AIPSO News Updates
Foreign Visa Trainee residents add to Doctor Shortage in Canada and
Ontario
Author: Julie Taub – Immigration lawyer, Ottawa
As an immigration lawyer, I am aware that one of the significant
problems facing Canadian or landed immigrant foreign-trained doctors
(IMG’s) who have passed the examinations of the Licentiate of the
Medical Council of Canada (MCCEE and the MCCQE1 is the fact that
there is a shortage of residency positions at Canada's teaching
hospitals. The principal reason may be that too many positions are
SOLD to foreign visa trainees before assuring that all Canadian
medical graduates and qualified IMG’S are matched for resident
positions.
In 2008-09 Canadian hospitals have 2,153 Foreign
Visa Trainees (“FVT”), up from 1150 in 1999-2000 a decade ago,
according to the Canadian post-MD Education Registry. (CAPER – p. 22
of 2008-09 report)
These medical resident positions across
Canada are SOLD to foreign countries, the most significant numbers
come from Saudi Arabia (416 residents and 229 Fellows), Libya (86
residents + 12 Fellows) Oman (56 residents + 12 Fellows) and Kuwait
(55 + 9 Fellows) in order of numbers for this year. (CAPER – Table
C-1i 2008-09 report, pp 48, 49)
These foreign trained
doctors who are NOT Canadians or landed immigrants, are sponsored by
their respective countries. These foreign visa trainees are
registered with the local provincial College of Physicians without
any exams or assessments upon the recommendation of their home
governments! They are immediately allowed to practice and do
procedures in the teaching hospitals, ostensibly under supervision.
These foreign visa trainees do NOT remain in Canada after their 2 to
5 years of training.
The general public is not aware of this
situation. For example, the University of Ottawa postgrad medical
website states:
"We have one of the largest foreign trainee
population in Canada. There are currently 700 residents and 150
fellows registered at the University of Ottawa".
A phone call
confirmed that Ottawa University has anywhere between 150 and 200
foreign trainees from the 700 resident positions available.
Ontario has a record number of FVT’s. Exactly 23% of all residents
in Ontario teaching hospitals are FVT’s, that is 1,205 residents are
FVT’S as opposed to 4,029 who are Canadian citizens or Permanent
Residents for a total of 5,234. (CAPER – Table F-4 2008-09 report,
p. 55) Surely those 1,200 resident positions should have been given
to Ontario’s qualified IMG’S.
British Columbia followed with
20% of its medical residency positions sold to FVT’s, that is 247 v.
989 Canadian citizens of permanent residents. (CAPER - Table F-4,
2008-09 report, p. 55)
In 2008, only 353 (26%) foreign-trained
Canadian and immigrant doctors (IMG’s) were matched for resident
positions and 994 went unmatched, when in fact 1,347 were qualified.
(having passed the qualifying exams). (CaRMS 2008-09 pp. 19, 29, 41)
This means that 74% went unmatched. This year, we could had have 994
more doctors who could be working and practising in Canada but could
not find positions.
In total there were 102 Unmatched
Canadian Graduates in 2008. (CaRMS 2008 – p.28) These are Canadian
doctors, medical graduates, who were not matched for residency
positions in Canada. We generally lose these doctors to the United
States where Canadian medical graduates are highly esteemed and
sought.
Canada is facing a severe shortage of doctors,
particularly for family doctors. In fact, 81 family medicine
resident positions remained unfilled in 2008, mostly at the French
speaking Faculties of Medicine in Quebec. However, 19 family /
community resident positions remained unfilled in Ontario. (CaRMS
2008 – p.42) These positions could have been allocated to Ontario’s
qualified IMG’s.
There are also significant shortages in
Anaesthesiology, Cardiology, Dermatology, Diagnostic radiology
General surgery, Internal medicine, Orthopaedic surgery Paediatrics
and Plastic Surgery. These critical shortages may be attributed by
the number of FVT residents who choose these specialities,
respectively:
Foreign Visa Trainees in Canadian Hospitals
• Anaesthesiology 131
• Cardiac Surgery 53
• Cardiology 148
• Dermatology 21
• Diagnostic radiology 110
• General Surgery 103
• Internal Medicine 116
• Neurosurgery 68
• Orthopaedic Surgery 145
• Paediatrics 77
• Plastic Surgery 35 (CAPER – Table F-5 –
2008-09 Report, p. 56)
These FVT’s are occupying resident positions that should go
firstly to Canadian medical graduates and then to IMG’s.
It is crucial to note that some Canadian medical graduates went
unmatched in these specialties. These doctors then head to the
United States to pursue their specialties of choice, to the
detriment of Canada. The unmatched results correspond to the
disciplines most populated by the FVT’s
Canadian medical
graduates Unmatched in 2008
• Anaesthesiology 7
• Dermatology 2
• Diagnostic radiology 7
• General Surgery 7
• Internal Medicine 12
• Orthopaedic Surgery 8
• Paediatrics 7
• Plastic Surgery 10 (CaRMS 2008, p. 28 )
Interestingly in examining the UnMatched results for IMG’s by
discipline in 2008, most of the unmatched IMG’s per discipline
also correspond to the positions heavily populated by the FVT’s
Unmatched IMG’s 2008
• 38 unmatched in Anaesthesiology
• 5 unmatched in
Dermatology
• 22
unmatched in Diagnostic radiology
• 512 unmatched in Family Medicine
• 33 unmatched in General surgery,
• 77 unmatched in Internal
medicine,
• 24
unmatched in Orthopaedic surgery
• 54 unmatched in Paediatrics.
• 8 unmatched in Plastic
Surgery (CaRMS 2008 – p.29)
For example, waiting times for joint replacements vary in Canada
from 112 days in B.C. to up to 18 months in Nova Scotia and
Saskatchewan with Ontario averaging 192 days. (www.cihi.ca p. 21)
There is a shortage of Orthopaedic surgeons in Ontario and in
Canada in general. There are currently 145 FVT’s in orthopaedic
resident positions in Canada, 85 of them in Ontario. Eight (8)
Canadian medical graduates could not get a residency position in
this field while 24 IMG’s also went unmatched. The numbers speak
for themselves.
There is a finite number of attending
physicians and resident positions across Canada. These attending
physicians must train ALL the residents, be they Canadian medical
graduates, IMG’s or Foreign Visa Trainees. They are not paid for
training the FVT's. They are compelled to train FVT's as part of
the resident training programmes which include all 3 categories of
doctors.
The FVT positions should be allotted to Canadian
medical graduates and IMG’s before offering them to FVT's.
While the CMA may argue it is a different programme for the
foreign visa trainees, it is different only insofar as the
sponsoring countries pay at least $25,000.00 per resident annually
to the medical schools plus their salaries, providing an average
of $115,000.00 per foreign visa trainee per year. This is money
the provinces do not have to pay and represents quite a financial
boon for the medical schools. Even more significant is the fact
that these foreign visa trainees do not have to pass the
qualifying exams to enter into the hospitals as residents.
The bottom line is the fact that a resident position is a
resident position, whatever label the CMA may assign it. Be they
Canadian medical graduates, IMG's or FVT'S, the same resources –
medical teachers and hospital facilities and patients are used for
the programmes. Thus it makes perfect sense to utilize the FVT
spots for local Canadians at this time of crisis.
The
Minister of Citizenship and Immigration should impose an immediate
moratorium on foreign visa trainees for 2009. Provincial funding
and allocation of these positions should go first to all Canadian
medical graduates and second to landed immigrant foreign trained
doctors. This would begin to make a significant difference in the
doctor shortage in Canada.
CaRMS – Canadian Resident Matching Service:
http://www.carms.ca/eng/operations_R1reports_07_e.shtml
CAPER – Canadian post M.D. Education Registry:
http://www.caper.ca/
Julie Taub
Immigration Lawyer
Ottawa 613-222-4446
Ontario
Immigration