Why is NS Seeking International Doctors Over Local Doctors? 

The Tim Houston government’s recent announcement to bring in foreign doctors and nurses raises an important question: what about the local talent we already have in Canada?

As of 2023, Nova Scotia is home to approximately 2,800 (approx depending on source) family doctors (GPs). At Dalhousie University alone, 436 medical students are currently enrolled in their four-year MD program, with more than 91 percent coming from the Maritimes. With such a significant number of aspiring doctors right here in our province, why aren’t we offering them positions first? We could provide additional experience and support until they are fully ready to practice independently. If we implemented this approach annually, it would help address Nova Scotia’s physician shortage and create a steady influx of new doctors. Moreover, this initiative could extend to other universities across Canada, further expanding our local talent pool.

The current steps taken to focus on international recruitment seems misguided when we have a wealth of qualified candidates domestically. It’s not about refusing to hire foreign-trained doctors or nurses; rather, it’s about prioritizing Canadian talent and ensuring they have the first opportunity. The Houston government is claiming that they will be able to attract Canadian doctors working abroad through this program and it would allow them to return home to work. Which sounds warm and fuzzy when you say it. However, there are no clear percentages or targets provided that detail this initiative. We have no real way of knowing if this will happen or by what means they will seek to attract Canadian doctors and nurses, that are presently working in other countries.

Approximately 3,500 Canadians study medicine abroad each year, with around 60% applying for residency in the U.S. and only 20-25% securing spots in Canada. This situation stems from government policies that reduced medical school seats and residency spots. Our healthcare system has failed internally, and correcting this is essential to retain qualified physicians within Canada. In other words, we are losing approximately 75% of our trained doctors to other countries because of our system’s flaws. Why is this not being corrected because if it were we would have never had a doctor shortage in the first place? 

Additionally, we cannot overlook the situation with nurses in Nova Scotia, especially concerning the government’s stance on unvaccinated healthcare workers. The repercussions of this policy have further strained our healthcare system and raised ethical questions about employment rights and public health. It’s time for the government to reevaluate its approach and consider the valuable contributions of local healthcare professionals who have the potential to help heal our system.

The purpose of this post is not to criticize the Houston government, as we need more doctors and nurses in the area. Rather, it is to question their methods for acquiring them. Why are we not focusing on attracting more local doctors?

How did we get into this mess in a nutshell
In the 1990s, Canada reduced medical school admissions and residency positions, anticipating an oversupply of doctors. At the time, the population was smaller (around 27-28 million) and younger, so the healthcare system was manageable. However, today, Canada’s population has grown to over 40 million, with a much larger aging demographic that needs more healthcare services.

In addition to Canada’s official population of over 40 million, there are many individuals residing in the country who aren’t included in the population total. These can include temporary residents, such as international students, temporary foreign workers, asylum seekers, and undocumented individuals. While exact numbers vary, these groups contribute to the demand for healthcare services but aren’t always factored into population counts, further increasing the strain on an already stretched healthcare system. This unaccounted-for population exacerbates the shortage of doctors and the challenges of meeting healthcare needs.

Aging Population

  • 1990s: The median age of Canada’s population was about 34 years.
  • Now (2024): The median age is over 41 years, and the proportion of people over 65 has significantly increased.
    Impact: An aging population requires more frequent and complex healthcare services. Older adults generally need more ongoing care, increasing the strain on family doctors, specialists, and hospitals. This aging demographic exacerbates the doctor shortage.

Despite increases in medical school admissions and residency spots in recent years, they haven’t kept pace with the growing population and healthcare needs. The shortages are most acute in rural areas, where attracting and retaining doctors is increasingly difficult.

What is this costing us
As of 2023, Canada’s healthcare budget is approximately $308 billion. Most of this funding comes from provincial and territorial governments, which cover about 70% of total spending, including hospitals and physician services. The federal government contributes through the Canada Health Transfer, projected to reach $49 billion by 2024-2025. While Canada primarily relies on a publicly funded healthcare system, some private spending exists for services not covered by the public system.

Let me put this in simple terms: if we divided this cost among all 40 million people, the cost of the Canadian healthcare system per person, based on a total budget of approximately $308 billion, is about $7,700 per year for each person. Let that sink in for a bit.

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