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CMA says national approach to physician numbers still needed

The Canadian Medical Association (CMA) continues to call for a coordinated national approach to planning the number of physicians needed in Canada, as well as a system for training doctors that is responsive to population needs.

The fundamental importance of a pan-Canadian strategy rooted in needs-based projections is contained in a new policy statement on physician resource planning approved at the recent meeting of the CMA Board of Directors.

The document updates the CMA statement on this subject last revised in 2003. It is part of a comprehensive 10-point Physician Resource Action Plan adopted at the end of 2013 in the wake of concerns about physician over- and underemployment among certain specialties and in some parts of the country.

“It is almost four decades since the federal government completed a needs-based projection of physician requirements in Canada, yet still there is precious little in terms of formal planning on physician workforce,” said CMA President Chris Simpson.

“As a result, we have situations where some newly graduated physicians are finding it hard to find secure employment while in other areas there is a woeful lack of access to physicians,” he added. “Many residents and medical students have concerns about their future due to this lack of national planning.”

The updated policy reiterates elements of the earlier statement, such as calling for a pan-Canadian approach and urging that this country become self-sufficient in matching medical schools’ undergraduate and postgraduate output with the medical needs of Canadians. However, the policy continues to recognize that Canadians studying abroad and other international medical graduates (IMGs) must be explicitly factored into planning and support measures to help IMGs in their acculturation.

The policy quotes a 2014 study showing a mismatch between the number and type of graduates from postgraduate training programs in Canada and actual practice opportunities, noting that this highlights the lack of monitoring and management of the physician specialty mix.

As in 2003, the CMA calls for flexibility in medical education and continues to recommend that a ratio of 120 postgraduate training positions per 100 medical graduates be re-established and maintained.

The policy also notes other considerations in physician resource planning such as the need to balance calls from governments and the public for 24-7 access to physician services with the potential resulting risk of more fragmented care as multiple physicians become involved.

There is a need for more clearly defined scopes of practice among primary care physicians as well as between physicians and other health care professionals, the policy points out.

An addendum dealing with emerging health care technologies notes “there is little evidence about whether new technologies will increase or reduce working hours.”

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