Science and Research Committee on May 5th, 2022

[Chad Collins, Liberal, Hamilton East—Stoney Creek, ON]

Thanks, Madam Chair.

Perhaps I could start with Dr. Leonardi and Dr. Bridge-Cook from McMaster. I was very intrigued with the suggestion of support for the centres of excellence concept they submitted to the committee. I'm interested in understanding how that would work in its implementation and in its form.

[Dr. Mathew Leonardi]

Thank you again for the invitation to be here tonight.

Centres of excellence in health care are not a new concept in Canada. They are established already in certain health domains, including cancer, bariatric surgery and mental health. The concept of endometriosis centres of excellence is built on some of the foundational work that others have already done to establish a network of individuals with clinical expertise but also academic research expertise on a topic.

The goal of a centre of excellence is really fourfold. The first domain is to improve the quality of care and the patient experience. The second is to improve population health. The third is to lower the cost of care because it is being done correctly the first time. The fourth is to improve the health care professional experience, which speaks to this purpose of the committee tonight around the retention of talent.

In Canada, being a gynecologist is quite challenging due to a number of barriers. Staying in Canada can be a challenge, particularly for those who want to maintain a strong research interest. There are really not very many centres around the country that are particularly supportive of research in the domain of endometriosis and research in gynecology in general. The centre of excellence would really support that concept as well.

Beyond the actual centre, we would need to build communities of practice around that to support the various regions around the centres of excellence that could be established at academic institutions with a health care affiliation.

[Chad Collins, Liberal, Hamilton East—Stoney Creek, ON]

Thanks, Dr. Leonardi.

Can I ask a follow-up on that? The report that we'll deal with here on top talent will drive policy decisions and funding. What does the funding model look like to support the concept that you just highlighted?

[Dr. Mathew Leonardi]

At present, health care is provincially funded. Gynecologic health care is not particularly prioritized. This is something that various institutions individually are trying to advocate for, including my institution at Hamilton Health Sciences and McMaster University. I'm incredibly grateful that they are making those strides.

Really, the idea around health care funding is provincial, but the idea of federal funding for research is how the academics who will drive forward clinical science and basic science in particular, as well as social science, will be able to work effectively in their institutions and collaboratively in an interdisciplinary model. It's partially health care provincially as well as federally through grant agencies.

[Chad Collins, Liberal, Hamilton East—Stoney Creek, ON]

Madam Chair, I will share the rest of my time with my colleague Ms. Diab.

[Lena Metlege Diab, Liberal, Halifax West, NS]

Thank you very much.

I want to continue with that, Dr. Bridge-Cook. Since I became an MP seven or eight months ago, I've had constituents who have this disease contact me in my office and sort of educate me about it. Can you talk about your experience for the committee and for the public record? I would like you to share whatever you're able to share with us.

[Dr. Philippa Bridge-Cook]

Sure.

I started having symptoms of endometriosis as a teenager, but because there's very little menstrual education in schools about what's normal, I didn't really know that my symptoms were abnormal. And that's the case for many people with endometriosis, they're just not aware that the pain that they experience with their periods, other pelvic pain throughout the month, gastrointestinal symptoms, bladder symptoms, fatigue, these things can all be a part of endometriosis. As teenagers, you don't know what's normal, there's a big taboo and stigma associated with talking about any symptoms that are associated with menstruation, so that prevents teenagers from coming forward. I never really spoke about that when I was a teenager.

I went to university, I started graduate school, I was doing my Ph.D. in medical genetics, so I was in a biomedical field and I still had never heard the word “endometriosis,” which is shocking in retrospect, but kind of not, because it's just not a topic that's generally understood or talked about. During graduate school, I realized that being debilitated for one week a month wasn't something that could move forward with me as an academic researcher, so I sought out other career options for myself.

After I was married, I wanted to have children, and my husband and I started trying to conceive and I ended up having recurrent miscarriages. I had six miscarriages with no known cause at the time; I still did not have an endometriosis diagnosis, although I'd started describing my symptoms to doctors. I saw five different gynecologists, and nobody gave me a diagnosis of endometriosis. I continued having miscarriages, nobody could explain why. Eventually, I had a very large endometrioma, which is a lesion of endometriosis on the ovary, and that was visible by ultrasound, which is how I ultimately got in to have surgery, confirm the diagnosis of endometriosis and treat the endometriosis at the same time.

[Lena Metlege Diab, Liberal, Halifax West, NS]

Dr. Bridge-Cook, I want to thank you for coming and sharing that with us publicly because it will go a long way to help many women and many families across the country.

Thank you.

[The Chair, Liberal, Kirsty Duncan]

Thank you, Ms. Diab.

Dr. Bridge-Cook, I think everyone here's heart goes out to you, and we're grateful for your courage, for coming to share that story and fighting for others.

[Dr. Philippa Bridge-Cook]

Thank you.

[The Chair, Liberal, Kirsty Duncan]

I'm now going to give Mr. Blanchette-Joncas the floor for six minutes.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Thank you, Madam Chair.

I'd like to welcome the witnesses who have joined us this evening to participate in our study. I would like my thinking to line up with their testimony, of course.

But I am still going to come back to attracting and retaining talent, the subject of the study.

Mr. Khoo, my first questions are for you. I'd like to say that your testimony particularly affected me. It's good to hear someone at the committee describe their career for us. In your case, that career led you to leave Quebec, and in fact Canada.

What changes do you think the federal government should make to avoid the kind of situation you went through that led you to leave the country?

[Dr. Shaun Khoo]

I think that the key things to change at a federal level are to improve the availability of funding and to improve the salaries that are offered to post-doctoral fellows. I think that there are also things that can be done around immigration to make, for example, the renewal of a work permit faster and easier. For example, at the moment, the work permit renewal is basically the same as a full application, so it takes a substantial amount of time to be processed and involves a significant cost not just for the researcher, but for the institution that's hiring us in as foreign post-doctoral or foreign temporary workers.

Other than that, the main thing, as I said in my opening statement, is to increase salaries and improve working conditions.

Thanks.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Thank you for your answer.

What do you think are the main obstacles for students who want to complete a doctorate?

[Dr. Shaun Khoo]

I think that there are a few obstacles. I think the biggest one, of course, is job security. It's very difficult to continue through all of your 20s and 30s on one- and two-year contracts, not knowing where you'll be or what you'll be doing in a few years.

There's a constant interest in alternative career paths, which can have great benefits for the rest of the economy. Skilled talent is needed, not just in academia but also in business and industry. For a lot of young researchers, that is a very difficult thing and a constant source of anxiety. Job availability is a big one.

Watching all of your non-academic friends and acquaintances be able to settle down, buy houses, have families and things like that is quite difficult for a lot of young researchers. That's one of the push factors that I think keeps people leaving academia and research.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

That's very interesting.

What could the federal government do to take on responsibility for that, of course, but also to improve the employability of doctorate holders in Canada?

[Dr. Shaun Khoo]

I think there are a few things that graduates struggle with in terms of finding jobs after a Ph.D. or other graduate research programs. For example, one is knowing what you can do. I think that, if the federal government were to provide some more support in institutions to provide more career training to graduate students, then they would be better able to identify alternative career paths and see how they can adapt their training during their Ph.D.s or master's to better prepare them for those alternative careers.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Thank you.

A report published last year by the Canadian Council of Academies said that employers were not recruiting enough doctorate holders, even though, as everyone knows, doctorate holders represent a skilled and trained workforce.

What should we conclude from that finding? Collectively, what are we losing when we don't enable these skilled and talented people to find a job easily?

[Dr. Shaun Khoo]

I don't fully agree that there is a shortage of Ph.D.s. I think there is an oversupply of Ph.D.s, and I think that the difficulty is matching the talent to the jobs. As I said in my opening statement, between 80% to 90% of Ph.D. holders will not find permanent jobs in academia. I think that's partially because the vast majority of people who do Ph.D.s want to find a job in academia. There is this process that I think a lot of Ph.D.s and postdocs go through where they learn that maybe a job in academia isn't the be-all and end-all of their career and that there are other equally worthwhile and rewarding careers outside academia.

I think that integrating this into our training programs is something that is really important and could better help people match their expectations and job searches as they develop during their Ph.D.s and through their early postdoctoral years.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Thank you for that information.

Mr. Khoo, if the government offered you incentives to come back and work in Canada, in Quebec, what incentives would be of most interest to you?

[Dr. Shaun Khoo]

I think it would be hard. In my case, the reason I'm back in Australia is mostly personal. It's to be near family and in my country of birth.

I think that a permanent job with good pay would be right up there. I think that's what I have now in Australia. I think a permanent job with good pay and a visa to go with it would be what would drag me back to Canada.

[The Chair, Liberal, Kirsty Duncan]

Thank you so much, Dr. Khoo.

Thank you, Mr. Blanchette-Joncas.

Dear colleagues, we will now go to Mr. Cannings for six minutes, please.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Thank you.

Thanks again to this set of witnesses.

I'm going to stay with you, Dr. Khoo, and drill down on some of the issues that are purely monetary in many ways.

You mentioned that the private sector out-competes the academic sector. I recall when I was working summers as a biological student helper being shocked to find out that the geological prospectors that I met—students like me—who were working for the summer with private companies in the Yukon mountains were making six times what I was making. I thought very seriously of going into geology at the time.

One thing we haven't talked about.... We've heard about the grad student funding that NSERC and other of the tri-councils provide, and the post-doc funding. I think you've looked at some of the funding that is provided for these jobs between years when students are trying to get experience that will be valuable in the years to come.

I'm reading something you put together that said the NSERC undergraduate programs for these summer jobs, even after the university kicks in their share, are barely minimum wage, if at all. Is that what you found?

[Dr. Shaun Khoo]

Yes, that is exactly what I found.

If you do the math on how much a summer scholarship would pay a student and how much we would have them work—and be assured that we work them hard, because we want them to get the best out of their experience—in terms of the pay they would get relative to the effort, it would be at or below the minimum wage. I think it would be in the order of $11-something per hour, which is less than the proposed $15 minimum wage.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Things haven't really gotten much better since the 1970s when I was doing that. That's very interesting. I would see a lot of students think twice about staying even at that level.

I'm wondering, since you have this experience in both Australia and Canada, if you could compare some of the.... We hear about rising tuition costs. Every year, tuition seems to go up, yet the funding for a grad student stays the same. As you said, you don't get a raise; you get a pay cut every year.

Could you talk to the tuition fee side of things? How does Canada compare with the rest of the world in that regard?