Newfoundland seeks solution to MD turnover
CMAJ 2000;163(4):434
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In Newfoundland and Labrador, the turnover of international medical graduates is so severe that for every IMG who arrives in the province, another leaves. Now, a new outreach program of the Newfoundland and Labrador Medical Association aims to keep foreign-trained physicians in the province.
Launched last fall, the IMG Preceptor Program matches incoming physicians with other physicians with similar backgrounds. A motivating factor, says NLMA Past President Ian Smith, is the simple desire to make new physicians feel more at home. "It turns out a lot of them are turned off in their first few weeks here by a wide variety of things, many of which are related to a lack of familiarity with the Canadian system," says Smith.
Bruce Squires, the NLMA's executive director, now meets every incoming IMG as they prepare to practise in the province. "I spend a little bit of time talking about the association and that program, [but] I usually spend a lot more time answering questions."
Typically, there is confusion about terms and conditions of working arrangements, such as on-call hours and working hours. "When we sit down there are usually a lot of questions, particularly when it comes to call. It's such an evolving issue."
The IMGs are then advised that they will be contacted by a preceptor once they start practising. So far, more than 30 physicians in 16 communities have volunteered as preceptors.
"Some [IMGs] never had any intention of practising here long term, but a significant number arrive with no fixed plans," Smith explained. "That's a group of physicians that we would very much like to attract to this province and keep for as long as we can."
Smith said first impressions are a potent factor. "We talked to several people who had already decided to leave and they had been here for less than 3 months."
Negative factors can include education opportunities and accommodation. "One of the things we were told was that if, for instance, you spend a hundred bucks and put some soap and towels in these places before someone shows up, it can make a huge difference. It gives you the impression that you're wanted, as opposed to just another body passing through."
Dr. Robert Young, registrar of the Newfoundland Medical Board, estimates that about 100 foreign-trained physicians arrive to practise in Newfoundland every year and the same number leave. — John Gushue, St. John's
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