Health committee  Thank you. Mr. Chair and members of the committee, thank you for inviting us back to speak with you again so soon after recently meeting on April 4. This reinforces to us the committee's interest in the acute crisis facing Canada's health workforce. My thanks go also to my CMA and CNA colleagues for working together with the CFPC in a spirit of collaboration on an issue that is truly important to the well-being of Canadians.

Health committee  Absolutely. That's why we see physicians moving out of practice. That trend was there prepandemic as well. They're moving out of comprehensive office practice and moving into areas such as hospice care, obstetric care and emergency medicine—areas where they do not need to carry the burden of overhead and staff salaries.

Health committee  Absolutely. As I mentioned, although it's not my personal experience, our urban areas—Vancouver and the greater Toronto area—are certainly feeling it the most, but we're feeling it across the board. I want to emphasize again that in the fee-for-service setting where family physicians are running a business, they need to pay for a medical office administrator, a clinical nurse and salaries within their clinic.

Health committee  Yes, absolutely. That's part of the rural road map that Dr. Lemire mentioned before, which we've collaborated on with the Society of Rural Physicians of Canada. The key to recruiting rural physicians to practice rurally, whether that's family physicians or specialists, is to recruit medical students from those communities.

Health committee  Certainly, the advent of virtual care has made it easier for patients to access specialist care across geographic barriers. That's certainly a barrier for rural physicians. I practice rurally. An additional contributor to burnout of rural physicians is the moral injury of trying to get patients access to care that they might have been able to access in a more urban setting.

Health committee  Thank you, Dr. Lemire. Certainly, there were significant adaptations throughout the pandemic from physicians stepping into areas where they don't traditionally practice or haven't traditionally practised. They have done their best to provide a high quality of care to Canadians, but that's certainly leading to burnout as well.

Health committee  The obvious answer is that we need to increase medical school enrolment and residency places across the country, and we have to make the practice environment enticing to learners. We're only going to entice medical students and residents to train in family practice when they can see that their preceptors or teachers are thriving and enjoying their practice environment.

Health committee  If you wouldn't mind, Dr. Lemire, I will. There are multiple parts to that question, of course. The IMG assessment programs that I'm familiar with are provincial, so there's certainly provincial responsibility there. One obvious structural barrier is that after a certain number of years of not practising in Canada, IMGs are, to my understanding, generally not eligible to enter retraining and assessment programs.