Our first FMEC PG recommendation (Ensure the right mix, di
stribution and number of physicians to meet societal needs) is the overarching reason for reforming PGME.
Our system needs to be socially accountable... we need to train physicians to address ongoing and emerging needs such as end-of-life care and seniors care, which are becoming increasingly important as the Canadian population ages. This expectation, combined with the reality that certain graduating residents are having difficulty finding employment (e.g. orthopedic surgeons, nephrologists, etc.) is a compelling argument for a flexible system that can respond to changing needs and that can create flexibility for the learner on entering training and while still in training.
Once we have a more accurate and comprehensive understanding of the national supply of physicians and can start to match this with the ongoing and emerging needs of the community, there will have to be some difficult discussions with our medical schools, looking at the numbers and types of physicians we are in fact training. Where there is a mismatch between the numbers and type being trained and the need, we will have to expect an adjustment in residency program allocation. This will lead to a discussion about our care model in many centres that is often built around a fixed resident compliment, and might have to be significantly altered.
These are huge issues but ones we need to address to create a truly respon
sive and socially accountable postgraduate medical education system.
r. Nick Busing led transformative change from 2005-2013 as President and CEO of the Association of Faculties of Medicine of Canada. Prior to joining AFMC, Dr. Busing spent 20 years at the University of Ottawa's Faculty of Medicine. He is a past president of the CFPC and a past chair of the Canadian Medical Forum.