Says decline in foreign doctors reflects recruitment, retention success at home
Dr. James Rourke has a good explanation for the steady decline in international medical graduates (IMGs) in this province. And he says it's good news for Newfoundland and Labrador.
Saskatchewan and Newfoundland still have the highest percentage of foreign-trained doctors in the country, according to a recent Canadian Institute for Health Information (CIHI) report.
But the percentage of IMGs practising in Canada is on the decline.
In 2007, the CIHI reported Saskatchewan had 48.8 per cent of foreign-trained doctors, while Newfoundland and Labrador had 35.2 per cent, down significantly from almost 60 per cent in 1977. Quebec and Prince Edward Island had the smallest proportion of foreign-trained doctors, at 10.7 per cent and 13.8 per cent, respectively.
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Rourke, Memorial University's dean of medicine, said the first students graduated from MUN's medical school in 1973. Prior to that time, Newfoundland had no medical graduates of its own. Doctors in the province would have been trained in other parts of the country or would have been IMGs.
"So, we've seen a cumulative effect of giving the opportunity for students here to train here and stay here," Rourke said.
"In fact, when we look back over some of our statistics, they're really quite good."
Among recent graduates, he said, about 72 per cent have set up practice in the province.
"And of those who set up practice in the province, we know that five years later, at least 80 per cent are still here," Rourke said.
He ranks recruitment and retention as being of equal importance. When a province recruits a lot of IMGs, he said, some stay, but a lot of them move on very quickly, whereas "our own graduates, once they set up practice here, they want to stay."
While foreign-trained doctors have contributed a lot to the province's health-care system, Rourke said he's pleased the provincial government has been 100 per cent supportive of a MUN medical school expansion - including facility, faculty and staff. This, he says, will ultimately enhance physician recruitment and retention.
The normal class size for the MUN medical school has been about 60, including 40 Newfoundland students, 10 from New Brunswick, two from Prince Edward Island and eight from other parts of the world.
Rourke said this past year, the class size was increased to 64. The 2009 admission criteria consists of 46 seats for Newfoundland, 10 for New Brunswick, four for P.E.I. and four for international students.
That's the maximum that can be accepted now, Rourke said. However, he said, detailed projections estimate that at least 60 students from Newfoundland and Labrador need to be accepted each year to stabilize the local physician workforce.
The new school is in the detailed architectural planning stage now. Construction is expected to begin early in the new year.
Rourke said it will accommodate an increase in class size to 80-plus students, including 60 from Newfoundland. He anticipates the first larger class of students in 2012.
As well as being a "state of the art medical education facility," Rourke said, the new school will include a clinical learning centre with facilities for simulated medical scenarios.
Rourke said people from Newfoundland and Labrador have a strong bond to this province, and the majority of them - if they have appropriate facilities, clinical support and funding - will choose to stay here.
Increased competition and shortages of health-care professionals across the country present challenges, especially in rural areas, Rourke said. That makes it more important to provide facilities and support teams for physicians.
"It's not just the money that's paid to the doctor, but it's the whole package that makes it a good place to work," he said.
About 40 per cent of MUN medical school students come from rural areas, compared to 11 per cent for the rest of Canadian medical schools, Rourke said. And 41 per cent of the school's family medicine graduates go into rural practices, compared to a national figure of 13 per cent for other medical schools.