% of respondents favoured each province/territory having their own license application requirements.

Asked about the likelihood to provide/practise in various settings if a national licensure system were implemented, practising physicians were likely or very likely to:

  • Seek out locum opportunities in other provinces/territories (48%)
  • Practise temporarily in rural/remote areas in other provinces/territories (47%)
  • Provide virtual care to patients in other provinces/territories (36%)
  • Practise in multiple provinces/territories on an ongoing basis (31%)

Medical residents were likely or very likely to:

  • Seek out locum opportunities in other provinces/territories (82%)
  • Practise temporarily in rural/remote areas in other provinces/territories (74%)
  • Provide virtual care to patients in other provinces/territories (68%)
  • Practise in multiple provinces/territories on an ongoing basis (58%)

Doing this would support the principles of the Canada Health Act in terms of portability and accessibility. It would help to relieve physician undersupply in some provinces.

- CMA Member Voice e-Panel respondent

I am increasingly of the view that health care should be a Canadian national standard, not up to individual provinces. There should be no difference in the skill and personal qualities of physicians in any one province over another. The provinces need to become less possessive of their health care systems.

- CMA Member Voice e-Panel respondent

Who responded

Chart showing respondent profile by language

Chart showing respondent profile by practise segment

Chart showing respondent profile by profile/territory

What’s next

These insights from physician members will help the CMA shape its approach to address current challenges with the licensing system and how it can provide support to physicians’ seeking to provide care across jurisdictions.

Other e-Panel survey summaries

See what CMA members had to say about other health topics: