‘brain drain’: international medical grads in sask. struggle to become doctors
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jamie eng left canada to study abroad and pursue his dream of becoming a physician, only to return to regina feeling sidelined.
like many canadians, eng had received a medical degree overseas but came back dealing with a system that makes it extremely challenging for aspiring doctors to take up residency in their home province.
many end up working in different fields or going back to school because they aren’t selected for residency after multiple years of applying.
“it’s like being on a basketball team or something. you’re sitting on a bench and you want to play, you want to help,” eng said in a recent interview. “i’m just stuck on the bench.”
at a time when saskatchewan and canada are experiencing a huge shortage of family doctors, some experts have pointed to locally training more people with international medical degrees as one solution to address current challenges.
these people already live in canada, working at your local coffee shop, as taxi drivers, office receptionists or in various other professions. many are also canadian citizens.
the problem is that residency training seats in canada, including those in saskatchewan, are highly competitive to get into. medical students are required to do their residency — a two-year-long supervised period after graduation — to become licensed physicians.
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through the canadian resident matching service, international and canadian grads apply for various residency positions across the country. however, international grads have to compete in a smaller pool of residencies than those who graduated in canada.
for instance, of saskatchewan’s 128 first-year residency seats, 81 were filled by canadian graduates while 47 were filled by international medical grads.
these prospects have already received a medical degree from an accredited school, passed a series of exams and, if required, received a work permit.
however, many of the international graduates who aren’t accepted end up working in the united states, said dr. chiranjib talukdar, a pediatrician who works out of a children’s clinic in north regina.
“and that’s very sad. and we don’t recognize that,” talukdar said. “i get very sad because we are an immigrant country. we got teachers, lawyers, doctors and other professionals. i think we should accommodate them, help them upgrade and help them train to start practising and contributing for themselves.
“there are a lot of unhappy people i have seen.”
dr. anurag saxena, associate dean of postgraduate medical education at the university of saskatchewan, said the number of seats funded is based on the number of physicians needed in a community, though he acknowledged more family doctors are needed in the province.
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he said there’s a larger dedicated number of seats meant for canadian students because they are funded by taxpayers, but added that applications from international grads are encouraged.
he explained international grads have a “good chance” to compete during the second iteration, where local and international grads compete in the same batch.
“i fully understand the situation needs to improve, and i’m confident that it will,” saxena said.
talukdar has become something of a point-person for many in saskatchewan who are international grads but haven’t been able to get residency.
he estimates there are around 300 people in the province in such situations. in fact, he said one of his staff members at the clinic has an international medical degree.
talukdar has also seen one former staff member leave for the united states because it’s easier to get into residency there, he said.
“they get very frustrated,” he said. “there are private hospitals (in the united states) that are very willing to take international medical graduates. they want to excel, they are hardworking and want to succeed. unfortunately, in canada, we are used as a stepping stone. we lose a lot of brains. there’s a lot of brain drain.”
dr. chiranjib talukdar at the 9th avenue north children’s clinic on friday, january 6, 2023 in regina.
troy fleece
/
regina leader-post
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many young people pursue their medical degrees outside of canada because it can be extremely difficult to get accepted into one of the country’s medical schools.
typically, these students stay where they got their degree, even though they want to come home.
“there’s so many people like me, who just want to come home and practice,” eng said. “but after so many years, you just give up.”
those looking to address the challenge say one of the most cost-effective solutions is for the provincial government to create more residency seats for international medical grads. it’s cheaper than creating new medical grad seats at universities.
“for each and every medical student to put through the medical system, you and i are paying $70,000 for each student, each year,” talukdar said, noting that families are usually footing the bill when students study abroad. “if you’re talking about the economy, we’re getting some free people here and now.”
decades ago, he said, it was easier for international graduates to land residency. roughly ten years ago, 499 residency positions were granted to international grads, according to data compiled by the globe and mail. it was nearly 700 in the late 1980s. there were 331 granted in 2022.
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talukdar, who himself graduated from an international decades ago, said he had five years of training in the united kingdom, which was partially recognized at the time.
“in the 1970s, it was much easier to come here,” he said. “the story is different now. i think there are barriers at various levels, and we need to sit down together and find out how we can use these very bright, highly trained people.”
he said collaboration should involve the government, the university of saskatchewan college of medicine, doctors groups and the college of physicians and surgeons of saskatchewan.
talukdar said other provinces and countries are making it easier for international grads to land residencies, particularly in norway, sweden and denmark.
in an emailed statement, the ministry of health said it increased its first-year residency seats from 120 to 128, opening up more opportunities for international grads.
it stated the number of current international grads in residency is “almost double” than it was five years ago. the minister was not made available for an interview.
saskatchewan, like other provinces, is also looking to hire doctors who are internationally trained. the province is staring down a shortage of 2,000 hard-to-recruit staff over the next five years.
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saxena said it’s a matter of having enough doctors to train before more seats can be opened.
“if we have a program that international medical graduates, with all the qualifications, can get into training, i think it will be a win-win for both sides,” talukdar said. “it would be extremely good for canada.”
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