Alberta doctors sound alarm over low number of grads seeking residency in province

The number of medical residencies in Alberta that went unfilled has grown during the last decade, especially in family medicine, data from the Canadian Resident Matching Service shows.

Numbers released last week show that 12 per cent of Alberta's post-graduate training spots for doctors went unfilled this year after a first round of matching.

It's the highest first-round vacancy rate in a decade, which the president of the Alberta Medical Association said is alarming news for the supply of future doctors.

"To me, that just screams we're failing," AMA president Dr. Fredrykka Rinaldi said in an interview. "People aren't interested in staying or coming to Alberta."

Alberta's health minister and medical school deans tried to quell those concerns, saying there is still time for doctors in training to fill the vacant positions.

Last week, Health Minister Jason Copping said he's asked the deans whether international medical graduates can assume any vacant spots that are typically reserved for Canadian medical graduates, should they still be empty when the process is complete.

"Let's find a plan to ensure that no spots go empty, because we need them," Copping said in an interview.

Many doctors will establish a practice where they complete their post-graduate training. 

The Canadian Resident Matching Service, or CaRMS, each year takes stock of all students graduating from the country's 17 medical schools and their preferred specialty and locations, and tries to match them with residency training programs. Each university also ranks their top picks.

In these two-to-nine-year programs, doctors train in family medicine, psychiatry, pediatrics, surgery and other specialties.

Most of the approximately 3,400 graduates participating each year will get a match in the first round. Others get a placement in the second round. Most provinces also have a set number of resident training seats reserved for doctors who went to medical school outside Canada.

Data posted on the CaRMS website shows that between 2015 and 2021, every family medicine resident position in Alberta was snapped up after the second round. That changed last year, when 11 family medicine seats went unfilled.

The number of Alberta residencies in family medicine that are vacant after the first-round match has grown over the last decade, CaRMS data shows.

Although some programs in Quebec have trouble filling their residency posts, most universities in Western Canada have had few or no spots remaining when the match is finished in recent years.

But last year in Alberta, 17 positions remained vacant.

The latest match results follow Copping's announcement the United Conservative Party government will add 120 medical school training seats and 100 more resident positions during the next several years.

Thirty of the new resident positions will be reserved for international medical graduates, adding to the existing 40 spots.

Copping said last week many of the new resident positions will also be in family medicine training programs set in rural areas, to match the high need.

He said he has asked the universities to consider creating a stream where medical students complete part of medical school in a smaller centre, such as Grande Prairie or Lethbridge, then are automatically placed into residency programs in those areas, without participating in the CaRMS match.

What makes a match?

Dr. Todd Anderson, University of Calgary dean of medicine, said it's crucial medical schools change how they're preparing students for careers.

"Across the country, over the last five or more years, family medicine has become less popular with medical students graduating from medical schools than it was in the years before," Anderson said.

He questioned whether students are seeing enough family doctors as role models and teachers in medical school.

Other new doctors find the idea of starting up their own practice daunting, he said.

Dr. Nathan Rider, a third-year resident in Calgary and president of the Professional Association of the Resident Physicians of Alberta, said he's not hearing that trainees are specifically turning away from Alberta.

Rider said medical graduates consider many factors when picking their top location and program choices, including proximity to family and friends, the culture of a program, whether their partner can find work, cost of living, and their debt load.

Both Alberta medical schools are changing their curricula to emphasize family practice, said Anderson and Dr. Brenda Hemmelgarn, University of Alberta dean of medicine and dentistry.

Both deans downplayed the importance of the first-round match results, saying the second-round result is more meaningful.

Rinaldi sees it differently. Some applicants who wanted to be specialists, but didn't get a match, may choose family medicine as a temporary second choice, she said.

"We may fill them with 42 disinterested people who have no interest in family medicine," she said of vacant Alberta positions.

Rinaldi said word got around about the UCP government's troublesome relationship with doctors, including its unilateral termination of doctors' master agreement in 2020.

Three years into the pandemic, doctors are still paid less for virtual visits, with no immediate resolution in sight, she said.

"The time is over to be politically correct."