One of the more pressing problems we're seeing is that many specialists are unable to find work in their specific field. Essentially, we are reaching a point, as Noura indicated, where there soon will be enough doctors, but these doctors will not be aligned with the specialties in demand.
Training spots in the various medical specialties simply do not match the population needs of Canadians. There are over 60 medical specialties that medical students can choose from. We're currently doing a very poor job of identifying current and future medical doctor labour shortages with respect to specialty and by geographic location.
For example, many specialists in cardiac surgery, radiation oncology, and orthopedic surgery currently have difficulties finding jobs in their fields. Because these specialists are highly trained, whenever they're unable to find work, they're often forced to leave the country.
The lack of a national level of cooperation is a large impediment. For instance, Ontario projects that before 2017 there will be labour shortages in almost every medical specialty in Ontario. Quebec is expecting an oversupply of physicians by 2016.
We're seeing similar trends across the country. When medical students apply to specialty spots after medical school, they apply through the CaRMS portal, which is essentially a national portal redistributing medical students across the country, not necessarily within their home province.
As of right now, there is no national health human resources database that tracks this kind of information. “The Future of Medical Education in Canada Postgraduate Project”, which is funded by Health Canada, actually calls for HHR planning on a national level, with government involvement.
Basically, we have demographic data on our population and on disease prevalence, and we know what the burdens are for our health care system. All we need now is a national database to collate this information and make it available so that we can use this information in the future to make projections and essentially align the residency and training spots in different specialties with the needs of Canadians.
According to the Society of Rural Physicians of Canada, 21% of Canadians are rural, but only 9% of Canadian physicians practise in rural areas. One of the main reasons that we have some underserved rural and remote areas in Canada—we're echoing previous messages from today—is that we're training few students from these rural and remote communities.
It is estimated that over 90% of medical students come from wealthy urban areas—essentially areas where there are no physician shortages. We know that medical students from rural or remote communities are far more likely to return to their communities to practise after medical school.
In Budget 2011, as you know, there was money allocated to forgive the loans of physicians and health care providers who begin to work in underserved rural and remote communities in Canada. This program aims to improve access to primary health care in underserved regions. We applaud this initiative; however, this program is inherently flawed as it currently stands.
Essentially, the loan forgiveness incentive begins only after residency, meaning that medical residents make payments on the federal portion of their Canada student loan during residency years. This greatly diminishes the incentive of loan forgiveness to attract physicians to underserved rural and remote areas. We need to defer the interest on and payment of the federal portion of the Canada student loan during residency in order to render this program effective.