Why aren't Alberta's family medicine training spots being snapped up?

The head of the Alberta Medical Association says she's worried about the number of unfilled family medicine residency positions in the province this year.

There are 31 vacant spots at Alberta's two medical schools.

The University of Calgary, which is growing its training seats this year, accounts for the lion's share of those openings.

"It is a bit concerning … that our younger health-care people aren't wanting to go into family medicine," said Dr. Shelley Duggan, president of the Alberta Medical Association (AMA).

Each year at this time, medical school graduates are matched with residency programs around the country.

The first round of matching for this year was completed last week.

At that time, 27 of the University of Calgary's 104 family medicine spots were unfilled. That's the highest number of vacant positions (at this point in the process) in the last 20 years.

Four of the University of Alberta's 73 spots remain unfilled.

"The health-care system in Alberta is quite unstable right now and I think that's impacting people's decisions," said Duggan.

Citing the numbers in a recent letter to AMA members, Duggan said she's worried about recruitment and retention of doctors in the province.

The matching, conducted by the Canadian Resident Matching Service (CaRMS), is done in two rounds. 

According to service, 9.3 per cent of positions remained unfilled nationally after the first round this year.

At the University of Calgary, 26 per cent remain vacant. At the U of A, it's 5.5 per cent.

CaRMS uses an algorithm that factors in an individual's top picks for specialty and location. It also factors in university preferences.

The jump in vacancies at the University of Calgary comes during a year when 16 more family medicine residency seats were added.

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"We just expanded in this current year, so I think that's a big part of having a little bit more spots open, for sure," said Dr. Martina Barton, post-graduate director for the family medicine residency programs at the University of Calgary. 

"I'm just excited we have growth. We need family doctors. It's a great specialty to be in. We obviously need to address the need in society, and I feel we are doing everything we can to do that."

According to Barton, the university filled all of its 21 rural training positions, in Lethbridge and Medicine Hat, an improvement over some previous years.

'National trend'

"There are dwindling numbers of residents that are currently applying to family medicine as a first round pick and … this is a national trend," said Dr. Pauwlina Cyca, president of the Professional Association of Resident Physicians of Alberta.

She points to CaRMS data showing the University of Ottawa has 42 unfilled spots in its family medicine programs and Queen's University has 29 vacant seats, for example.

"There are fewer people applying to family medicine. However, the people who are applying to family medicine are the people who want to be there," said Cyca.

She hosted an online orientation for incoming residents the day after they were matched to the University of Calgary.

"Even though the numbers are fewer, the quality of the applicants in terms of their engagement and the drive to be part of family medicine, from my assessment, seems way higher than previously."

Other factors could be at play as well, she said.

Alberta announced  a new pay deal for resident physicians last year. And, after repeated calls from the Alberta Medical Association, the province also announced a new pay model for family physicians in December.

Cyca believes it will take time for those changes to play out in the match numbers.

Meanwhile, Barton hopes the U of C will be able to fill all of its spots through the second round of matching.

"Historically, we have had very excellent, strong applicants that come in through the second iteration."

If they don't fill up, she said they can consider people who want to transfer in from other specialties.

In a statement, the health minister's office called concerns about unfilled seats "exaggerated and distorted."

A spokeperson said Alberta accounts for a smaller proportion of Canada's unfilled positions (after the first round) this year compared to 2024 and pointed to the increase in family medicine seats as a key reason for the vacancies.

"It's not surprising that there is some lag in uptake as all jurisdictions are challenged to attract residents into family medicine. We're confident that most or all of the unfilled seats will be filled in the second round; last year we filled all but one family medicine seat in Round 2," the statement said in part.

"Given the increase in available spots and the challenges in family medicine nationwide, the first round of results this year is a step forward. Alberta's government will continue working closely with the University of Calgary to explore options to fill any remaining positions after the second round of matching for medical residency positions takes place in April."

Data provided by CaRMS shows the U of C did fill all its family medicine positions by the end of the second round between 2016 and 2021. There were four unfilled spots in 2022, seven in 2023 and one last year.

The University of Alberta similarly filled all its spots between 2016 and 2021 after the second iteration. In 2022, it had seven unfilled spots. There were 15 unfilled in 2023 and zero last year.

The results for the second round will be announced on April 17.