When Dr. Judith Hall, head of pediatrics at the Children's and Women's Health Centre of BC, took up her position in 1990, she found that British Columbia had the lowest number of pediatric subspecialists in Canada, and only 5 new ones were being trained annually.
The result? In the last 5 years, says Hall, at least 50% of the province's subspecialists have been recruited from overseas. BC currently has about 90 pediatric subspecialists, well below the national average. Hall says fees and working conditions make it difficult to attract applicants. These subspecialists receive the same fee as a general pediatrician for an office visit even though they may spend up to 3 times longer with a child. In addition, some are always on call. Hall would like to see this reduced to 1 day in 4.
Despite the daunting conditions, turnover is not as serious a problem as recruiting: only 2 of the subspecialists, most of whom practise at the Children's Hospital, left in the last year.
Hall says BC offers excellent teaching and research opportunities, but "if [doctors] are so overworked, how can you be expected to show leadership?" She wants to work with the Ministry of Health to develop a national physician resource plan that would at least allow the province to meet the national average for practising subspecialists.