Throwing more money at the problem is not the sole solution to address the lack of family physicians in B.C.
For Dr. Josh Ramjist, a pediatric surgeon at the Hospital for Sick Children in Toronto, he says there are other factors that weigh into a medical school or residency graduate’s decision to move to B.C. or any other province.
Ramjist is part of fraternity of doctors who were unable to get accepted into the highly sought-after medical schools in Canada and found their education opportunities in other countries, many of whom continue to work abroad rather than coming home.
Ramjist was responding to a recent report from the Royal Bank of Canada which states by 2028, Canada will face a shortage of 44,000 doctors, 72 per cent of which will be family physicians.
The report further finds that about six million Canadians already lack access to a family doctor, a 30 per cent jump since 2019.
In B.C., the provincial government reports that more than 60 per cent of adults have no family doctor.
So far, the province has responded by expanding medical school seats and offering more money to physicians. A similar approach has also been taken in response to the nursing shortfall.
Ramjist points to his own example of a trained doctor abroad who has returned home, and the potential for many more like him.
He says the conventional statistic is that for every candidate accepted into a Canadian medical school, there are seven to eight others of equal or more qualified who are rejected.
“Part of the difficulty for Canadians who graduate from international medical schools is the limited access to residency programs…In Canada, we are talking about 2,900 to 3,000 residency spots available every year, whereas in the U.S. that number is 28,000 to 30,000, which is what attracts students from around the world to seek their residency training in the U.S.,” he said.
That is a path Ramjist followed himself. After being unable to secure a seat in a Canadian university medical school, he enrolled at med school in Grenada and did residency programs in Brooklyn, New York, and London, England.
Now back in Ontario, Ramjist is married and has two kids, so the idea of moving to B.C. at this stage of his life is not appealing to him.
He also cites the cost factor to be certified to practice medicine in another province, a cost in the thousands of dollars that can be prohibitive for someone to move.
“What needs to happen is the creation of a national certification program so someone can move from province to province without having to always go through that certification process. The cost of that alone can keep people from moving from one province to another,” he said.
“That kind of (certification) redundancy is unnecessary.”
Beyond the money and added certification costs, doctors also consider the state of health care in a particular location, and what it has to offer in terms of lifestyle.
“Yes, the money helps sure, but it is not the only answer,” he reiterated.
“But when you start looking at people moving around, the other aspects of living a certain quality of life is a big part of the missed conversation.
“Just throwing money at the problem is a button people push and think that is the solution.”
International medical graduates, many of whom are Canadian citizens like Ramjist, account for more than one-fifth of Canadian doctors. And they enter primary care specialties, including family medicine, at higher rates than Canadian-educated physicians.
Roughly two-thirds of residencies granted to international medical graduates in 2019 were in internal and family medicine.