Dalhousie grad faces odds to get medical training in N.S.

A Nova Scotian born doctor is hoping to land a residency spot in his home province, but because he graduated from a medical school outside Canada, his chances are slim. That's even with a physicians' task force report calling on the faculty of medicine at Dalhousie University to give preference to international graduates from Nova Scotia.

Justin White, 29, grew up in Dartmouth, graduated with two degrees in kinesiology from Dalhousie and spent four years getting his M.D. from Saba University in the Caribbean. 

This is my home, this is where I want to be.- Justin White

Dalhousie's Faculty of Medicine reserves seven family medicine residencies for doctors trained abroad. White is competing against 1,500 others from around the world, so he was thrilled with the recommendation to give preference to Nova Scotians.

"I was very excited. It was good to see the province start to bring people like me back to the province to practice," White said.

"I've only been out of the country a couple of times prior to starting medical school. This is my home, this is where I want to be."

White summered in Shelburne for years and says he would gladly commit to practising in a rural area. But he was unsuccessful in getting an interview to compete for a residency position with Dalhousie. Instead, he's interviewing at three hospitals in the northern United States.

White has been away for four years now. The last two years, he's spent $12,000 per term. His goal is to move as close as he can to his wife and parents in Dartmouth.

Approach concerns

Dr. Andrew Warren, the associate dean of post–graduate programs at the Dalhousie Medical School, says there are problems with a 'Nova Scotia first' approach when it comes to deciding who should receive expensive post–graduate training for doctors. 

Standards are one issue that affect graduates from Caribbean schools, he says. He also believes the fact Prince Edward Island and New Brunswick cost–share in training at hospitals around the region would make preferential treatment for Nova Scotians 'inappropriate.'  

"Just because a person is from a place doesn't make them a superior candidate," Warren said. "In fact, because the undergraduate training is unaccredited, then the standards that apply to that undergraduate training are often quite different than those that apply to graduates of Canadian medical schools."

Currently, about one in ten adult Nova Scotians are without a family doctor.

Dalhousie added two spots, including one in Yarmouth, with funding from the province to train more international medical graduates a couple of years ago. Two weeks ago, the government of Nova Scotia announced a tuition rebate to 25 doctors a year who agree to come and work five years in remote communities. 

White has an alternate suggestion for how Nova Scotia might get more bang for its buck.

"Why not use that money to fund more spots, why not open more residency positions for international medical grads from Nova Scotia and get us into the system three years sooner?" he asked. "I'm still of the mindset I'd love to come back and practice, but who's to say that will be true after I've been away another three years."

Research questions theory

But Warren says research from Saskatchewan shows which province or country a doctor is from is not likely to determine whether he or she commits to stay in a rural practice. Warren says the size of the community where a doctor grew up is more important.

"Simply growing up in Nova Scotia is a weak predictor of whether you would stay in a rural community to practice," Warren said. "I think the literature doesn't support that someone who grew up in Halifax is more likely to practice in a community like Bridgetown."