President's message: Foreign rural specialists: Endangered?
Keith MacLellan, MD
Shawville, Que.
President, Society of Rural Physicians of Canada
Can J Rural Med vol 3 (1):5
© 1998 Society of Rural Physicians of Canada
In October I represented the Society of Rural Physicians of Canada (SRPC) at a meeting, called by the Royal College of Physicians and Surgeons of Canada (RCPSC), on the subject of "off-shore" specialist graduates being licensed to practise in Canada.
Other than the occasional academic position, this topic has to do with providing specialist services to rural Canada. The RCPSC has recently, for its own good reasons, seen the need to refuse accreditation to any foreign specialty training programs other than some from the United States. However, graduates of our specialty training programs have never been able to meet all the needs of rural Canada, which has always had to rely heavily on international medical graduates (call 1 800 South Africa) .
The RCSPC invited some 70 players representing various health ministries, government, faculties of medicine, provincial and national medical associations such as the SRPC, provincial licensing bodies, and certain education ministries. What happened? Well, gentle readers, this observer has little experience in these matters, but here is what I garnered:
Quebec thought it had no need of off-shore specialists because of the well-oiled, collaborative machinery it had put in place years ago to determine its physician needs and to discourage physicians from setting up practice in the cities. Quebec representatives outlined their methods, but nobody seemed interested enough to challenge them on their program's effectiveness. Later in the conference a call came from Ontario to develop an effective way to determine physician resource needs: the fact that Quebec says it has been doing it for years was ignored. Is this a cultural problem?
Ontario said that it was a shame that so many neurosurgeons were driving cabs in Toronto, but it was not interested in looking at ways to help off-shore specialists gain access to Canada. More to the point was why the Canadian medical system could not produce its own rural specialists. Predictably, this discussion degenerated into generalities as people looking at rural issues for the first time suddenly realized the complexities of the problem. "Our hands are tied," say the licensing authorities. "Give us more money," say the universities. "It's the government's fault," say the medical associations. "Get lost," say the governments.
The College of Physicians and Surgeons of Saskatchewan made a plea for some practical solution. They are feeling the political heat and raised the spectre of entire rural communities marching in the streets. So did the Atlantic provinces. Ditto Manitoba. They want a quick process for licensing off- shore medical graduates, and they want it now and be damned any double standards. I never really understood what BC was saying. . . .
The day ended with a consensus to establish a task force. I am not sure if the SRPC will be invited to participate, because I fell asleep until my snoring woke me (I was on call the night before). We are, however, in the process of establishing the SRPC Specialties Committee, and I expect that the SRPC, as the only true representative of rural doctors in the field, will be able to have some clout
in any task force that is delegated.
