Human Resources committee  I think one of our biggest challenges is that without a human health resource plan, we've never defined clearly how many positions are needed to serve Canadians on different levels of medicine. For example, we know that we need people in primary care. Well, what's that exact number?

Human Resources committee  Thank you, Chair and committee members, for the opportunity to appear before you today. I'm Dr. Katharine Smart, and I'm speaking to you today from Ottawa on the unceded territory of the Algonquin and Anishinabe nations. I'm a pediatrician based in Yukon. As president of the Canadian Medical Association, I am honoured to represent physicians and medical learners from all jurisdictions.

Health committee  I could comment on that. Thanks for the question. From the CMA's perspective, what we would like to see is that the dollars used by the federal government to motivate action at the provincial level are really targeting what we see as the biggest issues facing the health care system.

Health committee  I think there are several aspects that are challenging. We're talking about increasing productivity on a backdrop of people who are incredibly burnt out and already working really extensive hours in conditions that are very challenging to sustain. You've heard from Ms. Silas about nurses being mandated overtime.

Health committee  One of the things we know is that there are huge costs to obtaining training in medicine. That can be a real barrier when you look at diversity in terms of who enters the medical profession right now, and that then, of course, goes on to where people choose to ultimately practice.

Health committee  Thank you for the question. I think there are two aspects to what you're asking. One is the training opportunities for Canadian-trained medical students to enter the residency training process that's required to become a practising physician in Canada. Again, this is part of the issue with not having a national integrated workforce plan.

Health committee  Thank you for the question. No, I don't think we're suggesting that, but I think what we would like to see is better coordination, with one national standard that every Canadian physician can be umbrellaed under, with ongoing co-operation and coordination at that provincial and territorial level, which will still be important from a regulatory perspective.

Health committee  I can comment on that. Thank you for the question. We know there are huge barriers right now for international medical graduates to be able to practise in Canada. There are many physicians who were trained in other countries living here and not working in the health care system.

Health committee  It's a great question. Again, I think it relates back to what some of the structural issues are that are impacting health care delivery. There's no question that some of the existent payment and structural models for primary care are preventing people from choosing longitudinal family practice.

Health committee  There are many reasons why a national licensure could be a huge benefit to Canadians, but I think primarily it relates to access to care. As we're learning more about virtual care and how it can be deployed, a pan-Canadian licence suddenly allows any practitioner in the country to be available to any patient.

Health committee  Thank you, Chair. Thank you, Dr. Hanley. It's such an important question. Burnout underscores so many challenges we're having in the system. Our understanding of the impact of burnout has really evolved over the last 10 or 15 years. We know that levels of burnout in physicians have doubled, as I stated.

Health committee  Thank you for the question. I think at this point we don't have the data to know how many additional primary care providers have been added to the system. What we know is that there are major barriers right now for people providing a longitudinal family practice type of care, as well as many barriers to providing integrated team-based care.

Health committee  Thank you, Chair and committee members, for the opportunity to appear before you today. I'm Dr. Katharine Smart. I'm speaking to you from the traditional territory of the Kwanlin Dün First Nation and the Ta'an Kwäch'än Council. I'm a pediatrician based in the Yukon. As president of the Canadian Medical Association, it's an honour to represent physicians and medical learners from all jurisdictions.