They did not examine the supply and demand of medical specialists in specific regions like northwestern Ontario. “I think it’s important when you look at the study not to jump to conclusions,” he told CBC News, addingthe study doesn’t consider how the demand for various types of specialized medicine might change in the future. Strasser said medical specialists who have the most difficulty finding jobs are likely located in other larger urban centresin the province. Dr. Stewart Kennedy, executive vice-president of academic and medical affairs at Thunder Bay Regional Health Sciences Centre, agreed. Dr. Stewart Kennedy, executive vice-president of academic and medical affairs at Thunder Bay Regional Health Sciences Centre, says northwestern Ontario is finally gaining much-needed medical specialists. (Nicole Ireland/CBC) “Sometimes [specialists are] unable to find a position in a locality that they want,” Kennedy said. “So I think we really have to look at the distribution of physicians [geographically].” ‘Advantage’ in northwestern Ontario Kennedy said NOSMis accomplishing its goalto graduate much-needed physicians and specialists to work at the hospital and in the region. “We had challenges with human resources for a good number of years,” he said. “We have increased medical student enrolmentby … 40 or 50 per cent over the past eight years, because we’ve had such shortages,” he said. “It’s playing to our advantage in northwestern Ontario because we are able to recruit top, talented doctors [who], at one point … always wanted to stay in an academic centre in eastern Ontario.” Strasser saidthe Royal College report shows the need for better medical workforce planning at the national level to ensure doctors are trained in the specialties where there is projected demand,and available to work in the geographic areas where they are needed.
Some fertility MDs lack proper training, specialists say
“This is about physicians training physicians to provide the highest quality of care that we have available,” said Dr. Roger Pierson, professor and director of research in the department of obstetrics, gynecology and reproductive sciences at the University of Saskatchewan in Saskatoon. One of the biggest concerns involves the use of injectable fertility drugs known as gonadotropins. The drugs stimulate a woman’s ovaries to produce multiple eggs. However, in some cases, the woman “over responds,” producing so many egg follicles that the ovaries grow big, fat and swollen. Fluid can leak into the chest and abdomen. In rare cases, ovarian hyperstimulation syndrome can lead to blood clots, kidney failure or death. Gonadotropins are frequently used in combination with intrauterine insemination, or IUI, where sperm is injected directly into a woman’s uterus; experts say the procedure is being widely practised outside fertility clinics. Last year, Ontario alone paid for 22,806 insemination cycles performed on 8,725 women. “It’s in a load of different places,” said Toronto fertility specialist Dr. Carl Laskin, a past president of the CFAS. “(Gonadotropin IUI) is easy to do,” Laskin said. “The problem is it’s also easy to do unsafely and easy to do wrong.” The risk of a multiple birth – twins or more – can be as high as 30 per cent. Blood tests and ultrasounds are required to measure hormone levels and determine how many eggs are maturing. If the woman produces too many eggs, the cycle should be cancelled. “IVF clinics have the option to convert those patients to IVF,” said Dr.
‘Surplus’ of medical specialists in Canada no surprise
It is not that the one in six implies that Canada now has an overall surplus of specialists, any more than the widespread claims of shortage in the mid-1990s meant we then had an overall shortage of physicians. Both then, and now, we have, rather, an inability or unwillingness as a country to develop plans and policies designed to train and deploy physicians in a sensible manner. The report was, however, correct in noting that there is no quick fix here. The Royal Colleges plan to convene a meeting early next year to discuss a nationally coordinated approach to health system workforce planning may be a useful start. It is difficult to imagine the recommendations that might emerge from such a meeting being worse than the current uncoordinated mess. At present, policy decisions, or often the lack thereof, are failing to meet the needs of new trainees or of patients. For example, there are no national (and few provincial) mechanisms in place to channel new graduates into the specialties where they are likely to be most needed rather than into the specialties most needed by teaching hospitals or most favoured by students. And despite the fact that we live in a hyper-active era of tweets and blogs in which the new generation seems to be constantly connected, there is no structured electronic meeting place for job hunters and job seekers. New graduates are somehow failing to figure out where the jobs are (and there are, in fact, plenty of communities desperately seeking specialists). In some cases, at least, the new specialists are simply the victims of the completely predictable fallout from that earlier medical school expansion. When those Ministers of Health agreed to fund an approximate doubling of medical school places, what did they think would happen when those students started graduating? Was there a plan in place to ensure that the complementary resources that are required for their practices would also be funded and in place? In a word, no. For example, operating room capacity or at least working capacity, meaning an available operating suite plus the funds, supplies and complementary staff to operate it has not kept pace. To make matters worse, the capacity is not used efficiently, and some of those who control that capacity are not all that keen to share with their younger brethren. The consequences for our future many more new physicians looking for practice opportunities each year than old physicians retiring are as predictable as what we are seeing in the Royal College findings today. Ministries of Health need to engage now in two separate but related conversations one about policies designed to take advantage of all these new highly skilled and motivated physicians available to Canadians, and a second about how to avoid repeating old policy mistakes down the road.