Surplus of foreign residents shortchanging Canadian medical trainees

By Staff

Canadian medical students are being shortchanged in terms of training opportunities by an influx of foreign residents, Toronto health lawyer Tracey Tremayne-Lloyd tells

The Globe and Mail reports that a deal has been reached to keep more than 1,000 medical trainees from Saudi Arabia working in Canada following a diplomatic row between the two nations.

The Saudi government funds its medical graduates to complete their training, and while the newspaper explains that they don’t take spots from Canadian medical graduates because provincial governments fund their own residency positions, Tremayne-Lloyd, principal of TTL Health Law., says that’s not the whole story.

“There’s not enough work to go around, and I think that’s a problem,” she says. “In order to give that many international medical graduates opportunities for learning, it means that Canadian graduates have to be shortchanged in training positions.”

“I’m not saying we shouldn’t be taking any foreign trained physicians, but the numbers are enormous, and it has to be interfering with the learning opportunities for the people that Canadian medical schools are graduating into the system. There should be some measure of balance to ensure hospitals are able to absorb all those physicians,” Tremayne-Lloyd adds.

She says the previous arrangement with the Saudi government incentivized hospitals to take as many residents as they can since they receive hundreds of thousands of dollars for every extra spot created. “It’s a cash cow for them,” Tremayne-Lloyd says. “It is also unwise to build our medical system on foreign physicians who can be ordered back to their home country at any time. We should be building our medical system with our own medical graduates.”

She says uncontrolled expansion in the number of residencies because they are funded by foreign governments, has the effect of watering down the pool of existing work that the system relies on to prepare trainee doctors for the rest of their careers. For example, an eye surgeon may need to do 500 cataract surgeries before they are considered fully competent. Tremayne-Lloyd says, “with hundreds of additional residents and fellows competing for the training, it must have the effect of watering down the training opportunities for Canadian doctors.”

“There are only so many operations and or procedures to be done each year under supervision and if you’re sharing them among an extra 1,000 residents, who also need to be given training opportunities, it’s going to take much longer to hit that number,” Tremayne-Lloyd says. “It’s a serious problem because the Canadian medical grads are the ones who will generally be coming back to work in our hospitals. If they haven’t done enough procedures in training each year to meet the core competence requirement, it’s patients in Canada who will suffer.”

“It’s horrifying as a layperson to see those numbers because there’s no reason to believe people are doing enough procedures to reach the necessary level of competence. It’s something that needs attention,” she adds.

Hospitals in Toronto alone reportedly account for more than 200 Saudi medical trainees under the long-standing program that allows medical graduates from the country to train at Canadian teaching hospitals.

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