Would changing how doctors in Canada are licensed help reduce the physician shortage? This MP feels it could

Thunder Bay-Rainy River MP Marcus Powlowski plans to make recommendations to the federal government aimed at easing the physician shortage in rural northwestern Ontario and other parts of Canada.

Powlowski, an emergency department physician and member of the parliamentary standing committee on health, recently visited Atikokan, Fort Frances, Rainy River and Kenora to speak with doctors about the challenges they're facing.

Rural hospitals across the province, including in the northwest, have been struggling to keep their emergency rooms (ER) open in the face of an unprecedented shortage of doctors and nurses.

In March, Red Lake's Margaret Cochenour Memorial Hospital was forced to close its ER for 24 hours due to a lack of available doctors. It came within hours of a second closure last month. 

Hospitals in Ottawa, Perth, Carleton Place and Mount Forest have also faced ER closures. 

Powlowski's proposed recommendations, outlined in a media release Monday, would require the federal government to work with the provinces to bring about change.

The proposals are:  

• Have the federal government establish a national licensure for doctors, so physicians can work across Canada without having to be licensed in each province.
• Have the Ontario government implement Practice Ready-Assessments (PRAs) for international medical graduates, which would allow internationally trained physicians to receive a licence after just 12 weeks of supervised practice, as opposed to the current year or more.
• Increase the number of residency positions, especially family practice residency, for foreign graduates, including in rural areas. (Powlowski initially called for the College of Physicians and Surgeons of Ontario, or CPSO, to take this on, but his office later clarified that it would require co-operation between several different bodies.)
• Have the federal and provincial governments work together to allow doctors in certain countries to practise in Canada without further accreditation or schooling. 

'Nothing safe in not having emergency rooms open'

"Certainly the colleges of physicians and surgeons have to ensure that people who are allowed to practise in Canada are of an adequate standard," Powlowski told CBC. 

"But as they are making the decision as to who should be accredited ... I think they also have to appreciate the fact that there's nothing safe in not having emergency rooms open because of doctor shortages, and nor is there anything safe when people don't have a family doctor." 

Powlowski plans to meet with several national health-care groups, including colleges of physicians and surgeons and doctors' organizations, to finalize his recommendations before presenting them to the minister of health in early fall, he said.

The physician recruiter for the Fort Frances and Rainy River area said he welcomes Powlowski's proposal for practice-ready assessments.

"If you can get a physician for … three to four years, and you have 12 weeks or 16 weeks of supervision to help them, I think it's a pretty good deal actually," Todd Hamilton said.

Hamilton said he also was buoyed last week by news that Ontario Health Minister Sylvia Jones had given the College of Physicians and Surgeons of Ontario (CPSO) and the College of Nurses of Ontario two weeks to come up with a plan to expedite the registration of foreign-trained health-care workers.

However, Hamilton said he wasn't sure how much the move would benefit the northwest. 

"I don't see a lot in the article that they would use either [international medical graduate] physicians or nurses and specifically assign them to communities in need in northern or northwestern Ontario." 

Still, he added, "For health care in general, it's important for them to leave no stone unturned."  

The president and CEO of the Lake of the Woods District Hospital said he's seen progress with the college around licensing out-of-province physicians to work in his hospital's emergency department. 

"We had our first Manitoba physician go through that process and get licensed, and that physician is picking up shifts this weekend, so we weren't facing closure," Ray Racette said on Friday. 

"We're really, really excited that the CPSO was willing to do that." 

Racette and hospital chief of staff Dr. Sean Moore previously told CBC that the CPSO licensing process for Manitoba physicians frequently took months and deterred doctors holidaying in the region from volunteering to pick up shifts with the hospital. In response, the CPSO said its processing time was two to three weeks. 

Racette said he now hopes the college will provide similarly expedited service for two other Manitoba physicians seeking licensure in Ontario.

The shift vacancy rate at the Lake of the Woods District Hospital currently sits at 41 per cent, Racette said, down from 44 per cent in June.

There's still no news on other proposals to ease the physician shortage in northwestern Ontario, which were put forward to politicians by the Northwest Regional Chief of Staff Council in March, according to Dr. Sarah Newbery, the associate dean of physician workforce strategy at Northern Ontario School of Medicine University.

Those proposals include supporting physicians working alone in rural northern emergency rooms with real-time virtual access to specialists, and providing funding for medical residents to accompany locums from their medical schools who are working in the region.