Human Resources Committee on May 7th, 2012

[Chloé Ward]

I'll take the first stab at it.

We actually do have some studies that have been done. They're just done in points of time. For example, in Ontario there was a study in 2010 that looked at one year and made projections for upcoming years. This is happening only in Ontario. However, whenever you apply for medical residency positions, you apply across the country. This is a nationwide problem. We need a central or national database so that we can work in collaboration with the provinces and territories to collate all the information from the localized studies that are happening in short periods of time. Basically, you would have longitudinal studies in a central location so that we could make that data available and use that data effectively.

[Colin Mayes, Conservative, Okanagan—Shuswap, BC]

You're saying that the data is fragmented.

[Chloé Ward]

Exactly. Pretty much.

[Noura Hassan]

I want to add to that.

We do have data, but we don't have enough data. The Royal College addressed this issue. Human health resource planning is complex. We can't just look at a snapshot every now and then and say that we're producing a surplus, or that the output this year was positive with 1,600 positions. That's not enough. We have to have a better idea globally of what's going on. We need to know who is graduating, how many hours they're going to be working, where they're going to be working, what infrastructure they're going to need. We need a lot more information than just the net numbers that we have now. It's multifactoral.

It wouldn't be an easy task to develop this kind of database, but there are a lot of stakeholders who are interested in this. A lot of stakeholders would be interested in contributing to the knowledge behind what we need. I think Health Canada would be a good partner.

Certainly, we agree there is information, but we just don't have all the pieces.

[The Chair, Conservative, Ed Komarnicki]

I think there are some other responses.

Ms. Vanderkooy.

[Pat Vanderkooy]

I think it's much the same response. The data is fragmented. We took on the survey simply because there wasn't data. Point in time data is as good as it gets, and it's certainly flawed. The data exists. The data is being collected differently at the provincial level. There are different definitions. We're not part of the CIHI database, so what we're getting from one jurisdiction might be different. That's why to plan properly we need some consistent data.

[The Chair, Conservative, Ed Komarnicki]

Ms. Nielsen.

[Christine Nielsen]

Regarding the complexity of being a service that provides testing for physicians, none of us can predict what tests will be coming on line in the next five years and what certain jurisdictions will be willing to fund. OMA has to agree to fund certain things. For us to do health human resource planning involves a large conversation with health care providers and health payees to see where the challenges lie.

What we do know is that no one's ordering fewer lab tests than before. Patients now walk in and tell their doctors what they want ordered, and when they want it done, and if the doctors can't do it, the patients offer to pay. I think the complexity of lab testing and what funders are willing to pay for it change the conversation for my professionals.

[Colin Mayes, Conservative, Okanagan—Shuswap, BC]

I saw a presentation on a machine that helped physicians practise. It was a simulation machine you could use to practise surgery. It shortened the time that a surgeon would have to stand beside a doctor to learn to do a surgery.

I guess the question I'm getting to is technologies. Do you think technologies like this are going to help, especially for medicine but also in the lab? Will technology improve productivity so that we won't need as many people?

[Chloé Ward]

This is something we see in different medical specialties. As technology evolves, it affects the needs we have in different specialties. In cardiology, for example, as technology and surgical procedures evolve, there's less demand for cardiac surgeons. We need to make long-term projections and identify needs based on a number of factors, including developments in the field and technology. We have to make sure we're training professionals to meet our needs so we don't have these labour problems.

[The Chair, Conservative, Ed Komarnicki]

Thank you.

We'll conclude with Mr. Cuzner. Go ahead, please.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Mr. Chairman, I'd like to get two quick questions in here.

[The Chair, Conservative, Ed Komarnicki]

Sure.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Mr. McColeman had an interesting line of questioning going there, and I'd like to give him the back end of my time.

[The Chair, Conservative, Ed Komarnicki]

Sure.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Most of the medical students coming out now would carry about how much in debt? Is there an average amount?

[Chloé Ward]

There are average amounts. Figures that I commonly see are $150,000 to $200,000 when they finish medical school. Then, when you go into residency, the salary is quite limited for the first two to five years, depending on the residency.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Your residency is two years?

[Chloé Ward]

It's two years for a family practice and five to six years for some of the more specialized areas.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Is there a costing on your request about the deferral of interest or payments? Have you guys costed that out? It sounds like an absolutely legitimate and modest ask. It's easy for me to say that on the opposition side, I guess, but have you costed it out?

[Chloé Ward]

Yes, and I can share with you a document afterwards that looks at that. We've met with senior policy analysts with the Minister of Finance, and they've essentially said that this is like a rounding error in the federal budget and that it's almost negligible.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Thank you very much.

I have a question on the practicum before I turn it over. Are they paid positions?

[Christine Nielsen]

No.

[Pat Vanderkooy]

That's the other thing.

[Marlene Wyatt]

They are not paid.