Skip to main content

Opinion There are no winners in the senseless withdrawal of Saudi residents and fellows from Canadian hospitals

One could scarcely imagine a better illustration of the expression “cutting off your nose to spite your face.”

Saudi Arabia, in a fit of pique over a tweet – a tweet! – by Foreign Affairs Minister Chrystia Freeland calling for the release of a human rights activist, has taken a series of retaliatory measures against Canada, including pulling all Saudi medical residents and post-doctoral fellows from Canadian teaching hospitals.

Those being punished most severely by this move are the 1,000 or so Saudi doctors-in-training.

Story continues below advertisement

Made pawns by their thin-skinned, authoritarian king, they are being uprooted abruptly and, if there is no resolution to the dispute before the Aug. 31 deadline, they will have to find training spots in other countries.

Practically that will mean at least an additional year of study and fewer doctors in Saudi Arabia. Take that Canada!

But petulantly yanking these physicians from their posts is also a blow to Canadian healthcare, and one that has exposed some of our dirty little secrets.

Many Canadians, including those who oversee and work in the health system, were surprised to learn that there were so many Saudi physicians being trained in Canadian hospitals. They make up 95 per cent of international medical trainees in this country.

This is the result of a longstanding, mutually beneficial arrangement between Canada and the desert kingdom.

The Saudi doctors (they have all graduated from medical school) are working as medical residents and training to be specialists at no cost to Canada.

In fact, they pay handsomely – the Saudi Arabian Cultural Bureau pays about $100,000 a year for each spot. In addition, the Saudi government pays the salaries of residents and trainees, so that Canadian hospitals get free labour. (Canadian residents and fellows are paid in the range of $40,000 to $50,000 a year during their training.)

Story continues below advertisement

Contrary to what many people believe, the Saudi residents and fellows are not “stealing” spots from Canadians trainees, nor are they taking Canadian jobs. They are being trained specifically to return to their home country.

Officially, the Saudi doctors are considered supplementary to the basic staffing requirements of Canadian hospitals.

This, of course, is a total fiction.

Over the years, the Saudi trainees have become an integral part of the workforce, especially in Canada’s teaching hospitals, where they make up 5 to 20 per cent of trainees.

There are 225 Saudi medical trainees working in Montreal hospitals, 216 in Toronto, 156 in Hamilton, 91 in London, 67 in Ottawa, 59 in Halifax, 44 in Vancouver and 23 in Calgary. Those are only partial numbers, and they tell only a small part of the story.

Because so many of the Saudis are training to be surgical specialists, the impact of their departure will be staggering in some areas. For example, at McMaster Children’s Hospital, half of the pediatric surgeons are Saudi.

Story continues below advertisement

We shouldn’t forget either that residents and trainees do the dirty work in hospitals – they work nights, weekends and on-call. Replacing those hours is a monumental human resources challenge.

The group of Saudi trainees is also a cash cow, bringing about $100-million a year into the coffers of hospitals, not to mention the spinoff exchanges.

On top of that, medical schools have also come to depend on the additional fees from international students – medical school tuition is roughly $25,000 a year for Canadians (with some exceptions, notably in Quebec and Newfoundland and Labrador), but $80,000 for non-Canadians.

As the full extent of the fallout becomes clear, the big unanswered question is: How will hospitals fill the gaping holes left by the sudden departure of Saudi trainees?

There are about 10,000 residents working in Canadian hospitals. Should that number be boosted by 10 per cent to make up the loss of the Saudi trainees? If so, who will pay?

And, on the off-chance provinces do find hundreds of millions of dollars to make up the shortage, who will fill these spots – medical school graduates who were unmatched to residency spots? Canadian graduates of medical schools in other countries? International medical graduates who have so much trouble finding work in Canada?

Story continues below advertisement

The way residency and post-doctoral fellowship spots are allocated has been under growing scrutiny in recent years.

The loss of Saudi trainees gives us another reason (and opportunity) to re-think medical training – and perhaps that will make the bitter pill Saudi Arabia has given Canada a little easier to swallow.

Report an error Editorial code of conduct
Comments

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to letters@globeandmail.com. Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to letters@globeandmail.com. Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff.

We aim to create a safe and valuable space for discussion and debate. That means:

  • All comments will be reviewed by one or more moderators before being posted to the site. This should only take a few moments.
  • Treat others as you wish to be treated
  • Criticize ideas, not people
  • Stay on topic
  • Avoid the use of toxic and offensive language
  • Flag bad behaviour

Comments that violate our community guidelines will be removed. Commenters who repeatedly violate community guidelines may be suspended, causing them to temporarily lose their ability to engage with comments.

Read our community guidelines here

Discussion loading ...

Due to technical reasons, we have temporarily removed commenting from our articles. We hope to have this fixed soon. Thank you for your patience. If you are looking to give feedback on our new site, please send it along to feedback@globeandmail.com. If you want to write a letter to the editor, please forward to letters@globeandmail.com.
Cannabis pro newsletter