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Government policies restricting medical training mean Canada's physician shortage will worsen; recruiting foreign doctors a necessary short-term solution

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Release Date: March 15, 2011

VANCOUVER, BC—Canada’s physician shortage will grow worse in coming years because of ill-conceived policies on physician supply, says a new article published by the Fraser Institute, Canada’s leading public policy think-tank.

“Canada’s physician shortage is a consequence of governments endorsing policies that restricted physician training,” says Nadeem Esmail, Fraser Institute senior fellow and author of Canada’s Physician Supply, which appears in the latest issue of Fraser Forum, the Institute’s bi-monthly magazine.

“Removing those restrictions now, while critical in the long term, won’t have an impact for much of the next decade because of the time it takes to train a new doctor. This means it will become increasingly difficult for Canadians to find a family doctor or to see a specialist unless Canada recruits additional foreign-trained physicians.”

In the article, Esmail examines the evolution of Canada’s physician supply over time and projects what could happen in the coming years, taking into account factors such as population growth and Canada’s aging workforce.

Among the key points:

  • With only 2.3 doctors per 1,000 people in 2006 (age-adjusted), Canada’s physician-to-population ratio ranked 26th out of 28 developed nations that maintain a universal access health care system.
  • Although Canadians enjoyed one of the highest physician-to-population ratios in the developed world in the early 1970s, Canada’s growth in doctors per capita has lagged far behind that of other developed nations since then.
  • Physician-to-population ratios are important. Studies have shown that jurisdictions that have higher numbers of doctors tend to have better population health outcomes across a number of health indicators.
  • Canada’s shortage of physicians arose because of government policies implemented in the early 1990s that restricted admissions to Canadian medical schools and training positions.

Citing recent medical school enrolment and graduation rates, Esmail points out that the cohort of new Canadian-trained physicians estimated to be entering the workforce every year through 2018 will fail to meet the number of new doctors required to maintain, let alone improve, the country’s physician-to-population ratio.

He calculates that Canada requires between 2,339 and 2,256 new physicians each year from 2011 through to 2020 to maintain the current physician-to-population ratio, a conservative estimate that doesn’t account for the increasing number of doctors currently practising who will retire between now and 2020.

“Given that approximately 38 per cent of Canada’s physicians were aged 55 or older in 2010, the number of physicians needed to replace those who leave the workforce is likely to rise significantly in the near future,” he says.

Esmail concludes that, without a substantial addition of foreign-trained doctors, the Canadian physician-to-population ratio will shrink in coming years, just as it would have through the 1990s if foreign-trained  doctors had not made up for the shortfall caused by insufficient admissions to Canadian medical schools.

“Government-imposed limitations on the number of physicians being trained in Canada is a policy choice that is not serving the best interests of Canadians, be they patients in need of physicians or capable students who wish to become doctors but are unable to access medical training in this country,” Esmail said.

“Relying on foreign-trained doctors to fill the gap is not a sensible solution to the problem. Canada needs to be training enough physicians to meet the future health care needs of Canadians. The unfortunate reality is that poor policy decisions of the past leave us in a situation where we have little choice but to rely on foreign-trained doctors to ensure the physician shortage doesn't grow more acute in the short term."



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