I saw this on Pinterest and thought I’d give it a try (it says it’s a “no-fail” happiness challenge, right?). Although, should happiness be challenging?
Day 1: Name three new things you are grateful for when you wake up. Continue for 29 more days.
- I’ve woken up (will not always be the case)
- It’s a holiday today
- About 100 books are waiting for me on my Kindle
Hi
I happen to read your post related to health care system in Canada and really appreciate the time you take out of your schedule to spread awareness on various topics. I am a medical graduate from Canada who is doing a medical residency in the United States on J1 visa. I would really appreciate if you could guide me on how to fight my case against the Statement of Need policy changes introduced by Health Canada in consultation with various lobby groups. This policy is adding road blocks and discouraging me from pursuing sub-specialty in Cardiology. There are many like me who are impacted by these unfair changes which are not only detrimental to its budding students but also to Canadian public health care. Below, is what I wrote to in my last email to J1 visa admin, Deputy Health Minister, and PM Trudeau:
The Honorable Prime Minister and Deputy Minister of Health Canada,
Sub: Health Canada mission statement is for public health care or RCPSC health care?
Honestly, I had to ask what I feel after going through the slides that ECFMG passed on to me regarding the recent changes in the Statement of Need (SON) policy presented by SON review committee within Health Canada. I would like to ask since when did more doctors become a problem for a country.
I am a medical resident in an Internal Medicine program within the US. Before I give my subjective comments, I would like to give some preliminary data on Cardiology subspecialty, which is my field of interest against the data presented to us by SON review committee. If you look at the slides by CMA on Cardiology profile (which one can get by simply googling), there are around 3.5 Cardiologists per 100K of the population. Furthermore, their number rather decreased from 2015 to 2016. The slides presented to the ECFMG on per 100K of the population by the committee not only lacks a full picture but also doesn’t apply to (at least) my field of interest. On top of that, we don’t know how many of the very few (single digit number) who went to the US to do Cardiology came back. So my obvious question is how is it fair to believe that they would saturate this job category?
The increase presented in one of the slides is primarily driven by Primary care field, which is a good sign as we need more of them. However, it doesn’t mean we don’t need sub-specialists who are also the researchers. Family medicine is already a lucrative field in Canada. Right after 2 years residency, one begins employment as a doctor while in Cardiology one has to spend at least 4-5 more years than that. The competitiveness and duration of the sub-specialties (their numbers per 100K are itself a proof) is more than enough to keep the numbers low and it doesn’t need any intervention by Health Canada. Moreover, getting into sub-specialties or even Internal Medicine specialty program in the US will be tougher in future. With stagnant budget allocated by US government and an upcoming huge increase in American graduates, there will be a significant decrease in slots given to foreign countries (Canada is one of so many).
The Stats talk about practicing doctors fear unemployment. This not only would sound hilarious to a common Canadian but is also offensive to someone who deals with real unemployment problems in other job sectors.
If some doctor doesn’t want to relocate or get everything he/she wants, he/she is considered unemployed? Health Canada should ask the public on how they feel about sub-specialists appointments rather than relying on RCPSC cherrypicked data. Or, even, it can take a look at the waiting queues of patients to get an idea on the unemployment of doctors. The whole world knows what it takes to get a sub-specialist appointment in Canada even in the urban areas. Health Canada is wrecking my aspirations to do sub-specialty in cardiology and making me scapegoat without even knowing the US trained students impact on Canada. Instead of relying on RCPSC handpicked data, why it doesn’t ask RCPSC ( an organization funded and formed by practicing doctors) to do a study on the impact of students who are sent to Ireland by their member doctors and then getting them absorbed in their programs through their connections? Why would a practicing any doctor wants other doctors in his/her area. It’s high time that Health Canada reviews the policies in place by RCPSC instead of relying on its cherry-picked data. Before, the excuse given by RCPSC for not meeting the need for doctors was that the residency slots are govt. funded and due to limited resources, doctors needs can not be met. Now, Canada is getting doctors well trained by U.S. Govt., RCPSC has a problem with it and is lobbying to add some level of complexity to discourage them from pursuing higher studies. While other countries feel indebted to this US-funded training program where they can get well-trained doctors and proven researchers free of cost, Canada is putting interests of unfair practicing doctors ahead of the Canadian public health care and careers of their budding students.
Unlike the kids who are funded and pursued by their parents to pick a career in the medicine field, I am driven by my interest and passion for pursuing this long journey. My family knows that I wanted to be a Cardiologist even before I began my school and when my grandfather suffered a heart attack. It’s my passion, my interest of work and I have worked hard my whole life to deserve this. I did not burn the midnight oil to settle for something that doesn’t interest me. I did not just pass but aced exams to become competitive for this sub-specialty. I have been doing side projects and research for long to be a strong applicant. These new complex changes and classification of candidates into categories will make me incompetent. Health Canada doesn’t have the right to break my back and decide my education.
The new policy changes are not only reckless, biased, inconsistent and defective but they even fail to meet the objectives for which these changes are made. The data presented in the slides is shallow and seems to be handpicked with a particular agenda in mind to target a particular group of applicants. Again, the study is missing a key input on how many trained doctors get SONs and how many of them come back to affect the workforce. I expect Health Canada to be an unbiased organization whose mission is to improve Canadian public health, and not RCPSC health.
While my colleagues are focused on building their profiles for fellowships slots, I am using this my time in writing this long email after my long work shift. The Honorable Ministers, I really appreciate if you could pay attention to this issue as it is set to ruin careers of many without benefitting anyone. I would also request Health Canada to carefully review this policy which is going disrupt the education of us like medical residents.
Regards,
David
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The information on new changes are here: http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/postgrad-postdoc/index-eng.php
To give more background on this: United States has this Physician Exchange program through J1 visa that requires Statement of Need (SON) from the country, which basically allows Physicians or medical graduates from foreign countries to participate in the residency program in the US. For this, ECFMG is the US body that makes sure foreign Physicians or graduates pass all the requirements as any American medical graduate would do, to be eligible to participate in the match. The match process favors American graduates the way our Canadian CaRMS favors, however, they accept some exceptional candidates. It might seem on the surface that United States is training them for free but they have a waiver system where they allow foreign country graduates to stay under some conditions. Now only Canadian and American Physicians regulatory bodies approve each other’s trainings. Canadian govt. has not spent a penny on my education and now, they have problems with me getting trained in the United States.
I have whole lot of analysis done with much more to do, however, I am too busy to follow this due to my busy schedule. My job is to look after patients and not fight against unfair policies. I don’t have resources to fight against this. So, I am looking for a platform where my concerns would be heard.
I was wondering do you have contact of Sir Neil MacDonald from cbc as I would like to write to him about this.