Tuition battle at U of T far from over
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* Patrick Sullivan

The battle over new tuition fees for medical residents at the University of Toronto is far from over, the university warns. Even though first-year residents will not have to pay the $1950 fee this year because the province has agreed to pick up the tab, it appears that the university has no intention of backing down.

The residents, led by feisty PAIRO (Professional Association of Internes and Residents of Ontario) President Joshua Tepper, reject the tuition fee outright, arguing that they already save taxpayers millions by staffing Toronto hospitals for less than half the OHIP rate. They also maintain that they save the university "millions" by teaching undergraduate medical students for free. Groups speaking out in support of them have included the CMA and Ontario Medical Association.

The issue was put on hold for a year after the province agreed to pay the fee for first-year residents this year - a move that did not sit well with some observers. Dentist John Mayhall, who chairs the university's Academic Board, told the U of T Bulletin that postdoctoral dental students pay tuition fees during their equivalent of residency training. They also serve the public and teach undergraduates. "The arguments have not changes," he said. "Pressure from a well-organized pressure group should not cause us to reconsider a decision we've already made."

Dr. Murray Urowitz, the university's associate dean of postgraduate medical education, had little sympathy for the residents. "Residents applying to the U of T all knew that applying to us meant paying a tuition of $1950, yet they still applied and were selected," he told CMAJ. "When we sent out our letters of acceptance, we added no new regulations. [And now] many of the trainees have decided to renege on their contract."

The next step in the dispute is an internal review. Urowitz said the task force that will conduct the review was to be appointed in early August, and will likely take 6 to 8 months to complete its work.

He said the university was introducing the fees simply because the province has cut its education grants and "the funding had to come from other legitimate sources."

He said the university remains adamant that medical students pay the tuition fee, and the Canadian Resident Matching Service will include this fact when it provides information to residents applying for the 2000 match. "The real issue here is not the tuition fee," he said, "but the funding of post-graduate education in this province."

PAIRO, meanwhile, would like a 2-year moratorium on the fee. Tepper says PAIRO will participate in the internal review "but we strongly believe that imposing tuition does not recognize the contribution that residents make to the bottom lines of hospital and universities."-Patrick Sullivan, CMAJ