10 more doctors per year to solve shortage

Magally Zelaya, staff

The provincial government announced that 10 spaces would be added to the University of Manitoba’s faculty of medicine for the upcoming academic year increasing the places available from 100 to 110. The announcement, which came as part of the government’s Nov. 20 Speech from the Throne is a fulfillment of Premier Gary Doer’s election commitment to improving health care in Manitoba.

There are currently 63,819 physicians in Canada, and Statistics Canada reported that more than 1.2 million Canadians could not find a family doctor in 2003.

The national physician shortage is expected to increase to 5,800 by 2010, according to the Royal College of Physicians and Surgeons of Canada (RCPSC).

Across the country the total amount of medicine students admitted every year is 2,500, an increase over the 1,500 admitted in 2000, according to the RSPSC.

Bruce Martin, associate dean (undergraduate) of the faculty of medicine at the U of M, said that said that 110 is not the capacity for the faculty of medicine. “There is certainly room to grow and there are very active discussions now with the minister of health and her offices to increase the class size.”

Simply increasing the amount of students admitted to medical programs is not an option, however.

“It’s all well and good to say we’ve got to educate more doctors but you have to look at teaching capacity of your faculty you have to look at clinical capacity and where these people are going to learn their medical clinical skills,” said Martin.

Martin also noted that whenever capacity changes are recommended they have to meet the criteria of the medical licensing criteria of the Liaison Committee on Medical Education (LCME).

Documentation must be provided to the LCME proving that there are adequate faculty to teach students (including courses, clerkships, and small-group training), adequate facilities (including lecture halls, dissection facilities, and clinical skills assessment centres), adequate funding (in Manitoba there is an approximately $70,000 direct cost per student per year, which is primarily funded by the provincial government), and an adequate pool of applicants in terms of admission requirements.

“You can’t herd a whole bunch of people through and think you’re providing the same foundation for safe practice,” said Martin. Still, he maintained that, “There are lots of reasons we need to increase our capacity. It’s the socially appropriate, accountable thing to do.”

He added that limited resources and a need to maintain a standardized level of training for physicians means that in the short-term, the medical educational system can only manage a 10 per cent increase in intake per year.

Other initiatives to increase capacity are underway across the country, including the interprofessional education for collaborative patient-centred program, which maximizes the individual skills of health care professionals to improve patient care in a team environment.

The physician assistant (PA) program, already in great use in the United States, is another initiative designed to expand the capacity of the health care system in Canada. Physican assistants are medical professionals who “work in collaboration with and under the authority and supervision of physicians,” according to Martin.

Manitoba is the only province with legislation governing the roles and responsibilities of physician assistants.

Martin said that the faculty of medicine has already established the curriculum for a two-year master’s PA program at the University of Manitoba. “We hope that the province of Manitoba will be supportive of a submission of the University of Manitoba to have a PA program starting within the next year,” he said.

The nationwide physician shortage can be traced back to the early ’90s when a federally funded report known as the Barer-Stoddart report recommended that provincial governments make cuts to the number of physicians entering medicals schools in light of perceived financial benefits.

“The shortage of physicians that you’re now seeing has a root cause in many things, but mostly by reduction in the number of students that were put through medical schools in the ’90s,” said Martin.

The shortage is expected to reach new levels as the baby boomers retire. In September 2007, the RCPSC reported that the retirement numbers of medical specialists had doubled from 2004.

Lifestyle changes will likely have effects on the health care system. “The expectations of graduate physicians in terms of lifestyles is totally different now,” said Martin pointing to the increasing demand of younger doctors to have more balance in their work-life ratio.

Further, Martin noted the effect that a change in the gender distribution of doctors could have. “We used to be 80 per cent male, so when you go to 50-55 per cent female across the country . . . it’s a huge dynamic shift.”

He pointed to the likelihood that many female physicians will require maternal leave, and increasingly male physicians will require time off for paternal leave, potentially contributing to the increasing physician shortage.

Retaining doctors also needs to be considered when addressing the physician shortage, said Fred Aoki, associate dean (admissions) of the faculty of medicine. He said that the shortage is heightened by the difficulty of attracting physicians to rural areas and the possibility of new doctors relocating away from Manitoba.

As part of the acknowledgement of the changing face of health care in Canada a two-year review of Canada’s medical education system is in currently in the beginning stages. The project called “The Future of Medical Education In Canada” is funded by Health Canada and will look at how to adapt the medical education system to societal changes.

The project may investigate the possibility of reducing the four-year medical undergrad program to three years, as is the case at McMaster University and the University of Calgary. As well, the possibility of eliminating or reducing the time spent in the non-medical undergraduate degree that is currently required for application to the undergrad medical school programs may also be examined.

Aoki said he has not heard substantial talk surrounding these possibilities, but added, “There’s also been talk the other way,” where discussion has surrounded the possibility of increasing the four-year undergraduate medical program to five years, in response to the larger body of knowledge physicians now have to learn compared to previous generations.

Still Aoki maintained that, “An additional year to get more training is probably as impractical as cutting a year off.”





Volume 95 Issue 15	The Official University of Manitoba Students' Newspaper Website	November 28, 2007

Home About Us Advertising Rates Contact Staff Current Issue PDF Employment Letters to the Editor Meet the Staff Online Archives Volunteer Online Classifieds St. Vincent's Academy Diaries	Font Size Respond Email Print-Friendly 10 more doctors per year to solve shortage Magally Zelaya, staff The provincial government announced that 10 spaces would be added to the University of Manitoba’s faculty of medicine for the upcoming academic year increasing the places available from 100 to 110. The announcement, which came as part of the government’s Nov. 20 Speech from the Throne is a fulfillment of Premier Gary Doer’s election commitment to improving health care in Manitoba. There are currently 63,819 physicians in Canada, and Statistics Canada reported that more than 1.2 million Canadians could not find a family doctor in 2003. The national physician shortage is expected to increase to 5,800 by 2010, according to the Royal College of Physicians and Surgeons of Canada (RCPSC). Across the country the total amount of medicine students admitted every year is 2,500, an increase over the 1,500 admitted in 2000, according to the RSPSC. Bruce Martin, associate dean (undergraduate) of the faculty of medicine at the U of M, said that said that 110 is not the capacity for the faculty of medicine. “There is certainly room to grow and there are very active discussions now with the minister of health and her offices to increase the class size.” Simply increasing the amount of students admitted to medical programs is not an option, however. “It’s all well and good to say we’ve got to educate more doctors but you have to look at teaching capacity of your faculty you have to look at clinical capacity and where these people are going to learn their medical clinical skills,” said Martin. Martin also noted that whenever capacity changes are recommended they have to meet the criteria of the medical licensing criteria of the Liaison Committee on Medical Education (LCME). Documentation must be provided to the LCME proving that there are adequate faculty to teach students (including courses, clerkships, and small-group training), adequate facilities (including lecture halls, dissection facilities, and clinical skills assessment centres), adequate funding (in Manitoba there is an approximately $70,000 direct cost per student per year, which is primarily funded by the provincial government), and an adequate pool of applicants in terms of admission requirements. “You can’t herd a whole bunch of people through and think you’re providing the same foundation for safe practice,” said Martin. Still, he maintained that, “There are lots of reasons we need to increase our capacity. It’s the socially appropriate, accountable thing to do.” He added that limited resources and a need to maintain a standardized level of training for physicians means that in the short-term, the medical educational system can only manage a 10 per cent increase in intake per year. Other initiatives to increase capacity are underway across the country, including the interprofessional education for collaborative patient-centred program, which maximizes the individual skills of health care professionals to improve patient care in a team environment. The physician assistant (PA) program, already in great use in the United States, is another initiative designed to expand the capacity of the health care system in Canada. Physican assistants are medical professionals who “work in collaboration with and under the authority and supervision of physicians,” according to Martin. Manitoba is the only province with legislation governing the roles and responsibilities of physician assistants. Martin said that the faculty of medicine has already established the curriculum for a two-year master’s PA program at the University of Manitoba. “We hope that the province of Manitoba will be supportive of a submission of the University of Manitoba to have a PA program starting within the next year,” he said. The nationwide physician shortage can be traced back to the early ’90s when a federally funded report known as the Barer-Stoddart report recommended that provincial governments make cuts to the number of physicians entering medicals schools in light of perceived financial benefits. “The shortage of physicians that you’re now seeing has a root cause in many things, but mostly by reduction in the number of students that were put through medical schools in the ’90s,” said Martin. The shortage is expected to reach new levels as the baby boomers retire. In September 2007, the RCPSC reported that the retirement numbers of medical specialists had doubled from 2004. Lifestyle changes will likely have effects on the health care system. “The expectations of graduate physicians in terms of lifestyles is totally different now,” said Martin pointing to the increasing demand of younger doctors to have more balance in their work-life ratio. Further, Martin noted the effect that a change in the gender distribution of doctors could have. “We used to be 80 per cent male, so when you go to 50-55 per cent female across the country . . . it’s a huge dynamic shift.” He pointed to the likelihood that many female physicians will require maternal leave, and increasingly male physicians will require time off for paternal leave, potentially contributing to the increasing physician shortage. Retaining doctors also needs to be considered when addressing the physician shortage, said Fred Aoki, associate dean (admissions) of the faculty of medicine. He said that the shortage is heightened by the difficulty of attracting physicians to rural areas and the possibility of new doctors relocating away from Manitoba. As part of the acknowledgement of the changing face of health care in Canada a two-year review of Canada’s medical education system is in currently in the beginning stages. The project called “The Future of Medical Education In Canada” is funded by Health Canada and will look at how to adapt the medical education system to societal changes. The project may investigate the possibility of reducing the four-year medical undergrad program to three years, as is the case at McMaster University and the University of Calgary. As well, the possibility of eliminating or reducing the time spent in the non-medical undergraduate degree that is currently required for application to the undergrad medical school programs may also be examined. Aoki said he has not heard substantial talk surrounding these possibilities, but added, “There’s also been talk the other way,” where discussion has surrounded the possibility of increasing the four-year undergraduate medical program to five years, in response to the larger body of knowledge physicians now have to learn compared to previous generations. Still Aoki maintained that, “An additional year to get more training is probably as impractical as cutting a year off.”


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