Provinces get cash to train rural doctors

The federal government announced a plan Tuesday to train more than 100 new doctors in rural areas across Canada, but it's not clear how long it will take to get them working, or whether they'll stay.

Health Minister Leona Aglukkaq said that $39.5 million from the Pan-Canadian Health Human Resources Strategy, included in last year's budget, will go toward medical residencies in Newfoundland and Labrador, New Brunswick, Ontario, Saskatchewan, British Columbia and Nunavut.

"We want to see more doctors open up family practices along the main streets of our rural communities," Aglukkaq said.

Aglukkaq says the residencies will run for two years, giving medical students the chance to get used to new life in small communities.

"It will expose them to the many rewards that can come from practicing medicine in rural parts of the country. We expect that the experience will lead many of those residents to establish practices in places that they might not have considered otherwise."

'If they're going to be training these new doctors for rural areas, what things are in place to ensure that they're going to stay practicing there long-term?' —Matthew Sheppard, president of the Canadian Federation of Medical Students

Doctors need medical degrees from accredited universities, but must also complete between two and seven years of supervised residency training, depending on their specialization, before they can be licensed.

Matthew Sheppard, president of the Canadian Federation of Medical Students, says he'd like to see more students from rural Canada applying for medical school. Training in remote areas affects where doctors end up practicing, he said, but not as much as coming from a small town.

"My biggest concern is retention issues. If they're going to be training these new doctors for rural areas, what things are in place to ensure that they're going to stay practicing there long-term?" Sheppard said.

Sheppard says with competition so strong to get into medical school, many students are older when they go in. That means by the time they start their residencies, they're less likely to develop the ties that keep people in rural areas.

NDP health critic Megan Leslie says her party has campaigned on the need for another 6,000 nurses and 1,200 doctors in Canada.

'Falls short'

"Frankly, 100 doctors falls very short of what's actually needed in Canada. We're in a crisis when it comes to family medicine. There are five million Canadians without a family doctor," Leslie said.

It would be more effective to get people from rural areas to go to med school and to make sure doctors can practice family medicine instead of having to take on higher-paying specialties so they can afford to pay off student debt, she said.

Liberal MP Dominic LeBlanc says the 100 new spots is symbolic.

"If the minister has some plan to put 100 family doctors in rural communities, that would probably be a good start in New Brunswick. We're two per cent of the country's population and I think we need a lot more than 100 doctors there," he said.

A Liberal news release said the party would forgive up to $20,000 in student debt for up to 6,000 doctors, nurses and nurse practitioners who practice in under-served communities.

The Canadian Medical Association called the announcement a step in the right direction. In a statement, the CMA also called on the government to work on strategies to retain doctors and nurses, while integrating internationally trained doctors and Canadian physicians returning from overseas. 

Canada had 68,101 doctors in 2009, the Canadian Institute for Health Information reported last December. That works out to an average of 201 doctors for every 100,000 people, or 497 patients for every doctor.

About 51 per cent of those doctors are family physicians.

There are 10,500 medical students in Canada and about 3,500 Canadians studying overseas.

Doctors who come from rural areas are more likely to return to rural areas to practice, according to a 2005 report published in the Canadian Medical Association Journal.

In the report, the Society of Rural Physicians of Canada estimated small communities needed another 1,175 family doctors to equal the ratio of doctors in urban centres. The estimate was based on 2002 numbers.

Some of the training in the new rural residency positions will focus on enhanced skills in emergency and acute care, mental health and obstetrics.

Ontario will get about 60 of the 100 spots for third-year residents, B.C. will get 20, New Brunswick and Saskatchewan will get six each, and Newfoundland and Labrador will get 16.

The money is being doled out over four years. It's up to the provinces and medical schools as to whether they ask participants to sign contracts promising to stay in the area after their residencies are done, a spokesman for Health Canada said.