Surgical team in operating room

Just under 20 per cent of recently certified specialists said they'd look for work outside of Canada, which could promote a 'brain drain' to the U.S., researchers say. (Scott Quintall/UCLA/Reuters)

About 16 per cent of newly graduated medical specialists in Canada say they can't find work, according to a new report suggesting that the economy, hospital resources and personal preferences are driving the unemployment problem.

For Thursday's report from the Royal College of Physicians and Surgeons of Canada, titled Too Many, Too Few Doctors? What’s Really Behind Canada’s Unemployed Specialists? researchers interviewed more than 40 people with in-depth knowledge, such as deans of medical schools and hospital CEOs, and conducted an online survey of 4,000 newly graduated doctors.

Among respondents, 208 or 16 per cent reported being unable to secure employment, compared with 7.1 per cent of all Canadians as of August.

Urologists, critical care specialists, gastroenterologists, ophthalmologists, orthopedic surgeons and general surgeons, and doctors from other sub-specialties were among those who said they were unemployed.

The report's authors said there were three main drivers:

  • More physicians competing for fewer resources such as operating rooms and hospital beds at the same time that relatively weak stock market performance meant many specialists were delaying their retirement.
  • Slower job growth for specialists as the health-care system in some cases substitutes other health professionals — such as nurse practitioners and physician assistants — for physicians. Established specialists may also be reluctant to share resources such as operating room time.
  • Lack of adequate career counselling and personal choices about type and location of practice when new graduates have family responsibilities (spousal employment, caring for children or elderly parents) that make it harder to move to job opportunities.

Half of respondents in 2012 said they hadn't received any career counselling.

Dr. Christine Herman is a recently trained cardiac surgeon. She is like about 31 per cent of new specialists who said they chose not to enter the job market but instead pursued more training, which they hoped would make them more employable.

Herman said medical schools and the provinces and territories need to do a better job of workforce planning.

"I think that the training programs aren't in sync with the needs that are out there," Herman said. "Long-term planning, committee planning for job availability is needed."

Steven Lewis, a health policy consultant based in Saskatchewan who was not involved in the study, thinks the situation will worsen.

"I think that there is no question that ... almost doubling medical school enrolments since the late 1990s combined with easier paths to licensure for international medical grads was the wrong thing to do. We didn't think it through as a country."

Just under 20 per cent of recently certified specialists said they'd look for work outside of Canada, which could promote a "brain drain" to the U.S., the report's authors said.

Dr. Andrew Padmos, chief executive officer of the Royal College, said more research and consultation needs to be done to understand the challenge. The college would like to see a pan-Canadian think-tank to plan the health workforce. Australia, Britain and the U.S. have such bureaus.

The college sent the survey to 4,233 specialists who completed their final certification exams. Of these, 1,371 or 32 per cent volunteered to participate in the survey. 

With files from CBC's Pauline Dakin and The Canadian Press