Increasing the Number of Family Doctors across Canada

On October 24, 2024, Senator Omidvar spoke about leveraging federal resources so that strategies could be implemented directly to address the shortage in family medicine, ensuring that Canadians have better access to primary care.

Hon. Ratna Omidvar: Honourable senators, I rise to speak on the Speech from the Throne to address an urgent need for Canada. Canada is facing a primary health care crisis, and the government stated in its Speech from the Throne that “To build a healthy future, we must also strengthen our healthcare system and public health supports for all Canadians . . .”

Yet an alarming 6.5 million people do not have access to a family physician, a number that is projected to rise to 10 million within the next decade. We find ourselves lagging behind our international counterparts, ranking last among 10 high-income countries when it comes to access to primary care. This is not just a statistic but a clear and present danger.

The shortage of family doctors in Canada is acute, and it is worsening, driven by a complex interplay of factors. Many provincial governments have hacked away at services and budgets and incrementally privatized health care, which has eroded the public system. Our population is growing and aging, yet we face significant administrative challenges and underfunded residency programs. Compounding these issues, fewer medical graduates are choosing to enter primary care. If we do not take decisive action, Canada is on course to experience a shortfall of 50,000 family doctors by 2031.

This looming crisis threatens to strain our health care system, leading to longer wait times and deteriorating health outcomes, especially in rural, underfunded and underserved communities.

Currently, about 1,500 residents complete their family medicine residencies every year. This number is woefully inadequate to meet the growing demand.

While the recent addition of 5 new medical schools, bringing our total from 17 to 22, holds promise for the future, we must recognize that building new schools and graduating new students is a lengthy and costly process. The first cohorts from these new schools will not graduate until the 2030s. Even then, merely increasing the number of graduates will not suffice. Without a corresponding increase in residency positions, we will not see an influx of new family physicians.

The federal government has been making efforts to tackle these challenges. The federal budgets for 2023 and 2024 outline a significant investment of $200 billion aimed at improving health care for Canadians. However, despite this increase in funding, we still lack workable timely solutions to address our immediate needs.

In light of these challenges, along with my colleagues who are both doctors, Senator Kutcher and Senator Ravalia, we offer solutions in a report called Maximizing Medical Talent: How Canada can increase the supply of family doctors by 50% quickly and cost-effectively.

Our report offers two crucial solutions that would make a meaningful difference in the short term. Canada has a wealth of trained doctors ready to address gaps in our health care system, but many are unable to practise due to a shortage of residency spots and limited capacity for Practice-Ready Assessments.

Currently, only 39% of international medical graduates are matched to residency programs on their first attempt, and just 18% on the next. These are graduates of overseas medical programs. They may be Canadians. They may be immigrants who have come to Canada. But they have passed all the exams required to determine that their training is on par with that of Canadian students graduating from Canadian medical faculties. Their training has been assessed through two exams. They have passed all the language tests. Many bring extensive clinical experience with them. Yet, close to 45% of them are left outside the tent. Instead of picking this low-hanging fruit, we are letting it lie fallow on the ground.

While health care is primarily managed at the provincial level, our proposals present a unique opportunity for the federal government to take the lead. First, we must increase residency spots for internationally trained medical graduates. Second, we must expand the existing Practice-Ready Assessment framework into a robust national framework.

We believe, colleagues, that these are viable pathways of federal initiatives aimed at significantly increasing the number of family doctors across the country. By leveraging federal resources, we can implement strategies that directly address the shortage in family medicine, ensuring that Canadians have better access to primary care. The time for action and innovative solutions is now. Thank you.

Read more about the report Senator Omidvar talks about in her speech: “Maximizing Medical Talent: How Canada can increase the supply of family doctors by 50% quickly and cost-effectively”