Graduating more Alberta doctors is just what the medical system ordered

This column is an opinion by Darius Ramrattan, a pharmacy student at the University of Alberta. For more information about CBC's Opinion section, please see the FAQ.

In my classes at pharmacy school, we are taught that if patients present with certain alarming symptoms, we refer them on to their family physician.

Unfortunately, this often erroneously presupposes something about life in Alberta: that every patient has a family doctor, and their family doctor will be able to see them in a reasonable timeframe. This, in practice, is often not the case.

The physician shortage places pharmacists in a unique situation. Our scope of practice has been expanded to reduce the stress on the health-care system, yet a lack of physicians impacts our ability to care for more complex patients. 

The University of Alberta's pharmacy program, medical school and other professional faculties like nursing and veterinary medicine, maintain a tight cap on how many students can enter. This exclusivity guarantees me a job upon graduation, and ensures well-paying roles for doctors, but I fear what this has done to the current crisis in the health-care system. 

Doctor? No

Currently, one in five Albertans does not have a family doctor.  Professional faculties at government funded universities are failing to graduate enough professionals to guarantee we address this. Our medical schools at the University of Calgary and University of Alberta only graduate a combined 312 people per year.

In 2021, nearly 2,000 students applied to Calgary's Cumming School of Medicine alone. And the University of Alberta medical school intake has only risen by six spaces, or four per cent, since 2008; the provincial population is up by more than a quarter over that same time.

Meanwhile, south of the border, the Association of American Medical Colleges boosted physician graduate spaces by 30 per cent between 2006 and 2018, in response to a projected shortage.

In the absence of growing Alberta's medical schools, the province has competed with other jurisdictions to recruit doctors from overseas. Focusing only on this approach overlooks the fact that  many Albertans aspire to serve their local hospitals and clinics, but don't make the universities' cut.

I am glad to see that the government's 2023 budget has finally funded a capacity increase in our province's two medical schools. The universities will have funding to create 20 more spaces in the upcoming school year, and within three years will be training 120 more students annually to become physicians than Alberta does today.

Though this is a large investment in our future — training doctors isn't cheap, for students or universities — sustainably increasing the number of physician graduates is critical to being able to provide care for a growing population. This has the potential to reduce the number of Albertans without a family doctor, giving more people an equal chance at living a long and healthy life. 

Furthermore, this will hopefully allow more medical issues to be handled early by a family physician, reducing the amount of patients seen in hospital emergency departments. This ounce of prevention will hopefully be worth a pound of cure. 

Rural Rx

Rural and northern Alberta face unique challenges in providing physician care to a dispersed population, as seen by recent struggles to keep the doors open at many health centres outside the major cities. Attracting and retaining physicians to rural communities like my own in Innisfail has always been a struggle. 

The number of rural doctors only rose one per cent between 2016 and 2020, compared to the nine per cent increase seen in urban centres. The government's plan to train doctors at the University of Lethbridge and Northwest Polytechnic in Grande Prairie is an interesting one. Having teaching hospitals and clinics in these areas will increase access to physicians.

The medical school capacity increase should also expand the number of spaces allotted to rural Albertans, up from the current 10 reserved seats at the University of Alberta. We will have to wait and see if these changes effectively address access to and retention of physicians in underserved communities long term. 

Increasing medical school class sizes should not hurt the quality of professionals produced.

Professional university programs should be able take nearly any above-average student and have them meet the program's necessary outcomes. A large portion of practical learning occurs during residency and continues on the job. 

This brings up another layer of complexity. We do not just need more medical school students; we need more residency positions. Medical students failing to match during the residency selection process means that qualified students are delayed in completing their medical training.

The long and shortage of it

We have more than enough students motivated to pursue professional degrees. We should not have a doctor, nurse, or pharmacist shortage while these faculties receive hundreds or thousands of well-qualified applicants annually. 

Because it takes between six and nine years from entering school to becoming a doctor, increasing medical school seats and residency capacity will not be a quick fix to the challenges facing our current health-care system. 

But it is a necessary and sustainable step. As a future pharmacist, I certainly look forward to having physician colleagues to work alongside in providing care for our rural population.

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