‘Surplus’ of medical specialists in Canada no surprise
Increased length of training may have also hindered the flexibility of our work force, just when flexibility is at a premium. Medicine will soon face a wave of disruptive technologies driven by genetics, consumer-accessible devices and micro-implants. Already, heart surgeons face lower demand for their services because better cardiac stents have reduced the need for bypass. Soon, gastroenterologists will lose their bread-and-butter colonoscopy, replaced by pill-sized cameras that one swallows. Right now, I can buy attachments to my iPhone that let me do an electrocardiogram or ultrasound. While such devices will never eliminate the need for specialists, they may dramatically change which specialists are needed and how specialists are used. Clearly, our medical education system needs to tackle some tough questions if it is to do a better job of serving the public. Will we continue to do most specialty training in urban centres, or will there be the political will to dramatically shift training to smaller, underserviced communities? (Most studies show that doctors tend to practice close to where they were trained.) Could we shorten residency training, by focusing more on demonstrated skills rather than time spent in the program? Do we still need rigid boundaries between specialties, or could more procedures be shared by different specialties, family doctors or other professionals to increase flexibility and meet local needs? Will formal residency-style training continue to be something done mostly in ones early years, or rather something done in short stints several times throughout ones career? Lastly, and most importantly, are our medical educators prepared to submit to a national strategy for managing health human resources? Its clear we need one.
Unemployed Doctors? 1 In 6 New Specialists Can’t Find Work, Study Says
The report was, however, correct in noting that there is no quick fix here. The Royal Colleges plan to convene a meeting early next year to discuss a nationally coordinated approach to health system workforce planning may be a useful start. It is difficult to imagine the recommendations that might emerge from such a meeting being worse than the current uncoordinated mess. At present, policy decisions, or often the lack thereof, are failing to meet the needs of new trainees or of patients. For example, there are no national (and few provincial) mechanisms in place to channel new graduates into the specialties where they are likely to be most needed rather than into the specialties most needed by teaching hospitals or most favoured by students. And despite the fact that we live in a hyper-active era of tweets and blogs in which the new generation seems to be constantly connected, there is no structured electronic meeting place for job hunters and job seekers. New graduates are somehow failing to figure out where the jobs are (and there are, in fact, plenty of communities desperately seeking specialists). In some cases, at least, the new specialists are simply the victims of the completely predictable fallout from that earlier medical school expansion. When those Ministers of Health agreed to fund an approximate doubling of medical school places, what did they think would happen when those students started graduating? Was there a plan in place to ensure that the complementary resources that are required for their practices would also be funded and in place? In a word, no. For example, operating room capacity or at least working capacity, meaning an available operating suite plus the funds, supplies and complementary staff to operate it has not kept pace. To make matters worse, the capacity is not used efficiently, and some of those who control that capacity are not all that keen to share with their younger brethren. The consequences for our future many more new physicians looking for practice opportunities each year than old physicians retiring are as predictable as what we are seeing in the Royal College findings today. Ministries of Health need to engage now in two separate but related conversations one about policies designed to take advantage of all these new highly skilled and motivated physicians available to Canadians, and a second about how to avoid repeating old policy mistakes down the road. Memories, it seems, have a short half-life; mistakes dont.
New study shows 1 in 6 newly graduated medical specialists can’t find work
The report paints a grim picture but does not recommend ways to fix it; that was not the mandate. The Royal College of Physicians and Surgeons is convening a national summit in February to explore ideas for developing a co-ordinated approach to planning health system workforce needs, Frechette said. She noted a fix will not be easy. Were hoping that our research shows that this is not a simple issue. And that we shouldnt have any knee-jerk reactions, otherwise we will perpetuate this boom-bust cycle that weve been in. Its like Groundhog Day, she said, referring to the popular Bill Murray movie. Frechette suggested, however, that a national health systems workforce planning body would be an important start. Australia, Britain and the U.S. all have such an entity. The report pointed to a number of factors that have contributed to the oversupply of specialists. Poor stock market returns in recent years have meant that some older doctors most of whom must finance their own pension plans have delayed retirement. And there has been a realignment or rationalization of tasks in health care, with nurses and physician assistants taking on responsibilities that were once left to doctors, freeing them up to do some tasks that used to fall to specialists. That effect, which Lewis called sensible, will only accelerate as less invasive treatments are brought on line.
Steven Lewis, a health policy consultant based in Saskatchewan, suggested the report is proof reactive moves made over the last 15 years or so solved one problem by creating another. And he said the situation the report captures will only get worse, because medical schools will continue to graduate specialists at current levels for the next few years at least. “I think we overshot the mark,” said Lewis, who was not involved in this study. “I think that there is no question that … almost doubling medical school enrolments since the late 1990s combined with easier paths to licensure for international medical grads was the wrong thing to do. We didn’t think it through as a country.” The study was conducted for and released by the Royal College of Physicians and Surgeons. The principal investigator was Danielle Frechette, executive director for health systems innovation for the college. Frechette said the organization, which sets standards for physician education in the country, had been hearing anecdotes about rising numbers of unemployed doctors, so decided to assess the situation. The ensuing report, released Thursday, is based on a survey of over 4,000 newly graduated doctors and interviews with about 50 people knowledgeable about the situation deans of medical schools, hospital CEOs and the like. The report paints a grim picture but does not recommend ways to fix it; that was not the mandate. The Royal College of Physicians and Surgeons is convening a national summit in February to explore ideas for developing a co-ordinated approach to planning health system workforce needs, Frechette said. She noted a fix will not be easy. “We’re hoping that our research shows that this is not a simple issue. And that we shouldn’t have any knee-jerk reactions, otherwise we will perpetuate this boom-bust cycle that we’ve been in. It’s like Groundhog Day,” she said, referring to the popular Bill Murray movie. Frechette suggested, however, that a national health systems workforce planning body would be an important start.