Canada must become self-sufficient in physician supply by increasing residency positions, quadrupling re-entry positions and launching long-term, pan-Canadian planning, delegates to the Canadian Medical Association's General Council decided Aug. 17.
Currently, 24% of Canadian physicians are international graduates.
Although international medical graduates can fill the human resource gap on a short-term basis, “[w]ealthy Canadians cannot and must not rely on the systematic recruitment of doctors from countries that cannot legitimately afford it,” said Dr. Peter Barrett, a Saskatoon physician and former CMA president (2000).
Dr. Michael Wilks, Chair of the Representative Council of the British Medial Association (BMA), told delegates sub-Saharan Africa now needs 1 million new physicians, but is losing many to the UK and other developed nations.
“Self-sufficiency is critical to success. If we fail, we can't address the problem globally either,” he told the Canadian delegates.
Nearly half of newly registered physicians and nurses in the UK were recruited from outside the European Union in 2002; most were from the English-speaking countries of sub-Saharan Africa (Lancet 2005;365:1893-900).
“At the moment, richer countries simply aren't doing enough to prevent a complete catastrophe,” said Dr. Edwin Borman, chairman of the BMA International Committee.
In 2003, the UK registered 5880 health and medical personnel from South Africa, 2825 from Zimbabwe, 1520 from Nigeria and 850 from Ghana. The UN Conference on Trade and Development estimates that each African professional migrant represents a loss of US$184 000 to Africa.
The UK has an ethics code preventing active recruitment from some developing regions, including sub-Saharan Africa, but allows doctors from these areas to apply for UK posts.
A May 11 report from the BMA and international partner organizations, including the CMA, found that “lives are being lost because of severe shortages of health care workers in areas such as sub-Saharan Africa, and that further losses of staff will cause the death toll to rise even further.”
The impact of migration from developing to developed countries is a significant component in the crisis, the paper states. It calls for the UK and other countries to end their reliance on overseas doctors and nurses.
Curently, 31% of practising physicians and 13% of nurses were born outside the UK.
The World Medical Association recently reaffirmed its policy that “every country should do its utmost to educate an adequate number of physicians ... [and] not rely on immigration from other countries to meet its need for physicians.”