Matthew Macciacchera of Vaughan, Ont., stands inside a building at the Royal College of Surgeons Ireland in Dublin, where he is studying in hopes of becoming an orthopedic surgeon.Lorraine O'Sullivan/The Globe and Mail
The Globe and Mail recently published a story about Canadian doctors who have been trained at international medical schools in places such as Ireland, Australia, Britain, the U.S. and the Caribbean, and are giving up on returning home for work.
Thousands of medical students are leaving Canada because it’s nearly impossible to get one of the 2,800 first-year seats in the country’s 17 medical schools – where roughly nine out of 10 applicants are rejected.
But the challenges for would-be Canadian doctors don’t end there. The Globe’s Greg Mercer reports that many international medical graduates want to come home after they’ve completed their medical education, but find more hurdles in their way. They are increasingly working as doctors in other countries – where they’re highly coveted – because their return to Canada is often blocked by a system that’s been slow to respond to crippling physician shortages here.
Globe readers reached out to us with many stories of physicians in their lives who’ve had similar experiences. We rounded up a collection of reader reactions, from people who chimed in with their personal stories, those from friends and family members, and their feelings about how this reflects on Canada’s health care system.
Reader reaction
From Facebook reader Justin McMaster:
Having lived through this experience, I can say it has been incredibly disheartening at every stage. I constantly hear about the shortages of physicians in Canada, but even after having completed residency in America, Canada has remained a relatively closed door. While I would love to return home to work, there are so many barriers in the way that I have lately begun to accept my fate of living/working in America for the rest of my life. I know many of my classmates from medical school feel the same way.
From Globe commenter Fralick56:
I finished top in my program at a Canadian university, was accepted to UBC, U of T and McMaster for med school, but chose to attend a U.S. school (U of Washington) because I was offered a full-ride scholarship. I finished my specialty in nine years (which exceeded the training offered in Canada by two years) and then came back to practice at Mount Sinai. When I returned, I was told I had to do two years of extra training to practice in Canada. Despite my colleagues and friends on both sides of the border asking why I would return to Ontario, I complied. If my wife and children had not refused to remain in the U.S. I would have never returned. I have practiced in Canada for 33 years.
From Globe commenter CognitiveDissonance:
My daughter couldn’t break into a Canadian medical school after undergrad despite an A+ average, went to Austria and studied in English and German. She's graduated after a six-year program and now cannot get into a Canadian residency program as too few spots plus two years training to be a family physician seems a little overkill after a six-year medical degree. So, she lives in Stockholm, started practice immediately as an EU-certified physician and unfortunately for Canada, has NO plans to return here to practice medicine in our overwhelmed system. This article addresses a number of points where the system has failed to take a Canadian kid and turn her into a desperately needed Canadian physician. Desperate times call for desperate measures. Canada needs to do better.
From e-mail commenter Heather Goodall:
My Canadian daughter is one of those international students who trained in Cork, Ireland to become a doctor. She was one of the lucky ones who got a family med residency in B.C. Anyway, I appreciate your attention to this important issue. As a mom who has watched her daughter do all the "right" things to become a doctor, it breaks my heart and infuriates me to see health authorities and government put up one barrier after another. All I can say is: How lucky her future patients will be to have such a determined and passionate doctor.
From Globe commenter Golfguy3:
My daughter’s fiancé is now head of emergency at a downtown Toronto hospital and recounted the number of schools who rejected him. He’s just under 30 and already incredibly cynical about our health care system. It’s criminal that Canada has as many seats as the state of Michigan. We knew that baby boomers would eventually overwhelm the health system. We didn’t need COVID to illuminate the inefficient provincial health care. Folks, this is a 10-year fix.
From e-mail commenter Jason Donville:
My son is a classmate of the students you interviewed at RCSI and he has experienced incredible frustration with the various issues you have described. He grew up in Oakville, has degrees from Cornell and Johns Hopkins and when he graduates, he will be heading to the U.S. to become a pediatrician. This, of course, will be a great loss for Canada, but it’s also a great loss for his parents too. He’s a wonderful young man, with a terrific bedside manner around children. He will make a great pediatrician! He’s also a wonderful lacrosse player and coach, having played for Canada at three world championships. So, we are not just losing another doctor. We are losing a son, a brother, a coach and a community builder.
From Globe commenter Bodlizkin:
It’s a stupid system and colonial/racist. My husband completed four years of fellowship training at U of T with residency abroad (from India). Unless he redid his residency training here, he was only able to get a restricted license (an academic license) to practice at a university hospital. This severely limited the pool of hospitals he could work at and he almost did not find a job. He now works at a hospital in emergency under a restricted license doing the exact same work as a Canadian-trained physician. It’s unfair. In the USA to qualify, I understand there is a standard test you must pass that even American graduates are required to take. Seems fair. In Canada, other Commonwealth countries don’t face the same barriers (Australia, Ireland, England) however, physicians trained in other countries (India) do.
From Globe commenter doug5985:
I had a good friend who was a general surgeon who practiced in B.C. He left Canada to practice in the U.S. not because of the money but due to the fact that he was assured in the U.S. that he would have daily access to properly equipped surgical rooms with staff. In Canada, he was lucky if he got a surgical room with staff once per week. The rest of the week he spent his time trying to assure anxious patients that the delay in their surgeries hopefully would not be life-threatening. Finally in frustration he bid fond farewell to Canada.
From Globe commenter twofifths:
I know somebody who married a medical student in Wales and when she completed her degree they moved back to Canada but she was not able to get a resident position so she’s working as a receptionist in a medical practice. Similarly, the son of an employee of mine got his medical degree in Ireland and was not able to get a residency in Canada. He went to the US and is getting board-certified in neurology. He’s not coming back. What’s going on?
From Globe commenter mb555:
My father started university at 17 and did two years pre-med and then four years in medicine and started his own practice at 23. Now you need 4+ years of university before starting 4+ years of medical school and then residency for a family doctor. Many doctors don’t start to practice until they’re over 30. They lose six to seven years of their careers and the system is more costly for everyone. Why can’t students be admitted after two years of pre-med like they were in the past? Better and much less expensive for everyone.
From Globe commenter 1594959413891:
I have a daughter in her third year (of five years) of residency in Alberta. In order to understand our doctor shortage (and indeed our medical system), all you have to understand is quotas. When she applied to medical school here, she was accepted at a school that had 4,000 applicants for 100 seats. When she went through the Canadian Resident Matching Service (CaRMS), there were over 2,000 medical grads (including international and Canadian grads who did not make it through previous rounds of CaRMS matching) for 1,100 resident positions in Canada. Luckily, she got placed – but she faces two more future quotas: (1) at the end of her fifth year of residency, she has to do two years of specialty fellowships for which there are also limited spaces; then (2) she has to hope there are funded full-time physician spaces available to fill here in Canada in her specialty when she finishes her fellowships (when she is 33 years old).