It may soon be more difficult for Saskatchewan to import doctors from other countries, Dr. Dennis Kendel warned delegates to the mid-term convention of the Saskatchewan Association of Rural Municipalities.
Kendel, registrar of the provincial College of Physicians and Surgeons, said an agreement among premiers to free up labour mobility in Canada would make it harder to keep doctors in Saskatchewan because the province would be unable to hang onto the ones it recruits.
He called it a potential disaster for rural Saskatchewan.
The province is the most dependent in Canada on foreign doctors, with 57.4 percent of all physicians licensed to practise having done their undergraduate degree outside of Canada.
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Kendel noted that at a recent health conference in Capetown, South Africa, he felt shamed when a South African official named Canada as a place that steals the poor country’s doctors.
He toured South Africa’s largest township, which has 2.5 million people and no resident doctor.
Another complication is that the Saskatchewan college has decided to develop a new way to assess the qualifications of foreign trained doctors, Kendel said. Previously, the college would require such doctors to serve for three years in a rural area in exchange for a provisional licence. Doctors disliked the system, and now rural communities are also protesting, saying it is a form of indentured work.
Kendel said rural Saskatchewan communities need to build alliances with other towns to establish clinics of five or more doctors, which is the number the college has found is best in terms of training foreign doctors to Canadian standards and allowing each doctor more time for personal and family interests.
He also told rural councillors that the fixation on doctor numbers has hindered creative solutions in the health system. Doctors are only part of a health-care team that could provide good service.
Kendel said rural communities have been slow to recruit Canadian-born medical students. Statistics show only seven percent of recent doctor graduates locate in rural Canada to serve the 22 percent of the population that lives there.
Surveys have shown that new Canadian doctors want two things in their practice – nearby colleagues and personal time off.
“Compensation, surprisingly, is no longer the main thing,” he said.
“We’ve been talking about group practices for 25 years. So we need action; otherwise we’ll lose out.”
Kendel had good news for the SARM delegates. All 17 medical schools in Canada have increased their training spots for doctors.
This year, the University of Saskatchewan medical college admitted 84 first-year students, its largest ever class. Within two years the U of S college hopes to raise that to 100.
He also said the provincial government wants to see a system developed to accelerate the assessment of foreign doctors’ skills. However, no details came with that promise in the recent throne speech.
It now can take three to five months to evaluate a foreign doctor’s skills, and after taking the Canadian test, two-thirds of foreign doctors need to upgrade some areas.
The college is suggesting that all foreign doctors first practise in a group setting to learn the culture and skills before taking their Canadian qualifying exam. It said recent checks showed the orientation system seemed to help them do better on the exam.
Barb Porter of the College of Physicians and Surgeons noted that in January 2007, of all doctors in rural Saskatchewan, about 80 were trained in South Africa, 25 had other international training and 18 were Canadian trained.
When the college tracked a sample of 39 rural doctors for three years starting in 2000, it found 51 percent moved to other provinces or returned to South Africa, 31 percent went to larger towns and cities in Saskatchewan and 18 percent stayed in a rural area.
