Evidence of meeting #17 for Health in the 40th Parliament, 3rd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was jurisdiction.
A recording is available from Parliament.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
That number of 392 concerns me. We're losing 25%. If 91 are visa trainees, does the 392 include Canadian IMGs as well as IMGs...?
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
These are very different groups of physicians at dramatically different stages of training, right?
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
I understand that. I am still asking. Some people coming from abroad--for example, from Britain--are senior health officers or at a higher level, and they cannot get spots in this country.
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
But I'm not.... It's a different issue.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
If they can't get spots and visa students are getting spots, that's of concern. Canadian students have gone abroad to study and cannot get spots, and we're giving 91 places to visa students. This is the first time we've seen these data.
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
The only thing I would say is that, again, the areas of training are very different. The difference between a family doctor and a neonatologist who's doing a subspecialty in echo--
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
It's important to realize the capacity isn't totally comparable. That's what we're hearing from the universities.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
Sorry, Dr. Tepper; could I ask about the fee schedule? What is the cost per year, for example, if we go down to the postgraduate training, versus an IMG versus a visa student? We must have the average data on that.
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
It varied dramatically by jurisdiction.
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
I couldn't tell you for every jurisdiction. I can work on getting it for you. It will take some time.
Liberal
Kirsty Duncan Liberal Etobicoke North, ON
I would like that. We hear that we're watching this closely, and so I would very much like to see those data.
Conservative
The Chair Conservative Joy Smith
When you do get it, Dr. Tepper, if you would be so kind as to share it with all of us, that would be very good.
We'll now go to Ms. Davidson.
Conservative
Patricia Davidson Conservative Sarnia—Lambton, ON
Thank you very much, Madam Chair.
I'd like to go back to Ms. Hoffman, please. When you were talking about the IMGs and the vacant spaces, I think you made the comment that the matching process was very complicated. Could you explain that a bit more? How do we make it less complicated?
Associate Assistant Deputy Minister, Strategic Policy Branch, Department of Health
I wish I could explain it in more detail. I have to be quite candid; I'm not an expert on the CaRMS system. Perhaps Dr. Tepper could talk a bit about it. I simply referenced it with respect to the fact that when the system plays out, at the end of the day there are unoccupied seats.
Conservative
Patricia Davidson Conservative Sarnia—Lambton, ON
I think that's part of our problem. We're wrestling with the idea of how to improve the status of health human resources across this country and we keep hearing that there are vacancies here and vacancies there, but it's a very complicated process. I think part of our solution has to be how we uncomplicate some of this and how we make things less--
Associate Assistant Deputy Minister, Strategic Policy Branch, Department of Health
Before I ask Dr. Tepper to speak about this, I would just note that the residency matching service principally involves the universities, the matching service organization, and the provincial and territorial jurisdictions. This is not something over which any one party has complete control.
Josh, if you would, could you say a bit about it, please?
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
Sure.
Please ask the question again so that I answer the right part of your question.
Conservative
Patricia Davidson Conservative Sarnia—Lambton, ON
One of the previous questions asked about IMGs, vacant spaces, visa spaces, and so on, and the statement was made that the matching process is complicated, the inference being that you couldn't just take the straight number of spaces with the numbers waiting, because the matching process doesn't always fit directly into that. How do we make it less complicated?
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
It's actually a fairly organized computer-based algorithm that's used. The same algorithm is used in Canada and the United States. It's actually quite a clean process. The additional capacity is there at the end because we put more capacity into the system than there is need for, and those spots are then used if there is any additional capacity. It's not as if there is additional capacity that goes unfilled. It's a point in time, so we just keep filling it up.
For example, Ontario offers—and I apologize for using an Ontario-specific example, but I know it best—200 spots for international medical graduates, but we often end up with 220, 225, 227, or 230 in our education system because we immediately fill any additional capacity that we have at the end to make sure there is no training spot left open.
We have a dedicated stream of 200, but if there is anything else left open, we immediately open it up wide to make sure it is filled.
Conservative
Patricia Davidson Conservative Sarnia—Lambton, ON
In earlier testimony I believe you made a comment about B.C. taking a different perspective on Canadians studying abroad.
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
This is brand new. It's in the last week or two.
Conservative
Provincial Co-Chair, Advisory Committee on Health Delivery and Human Resources
I probably would need to get a little bit more detail about what they've done. My understanding—and I would stand to be corrected by a representative from B.C.—is that they have put aside some very specific positions. Currently there are two groups of capacity: Canadian medical graduates and international medical graduates. What I believe B.C. has done is create a new capacity, or a separate pool, just for Canadians studying abroad. That's my understanding.