Health Committee on Nov. 27th, 2025

[Burton Bailey, Conservative, Red Deer, AB]

How can we increase those domestic spots? What type of dollar figure do we need to have? I understand that you want it to be provincial, but could you indicate to me a dollar figure per year per student for a resident on a five-year program, not in family medicine but a specialty? Is it $100,000? Is it $50,000? Is there a number?

[Dr. Patricia Houston]

Yes, there is a number. Let's start with medical school, because you can't have a resident unless you put a student through medical school. It costs approximately $80,000 a year to put a medical student through the MD program—per year, one student, one year—at the University of Toronto.

The reason the tuition for the postgraduate medical education programs is $100,000 for the Middle Eastern countries is that it's approximately the cost to support that residency position.

[Burton Bailey, Conservative, Red Deer, AB]

Thank you.

Now, other universities that I have spoken with have received donations. You indicated that the University of Toronto has not received any donations towards any expansions or anything from the Saudi government, just $100,000 per student. There's been no extra kindness.

[Dr. Patricia Houston]

I said that to the best of my knowledge. I was not aware of any other donations from the Saudis to the Temerty Faculty of Medicine, and these are not donations; this is tuition that they pay.

[Burton Bailey, Conservative, Red Deer, AB]

Thank you.

I feel really bad for these IMGs that we have in Ireland.

I'm from Alberta. We have 44 students who want to come back to Alberta and do the CaRMS match. They're not having any success. They're finding difficulty. The Alberta government is now looking at creating spaces, and I guess they will associate a number to increase those IMGs. What would it take for your university to increase spots?

[Dr. Patricia Houston]

It would take, first, the province saying they would support the expansion and, then, the funding from the province for those spots.

[Burton Bailey, Conservative, Red Deer, AB]

Do you have any concerns about Canadian universities' dependence on the visa trainees from Saudi Arabia, a theocratic monarchy alleged to have committed human rights violations, including state-sanctioned murders and the oppression of women and minorities, and curbing freedoms daily?

[Dr. Patricia Houston]

The University of Toronto trains those physicians to take the values of the Canadian health care system and our university back to improve their health care system.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

I now go to Ms. Chi from the Liberals.

You have five minutes, please.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you, Chair.

Thank you, Dr. Houston, for appearing today. For the record, who determines the number of public-funded residency positions and their allocation?

[Dr. Patricia Houston]

It's the Ministry of Health in the province of Ontario.

[Maggie Chi, Liberal, Don Valley North, ON]

What does that process usually look like? Each year you go to the province with a number of spots, and.... Can you outline those steps for us?

[Dr. Patricia Houston]

Sure, I'd be happy to take you through the process. I'm going to speak specifically about the University of Toronto. First, we meet with the Ministry of Health, and they tell us, through a transfer payment agreement, how many residency positions—this is the total number of positions, from PGY-1 to PGY-7—they will support for the upcoming academic year. They also give us direction as to how they want those spots distributed—first and foremost, between family medicine and the Royal College of Physicians and Surgeons spots and, then, their preference as to which Royal College specialties should increase in number or, at some times, decrease in number.

We then take that information back. We have a committee, at which we ask every program to send to the committee their capacity for the upcoming academic year. Usually their capacity is more than the number of spots that we have funded. We then sit down at a subcommittee of our postgraduate medical education advisory committee—and this committee is called the allocation committee. Collaboratively, we decide on this many spots to family medicine, this many spots to Royal College and how many across the different specialties. We come to consensus and agreement. We send it back to the Ministry of Health for their approval, then we go forward with our plan and we submit it to CaRMS for the next year.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you, Dr. Houston.

On the expansion, you mentioned UTSC...or the medical school. How many additional spots does it provide?

[Dr. Patricia Houston]

In that expansion, we got 44 new MD spots in addition to our base of 259 spots. We got 67 postgraduate spots: 40 are in family medicine and only 27 are in the Royal College spots. Of the 27 of those, 12 were taken away, in a prior iteration of adjustment of residency spots, so there were, truly, only 15 in addition to what we had previously had in postgraduate Royal College spots. That is why I'm saying that, for a program as large as ours, we have capacity to further expand.

[Maggie Chi, Liberal, Don Valley North, ON]

I want to dwell on the UTSC piece because—

[Dr. Patricia Houston]

Sure. I'm happy to talk about Scarborough.

[Maggie Chi, Liberal, Don Valley North, ON]

—as you know, in Scarborough, the east end of the city is very underserved.

[Dr. Patricia Houston]

It is one of the worst in Ontario.

[Maggie Chi, Liberal, Don Valley North, ON]

Yes. Do you find that the graduation rate from the UTSC campus will help with the capacity in that region?

[Dr. Patricia Houston]

That is our hope. The 44 spots are in place. It was just this year that we went up to the total of 44. We will not be opening the Scarborough campus for the MD program until fall 2027 because the building isn't open. Our experience, in our prior expansion to UTM, when we expanded by 54 spots in 2010, was that they stay.

This has also been borne out by the work that's been done by NOSM. If you train them in a community, many of the medical students and postgraduate trainees go on to stay in the community. Another example of that is the family medicine teaching unit we opened in Barrie, at Royal Victoria hospital, in 2009. Most of their graduates have stayed in that community, which, again, is an under-serviced community.

[Maggie Chi, Liberal, Don Valley North, ON]

Thank you so much.

I will share my time with Dr. Jaczek.

[The Chair, Liberal, Hedy Fry]

Dr. Jaczek, you have one minute.

[Helena Jaczek, Liberal, Markham—Stouffville, ON]

Thank you so much, Madam Chair.

Dr. Houston, I've just come to this committee from the science and research committee. Of course, as you noted and has been discussed, our budget 2025 is looking to attract international expertise to come back, particularly on the research side. You mentioned, specifically, post-doctoral fellows potentially being part of that attraction to Canada. Are there specific areas of specialty, in terms of the types of medical assistance, that are crucially needed, perhaps, at this point?

[Dr. Patricia Houston]

I think that we need to do work in the neurosciences. I think Alzheimer's and neurodegenerative neurocognitive disorders are a particular concern with our aging population. We have a strength in this in Toronto through our Toronto Academic Health Science Network. Cardiovascular disease and cancer, of course, will always be something that we have a burden of. I think that really looking at health systems, not just who the doctors are and what the research is but the research around how to make a better health care system, is something that we have to explore.