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Two students ascend the stairs to the University of Toronto's Medical Sciences Building on the downtown St. George campus on Aug. 8, 2018.CHRIS HELGREN/Reuters

Saudi Arabia will allow those medical trainees who have already left Canada or taken leaves of absence to return to their posts at teaching hospitals, ending a tumultuous three-week period of uncertainty.

A letter sent on Tuesday from the Saudi Arabian Cultural Bureau to Canadian deans of medicine states that medical residents and fellows can remain in Canada until they find alternative placements in other countries. Those that have taken leaves of absence “may, at their option, return to their programs and resume their training in Canada,” stated the letter, a copy of which was obtained by The Globe and Mail.

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On Aug. 5, Saudi Arabia recalled 1,053 medical residents and fellows as a result of a diplomatic conflict with Canada, giving them until Aug. 31 to leave the country. The deadline was later extended to Sept. 22. The news created a major headache for teaching hospitals across the country that had to scramble to figure out how to deal with the sudden loss of numerous health-care professionals. The trainees received e-mails on Monday night informing them they could stay in the country until they find alternative placements.

While the letter stipulates the Saudi trainees can remain until they find placements elsewhere, it’s expected most of them will be able to finish their programs in Canada. For instance, some of the medical residents or fellows are in their final year. Many others won’t be able to find an equivalent spot in another country for several years, meaning they will be able to finish their training in Canada.

As the crisis winds down, one Ontario hospital chief executive says the saga exposes serious flaws in Canada’s system for training foreign doctors and that it’s time to overhaul the program.

“The Canadian health-care system should not depend on foreign government funding,” Alex Munter, CEO of the Children’s Hospital of Eastern Ontario, said in an interview on Tuesday.

Canada has had an arrangement with Saudi Arabia for decades under which medical residents and fellows from that country come here to train and get certified in their field. The kingdom pays $100,000 a year for each of the medical trainees and also covers the cost of their salary. The trainees work at teaching hospitals and provide patient care to Canadians. Saudi Arabia accounts for 95 per cent of the international trainees in Canada.

After the Saudis called on the trainees to leave Canada, hospitals here were left scrambling to find ways to fill the gaps left by the sudden departure of such a large number of health-care professionals.

Mr. Munter said the incident shows Canada is relying too heavily on the funding from foreign doctors-in-training and is calling on hospitals and governments to rethink the scope of the program.

“This whole situation has exposed that [it’s] fraught with risk,” he said. “We’re going to have to think about other ways for provincial and federal governments and universities and hospitals to ensure that we have enough, that we’re training enough people … to deliver on the health needs of Canadians.”

Paul-Émile Cloutier, president and CEO of HealthCareCan, said the program under which Saudi residents and fellows train in Canada has many strengths and that this country gains from the relationship. But he said health-care organizations, governments, universities and others should think of strategies to ensure that any future disruptions don’t affect patient care.

“Canada should try to be sustainable on its own,” he said.

Several hospitals – including the London Health Sciences Centre, Hamilton Health Sciences Centre and McGill University Health Centre – declined to comment on the situation or future status of foreign-doctor training programs.