Medical school graduates face growing problems obtaining required residency positions

May 26, 2018

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PAUL ATTFIELD

PUBLISHED 3 HOURS AGO

UPDATED MAY 25, 2018

Around 115 medical-school graduates across the country will be without residency positions this year – up from 99 in 2017 and 77 the year prior.

Around 115 medical-school graduates across the country will be without residency positions this year – up from 99 in 2017 and 77 the year prior.

 

More than many Canadian medical schools, the Rady Faculty of Health Sciences at the University of Manitoba seems to understand the current plight of the country’s medical students.

With around 115 medical-school graduates across the country without residency positions this year – up from 99 in 2017, and 77 the year prior – the school acknowledges the state of limbo that these students face.

Quite simply, without those two-to-seven years of required training in their fields following graduation from faculties of medicine, they are unable to practise.

“It’s not a degree that you can move into the work force without residency training, so it really does strand you,” says Dr. Brian Postl, dean of the Max Rady College of Medicine and the university’s Rady Faculty of Health Sciences.

Residency positions are allocated through a process known as matching, in which students rank their preferred specialties and residency locations and the medical schools do the same, with a system of algorithms determining a match. If students are passed over in the first round of selection, they can try again in the second round of matching. However, if they are unable to find a match at that point, they have to wait a year.

The number of unmatched students is increasing on a yearly basis; this year, there were 101 positions available for every 100 graduates, compared with a ratio of 110:100 in 2009. But many of those left over are francophone positions in Quebec, and/or in locations or specialties which students didn’t rank among their preferences.

To help address the problem, the University of Manitoba has devised something of a solution, offering positions for any of its unmatched students.

“We, for a very long time, have felt that there was an inherent crap-shoot effect to the match [process] that we were uncomfortable with ,” Dr. Postl says of the policy, which was approved by the faculty council six or seven years ago.

According to the Association of Faculties of Medicine of Canada (AFMC), which represents the country’s medical faculties, the University of Manitoba’s ability to find matches for unmatched graduates is unparalleled at other schools. “It is the ideal [solution] of course,” Marie-Hélène Urro, the communications co-ordinator at AFMC, said in an e-mail. Read more »

Local Health Advocates take Provincial Steps

May 17, 2018

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Andrea DeMeer
Spotlight Staff

May 17

Princeton is earning its spot on the health care map with local advocates taking a leadership role in the newly founded BC Rural Health Network.

Ed Staples, president of Support our Health Care, is directing the fledgling network, which already includes 10 other communities from Salt Spring Island to Trail and includes Nelson, Sicamous and Ashcroft.

“I guess the main reason is that rural British Columbians, for the most part, have been underserved by the health care system and that’s been a gradual erosion of services,” said Staples in an interview with The Spotlight.

“Rural communities have seen the services that are available to them centralized and regionalized and as a result that’s created all sorts of problems that people living in urban communities have no idea about.

Transportation, a chronic shortage of doctors, and longer wait periods for treatment are the common problems being experienced in small communities, said Staples.

“Those kinds of issues are things that we all share and what we are hoping to do is band together and provide rural BC a strong advocacy voice.”

While some of the solutions that rural communities would like to see implemented require provincial policy change, the network is also proving to be useful for sharing strategies that can be applied locally.

“Something that works well in one community might not have been thought of somewhere else,” said Staples.

Examples of Princeton models that are generating interest in other communities are the Love a Locum campaign, and the visiting specialist program, he added.

The network has been joined by the Rural Coordination Centre of BC, a physician driven organization that has already provided funding and resources for promotional materials and a website.

The BC Health Coalition also recently established a relationship with the Rural Health Network.

“So it’s growing quite quickly and it’s growing in a very important way.”

The network members have so far just met using teleconference, but will have their first face-to-face gathering at the end of the month.

Advocates demand end to extra-billing, upset over $15.9 million federal claw back

May 1, 2018

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BC Health Coalition present symbolic $15.9 million invoice to private clinics

May 1, 2018

For immediate release 

Vancouver and Kelowna, BC – Today, health care workers, seniors and other public health care supporters presented a symbolic $15.9 million invoice to False Creek Surgical Centre in Vancouver and the Okanagan Surgical Health Centre in Kelowna on behalf of the public. 

Both clinics are suspected to be two of the many BC private clinics unlawfully extra-billing patients. [1] [2]

Extra-billing is an unlawful practice where doctors or private clinics charge a patient for a health care service that should be provided at no cost because it is publicly insured as necessary care.

When extra-billing occurs in a province/territory, the federal government claws back an equivalent amount from the health transfer money sent to that province/territory. This is one of the enforcement measures the federal government uses to uphold the Canada Health Act. The BC government recently announced that the federal government clawed back $15.9 million in health funding from B.C. this year.

The $15.9 million was the estimated amount of extra-billing in BC this year, based on the audits of four clinics (3 audits completed for the year 2015-2016 and an earlier audit). [3] If BC does not stop the unlawful extra-billing, there may be more fines to come.

“We are here to send a clear message that unlawful extra-billing at the expense of patients in need, and the public purse, will no longer be tolerated in B.C.,” said Nat Lowe, BC Health Coalition organizer. “Our ask is that all private clinics in BC who are currently extra billing patients stop breaking the law at the expense of patients and public funds.”

“With the growth of private clinics and the lack of the enforcement of extra-billing in this province, BC has some of the longest diagnostic and surgical wait times in Canada. The government’s new strategy to complete thousands more surgeries and diagnostic tests in the public system is one step in the right direction,” said Rick Turner, BC Health Coalition co-chair.

“With the recent announcement to bring the full Medicare Protection Amendment Act into force and crack down on private clinics who extra bill, the current provincial government is taking responsibility to ensure private clinics are not unlawfully extra billing patients,” Edith MacHattie, BC Health Coalition co-chair. “This is great news for patients and our public health care system.”

Sources

[1] https://www.theglobeandmail.com/news/investigations/doctors-extra-billin…

[2] https://www.bchealthcoalition.ca/sites/default/files/uploads/documents/p…

[3] https://news.gov.bc.ca/releases/2018HLTH0027-000559

Legislation will prohibit payment for blood and plasma collection

April 26, 2018

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Health Minister Adrian Dix today introduced the Voluntary Blood Donations Act, which will help preserve the integrity of Canada’s public blood and plasma collection system by preventing payment for blood and plasma collection in British Columbia.

“Our voluntary blood donation system is an integral resource that helps saves lives thanks to people who graciously donate,” said Dix. “We are taking action to prevent payment for blood and plasma collection, and to make sure that the donations people give benefit people in our province and Canada.”

No paid plasma collection clinics are operating in British Columbia. This legislation is meant to prevent such operations from being established, by making it illegal to pay, offer to pay, or advertise that they will pay someone for blood or plasma. This is similar to legislation in Alberta, Ontario and Québec.

Currently in Canada, there are private for-profit organizations paying individuals for plasma, and then selling that plasma on the global market. By preventing these businesses from operating in B.C., this legislation will ensure that blood and plasma collected in B.C. stay as part of the national supply system run by Canadian Blood Services (CBS). As the national blood and plasma supplier, CBS is exempt from the legislation, as are the provincial government and medical researchers.

Blood

“This is an issue that is very important to me and people around B.C.,” said Judy Darcy, Minister of Mental Health and Addictions. “Our government stands with public health care, and that means keeping the blood supply system a public resource.” Read more »

Report on the Health Sciences Association Conference – April 2018

April 24, 2018

Edward Staples

Edward Staples, President of SOHC (Support Our Health Care) and BC Rural Health Network Lead.

Vancouver Hyatt Regency April 13, 2018 

Achieving High-Performing Primary and Community Care: the Critical Role of Health Science Professions 

The conference opened with a welcome from Val Avery, Health Sciences Association (HSA) President and a First Nations Welcome from Coast Salish Elder Roberta Price. 

The keynote speaker was the Honourable Judy Darcy, BC Minister of Mental Health and Addictions. She gave a brief overview of her first 9 months in office and made the following points: 

• collaboration and team building on the “front lines” is critically important to address the opioid crisis 

• addressing the crisis will require “all hands on deck” 

• the focus of the Ministry is on child and youth prevention, First Nations, and the high rate of death associated with substance use

  • most people who die from opioid overdose die alone 
  • 3 out of 4 are male between the age of 30 and 59
  • 1 in 10 are indigenous 

• problems with the current system:
• “no coordination of services”
• gaps in the service – fragmentation  lack of a team approach
• the goal is to develop an “ask once” system that will take you where you need to go  Read more »

A welcome second chance for BC Medicare protection

April 11, 2018
 FILE PHOTO - Seth Klein is B.C. director of the Canadian Centre for Policy Alternatives. PNG


FILE PHOTO – Seth Klein is B.C. director of the Canadian Centre for Policy Alternatives. PNG

This article points out a few aspects that are not often talked about.

For every dollar of extra billing by a private for profit clinic, the federal government claws back an equal amount from its cash transfers. In 2015-16, that amount was $15.9 million, enough for 53,000 MRIs.

So effectively, we all pay for the extra billing.

(Cash transfers are the payments that every province and Territory receives from the Federal government for health care.)

B.C. is the only province that Ottawa has repeatedly fined for unlawful extra billing.

I believe that there is a misconception that private companies will be forced to close; this is incorrect, they can continue to operate as long as they follow the law.

http://vancouversun.com/opinion/op-ed/colleen-fuller-and-seth-klein-a-welcome-second-chance-for-b-c-medicare-protection-amendment-act

Charter challenge issues strike at the heart of the principles of Medicare

April 10, 2018
Public unions hold a march in support of medicare - Brian McInnis

Public unions hold a march in support of medicare – Brian McInnis

BY PAULINE WORSFOLD

GUEST OPINION

(SPECIAL TO THE GUARDIAN)

A charter challenge case that could very well affect how health care is delivered in Canada resumes in British Columbia this week.

Dr. Brian Day, CEO of a for-profit surgery clinic, is challenging the ban on extra billing and the use of private insurance for publicly insured services under the Charter of Rights and Freedoms, alleging that these laws infringe on a person’s right to defend their body.

Make no mistake. This case is about profit. Profit for doctors, profit for private clinics and profit for insurance companies. 

First, it is no coincidence that Dr. Day began this case after his clinic was audited and found in contravention of the B.C. Medicare Protection Act. Instead of paying back the money he gained through illegal billing, he decided to put medicare on trial.

Second, Dr. Day points to wait lists as evidence patients need the right to seek private care. However, that right already exists. Doctors can opt out of the public system and patients are free to pay the price for private service. What does not exist is the right to charge patients more than the public fee while at the same time collecting the public fee from the province. Using private insurance to pay the extra fees is also not allowed by law. In other words, it is against the law to use the public purse to subsidize private profits. Read more »

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SOHC Discussion Paper

Developing an Improved and Sustainable Health Care Model for Princeton, B.C
Support Our Health Care has released a discussion paper in order to get feedback from the community, politicians and professionals about the state of local healthcare and what the long term solutions should be.
Download PDF Here